■神经胶质肿瘤通常与药物难治性癫痫有关。然而,关于癫痫手术后的长期结局和结局的主要预后因素的综合知识仍然有限.我们试图评估在单中心环境下接受神经胶质肿瘤手术的大型患者队列的长期结局和潜在影响因素。
■该研究分析了在2001年至2020年期间在癫痫学系因神经胶质肿瘤而接受癫痫手术的107例患者的结果,波恩大学医院,在德国。使用Engel分类法评估结果。使用Chi2检验检查与潜在预后因素相关的结果差异,费希尔精确检验和符号检验。此外,采用逐步logistic回归分析确定独立的预后因素.
■75%的手术患者在12个月时实现了完全的癫痫发作自由(EngelClassIA),和56%在最后一次随访(70.4±6.2个月,中位数:40个月)。切除的完整性是12个月随访结果和最长可用结果的关键因素。而叶部肿瘤定位,组织学(神经节胶质瘤与胚胎发育不良性神经上皮肿瘤),手术前双侧强直阵挛性癫痫发作史,侵入性诊断,手术侧(优势vs.非优势半球),癫痫发作的年龄,手术年龄,癫痫持续时间并不一致地影响术后结局.在颞叶手术中,接受病变切除术和病变切除术的患者,包括海马切除术,表现出类似的结果。
■神经胶质肿瘤作为治疗结构性癫痫的优良手术基质。为了获得最佳的术后结果,应尽可能进行完整的病变切除。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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 vs. dysembryoplastic neuroepithelial tumor), history of bilateral tonic-clonic seizures prior to surgery, invasive diagnostics, side of surgery (dominant vs. 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.
UNASSIGNED: 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.