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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Epilepsy
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1384494

Long-term seizure outcome after epilepsy surgery of neuroglial tumors

Provisionally accepted
Attila Racz Attila Racz 1*Philipp Müller Philipp Müller 2Albert Becker Albert Becker 2Nico Hoffmann Nico Hoffmann 2Theodor Rüber Theodor Rüber 1,3Valeri Borger Valeri Borger 4Hartmut Vatter Hartmut Vatter 4Rainer Surges Rainer Surges 1Christian E. Elger Christian E. Elger 1
  • 1 Department of Epileptology, University Hospital Bonn, Bonn, Germany
  • 2 Institute for Neuropathology, University of Bonn, Bonn, North Rhine-Westphalia, Germany
  • 3 Department of Neuroradiology, University Hospital Bonn, Bonn, North Rhine-Westphalia, Germany
  • 4 Department of Neurosurgery, University Hospital Bonn, Bonn, North Rhine-Westphalia, Germany

The final, formatted version of the article will be published soon.

    Purpose: Neuroglial tumors are frequently associated with pharmacorefractory epilepsies. However, comprehensive knowledge about long-term outcomes after epilepsy surgery and the main prognostic factors for outcome is still limited. We sought to evaluate long-term outcomes and potential influencing factors in a large cohort of patients who underwent surgery for neuroglial tumors in a single-center setting. Methods: The study analyzed the outcomes of 107 patients who underwent epilepsy surgery for neuroglial tumors between 2001 and 2020 at the Department of Epileptology, University Hospital Bonn, in Germany. The outcomes were evaluated using Engel classification. Differences in outcome related to potential prognostic factors were examined using the Chi2-test, Fisher's exact test and sign-test. Additionally, stepwise logistic regression analysis was employed to identify independent prognostic factors. Results: Complete seizure freedom (Engel Class IA) was achieved in 75% of the operated patients at 12 months, and 56% at the last follow-up visit (70.4 ± 6.2 months, median: 40 months). Completeness of resection was a crucial factor for both 12-month follow-up outcomes and the longest available outcomes, whereas lobar tumor localization, histology (ganglioglioma versus dysembryoplastic neuroepithelial tumor), history of bilateral tonic-clonic seizures prior to surgery, invasive diagnostics, side of surgery (dominant versus non-dominant hemisphere), age at epilepsy onset, age at surgery, and epilepsy duration did not consistently impact postsurgical outcomes. Among temporal lobe surgeries, patients who underwent lesionectomy and lesionectomy, including hippocampal resection, demonstrated similar outcomes. Conclusions: Neuroglial tumors present as excellent surgical substrates in treating structural epilepsy. To achieve an optimal postsurgical outcome, a complete lesion resection should be pursued whenever possible.

    Keywords: neuroglial tumor, Ganglioglioma, Dysembryoplastic neuroepithelial tumor, DNET, epilepsy surgery, Outcome, Hippocampal Sclerosis (HS)

    Received: 09 Feb 2024; Accepted: 29 Apr 2024.

    Copyright: © 2024 Racz, Müller, Becker, Hoffmann, Rüber, Borger, Vatter, Surges and Elger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Attila Racz, Department of Epileptology, University Hospital Bonn, Bonn, Germany

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