Abstract PURPOSE: Seizures are a common clinical symptom in high-grade gliomas (HGG). The aim of the study was to investigate the relationship between seizures and HGG relapse (HGG-R). METHODS: We retrospectively evaluated 145 patients who were surgically treated for HGG-R. By analyzing clinical characteristics in these patients (all operated and treated by the same protocol), we identified 37 patients with seizures during follow-up. This cohort was divided into four subgroups according to a) presence or absence of seizures at the time of diagnosis and b) temporal relationship between seizure occurrence and HGG-R during follow-up: subgroup A (25pts) had seizures at follow-up but not at onset, subgroup B (12pts) had seizures both at follow-up and onset, subgroup C (30pts) had seizures before MRI-documented HGG-R, and subgroup D (7pts) had seizures after MRI-documented HGG-R. RESULTS: Although the datum was not statistically significant, survival was longer in patients with seizures during follow-up than in those without seizures (59.3% vs 51.4% alive at 2 years). In 30 patients (subgroup C) seizures heralded HGG-R. In a correlation analysis for this last subgroup, the time interval between seizure and the HGG-R was significantly associated with the number of chemotherapy cycles (r=0.470; p=0.009) and follow-up duration (r=0.566; p=0.001). A linear regression model demonstrated a reciprocal association between the above factors and that it may be possible to estimate the timing of HGG-R by combining these data. CONCLUSIONS: Seizures may herald HGG-R before MRI detection of relapse, thus suggesting that seizures should always be considered a red flag during follow-up.

Epileptic seizures heralding a relapse in high grade gliomas / Di Bonaventura, Carlo; Albini, Mariarita; D'Elia, Alessandro; Fattouch, Jinane; Fanella, Martina; Morano, Alessandra; Lucignani, Giulia; Manfredi, Mario; Colonnese, Claudio; Salvati, Maurizio; Vanacore, Nicola; Berardelli, Alfredo; Giallonardo, Anna Teresa. - In: SEIZURE. - ISSN 1059-1311. - 51:(2017), pp. 157-162. [10.1016/j.seizure.2017.08.009]

Epileptic seizures heralding a relapse in high grade gliomas

Di Bonaventura, Carlo;Albini, Mariarita;D'Elia, Alessandro;Fattouch, Jinane;Fanella, Martina;Morano, Alessandra;Lucignani, Giulia;Manfredi, Mario;Colonnese, Claudio;Vanacore, Nicola;Berardelli, Alfredo;Giallonardo, Anna Teresa
2017

Abstract

Abstract PURPOSE: Seizures are a common clinical symptom in high-grade gliomas (HGG). The aim of the study was to investigate the relationship between seizures and HGG relapse (HGG-R). METHODS: We retrospectively evaluated 145 patients who were surgically treated for HGG-R. By analyzing clinical characteristics in these patients (all operated and treated by the same protocol), we identified 37 patients with seizures during follow-up. This cohort was divided into four subgroups according to a) presence or absence of seizures at the time of diagnosis and b) temporal relationship between seizure occurrence and HGG-R during follow-up: subgroup A (25pts) had seizures at follow-up but not at onset, subgroup B (12pts) had seizures both at follow-up and onset, subgroup C (30pts) had seizures before MRI-documented HGG-R, and subgroup D (7pts) had seizures after MRI-documented HGG-R. RESULTS: Although the datum was not statistically significant, survival was longer in patients with seizures during follow-up than in those without seizures (59.3% vs 51.4% alive at 2 years). In 30 patients (subgroup C) seizures heralded HGG-R. In a correlation analysis for this last subgroup, the time interval between seizure and the HGG-R was significantly associated with the number of chemotherapy cycles (r=0.470; p=0.009) and follow-up duration (r=0.566; p=0.001). A linear regression model demonstrated a reciprocal association between the above factors and that it may be possible to estimate the timing of HGG-R by combining these data. CONCLUSIONS: Seizures may herald HGG-R before MRI detection of relapse, thus suggesting that seizures should always be considered a red flag during follow-up.
2017
epilepsy; high grade glioma; relapse; seizures
01 Pubblicazione su rivista::01a Articolo in rivista
Epileptic seizures heralding a relapse in high grade gliomas / Di Bonaventura, Carlo; Albini, Mariarita; D'Elia, Alessandro; Fattouch, Jinane; Fanella, Martina; Morano, Alessandra; Lucignani, Giulia; Manfredi, Mario; Colonnese, Claudio; Salvati, Maurizio; Vanacore, Nicola; Berardelli, Alfredo; Giallonardo, Anna Teresa. - In: SEIZURE. - ISSN 1059-1311. - 51:(2017), pp. 157-162. [10.1016/j.seizure.2017.08.009]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1073059
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