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Seizure characteristics and outcomes in 508 Chinese adult patients undergoing primary resection of low-grade gliomas: a clinicopathological study

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]Univ Minnesota, Sch Med, Dept Neurol, Minneapolis, MN 55455 USA; [3]Capital Med Univ, Beijing Tiantan Hosp, Dept Neuroradiol, Beijing, Peoples R China; [4]Beijing Fengtai Hosp, Dept Neurosurg, Beijing, Peoples R China; [5]Beijing Elect Hosp, Dept Neurosurg, Beijing, Peoples R China; [6]Beijing Neurosurg Inst, Dept Neuropathol, Beijing, Peoples R China; [7]Tianjin Med Univ, Gen Hosp, Lab Neurooncol, Dept Neurosurg,Tianjin Neurol Inst, Tianjin, Peoples R China
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关键词: calcification extent of resection Ki67 low-grade glioma seizure

摘要:
Seizure is a common presenting manifestation and plays an important role in the clinical presentation and quality of life for patients with low-grade gliomas (LGGs). The authors set out to identify factors that influence preoperative seizure characteristics and postoperative seizure control. Cases involving adult patients who had undergone initial surgery for LGGs in a single institution between 2005 and 2009 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to identify factors associated with preoperative seizures and postoperative seizure control. Of the 508 patients in the series, 350 (68.9%) presented with seizures. Age less than 38 years and cortical involvement of tumor were more likely to be associated with seizures (P = .003 and .001, respectively, multivariate logistic analysis). For the cohort of 350 patients with seizures, Engel classification was used to evaluate 6- and 12-month outcome after surgery: completely seizure free (Engel class I), 65.3% and 62.5%; not seizure free (Engel classes II, III, IV), 34.7% and 37.5%. After multivariate logistic analysis, favorable seizure prognosis was more common in patients with secondary generalized seizure (P = .006) and with calcification on MRI (. 031). With respect to treatment-related variables, patients achieved much better seizure control after gross total resection than after subtotal resection (P < .0001). Ki67 was an independent molecular marker predicting poor seizure control in the patients with a history of seizure if overexpressed but was not a predictor for those without preoperative seizures. These factors may provide insight into developing effective treatment strategies aimed at prolonging patients' survival.

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出版当年[2011]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 肿瘤学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 肿瘤学
JCR分区:
出版当年[2010]版:
Q1 CLINICAL NEUROLOGY Q1 ONCOLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2010版] 出版当年五年平均 出版前一年[2009版] 出版后一年[2011版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China;
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