Prognostic Factors in Glioblastoma: Is There a Role for Epilepsy?

Dobran, Mauro; Nasi, Davide; Chiriatti, Stefano; Gladi, Maurizio; Somma, Lucia di; Scerrati, Massimo

doi:10.2176/nmc.oa.2017-0167

Cited by 30 publications

(21 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SP was significantly associated with increased OS independent of age, sex, tumor location, and size in the systematic review of Phan 2018 19 . However, we and others found that OS was not dependent on clinical seizure presentation 10,29,30 despite smaller tumor size in the SP group. We did find that Grade III SP patients had significantly greater OS.…”

Section: Overall Survivalcontrasting

confidence: 60%

“…Tumor location matters in SP, but the methods used to ascertain tumor location strongly vary across groups making comparisons and conclusions difficult. Many 22,25,28,29 studies reported highest incidences for frontal lobe tumors are associated with SP in both univariate and multivariate analyses. While Lee found temporal lobe tumors in LGG were twice as likely for SP but not true in HGG 24 .…”

Section: Tumor Location Lobes and Lateralitymentioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Predictors of Seizure in Contrast-Enhancing Gliomas at Clinical Presentation: A Network Approach

Johnston

Khurana

Whitmire

et al. 2019

Preprint

View full text Add to dashboard Cite

BackgroundBrain tumor related epilepsy (BTE) is a major co-morbidity related to the management of patients with brain cancer. Despite published practice guidelines recommending against anti-epileptic drug (AED) utilization in patients with gliomas, there is heterogeneity in prescription practices of AEDs in these patients. In an attempt to impact BTE management, we statistically analyzed clinically relevant attributes (sex, age, tumor size, tumor growth kinetics, and tumor location) pertaining to seizure at presentation and used them to build a computational machine learning model to predict the probability of a seizure (at presentation). Methods From our clinical data repository, we identified 223 patients (females, n=86; males, n=137) with pathologicallydetermined glioma and known seizure status at clinical presentation. Non-parametric and Fisher's Exact tests were used to identify statistical differences in clinical characteristics. We utilized a random forest machine learning method for generating our predictive models by entire cohort and separated by male and female. Findings Patients were divided into those that presented with seizure (SP, n=96, 43%; F, n= 28; M, n= 68) and those that presented without seizure (nSP, n=127, 57%, F n=58, M n=69). Females presented with seizures significantly less often than males (x 2 =6·28, p=0·01). SP patients had significantly smaller T1Gd radius compared to nSP (SP 11·30mm, nSP 18.66mm, p<0·0001). Tumor size and patient age were significant negative predictors for SP; patients with larger tumors, older age and less tumor diffusivity (p/D) were at lower risk for SP. Interpretation Despite heterogeneity across our patient cohort, there is strong evidence of a role for patient sex, tumor size, tumor invasion, and patient age in predicting the incidence of seizures at diagnosis. Future studies, with prospectively detailed data collection, may provide clearer insights into the incidence of seizures through a patient's treatment course.

show abstract

Section: Overall Survivalcontrasting

confidence: 60%

Section: Tumor Location Lobes and Lateralitymentioning

confidence: 99%

Sex Differences in Predictors of Seizure in Contrast-Enhancing Gliomas at Clinical Presentation: A Network Approach

Johnston

Khurana

Whitmire

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Seizures can occur either at initial diagnosis or result from recurrence of the disease. Although they reduce the patient quality of life, seizures as a symptom are positively correlated to longer survival in glioblastoma patients [60][61][62]. However, in cases where there is a longer delay between epileptic seizures as a symptom and surgical resection of tumor, this correlation does not seem to be significant [62,63].…”

Section: Long-term Glioblastoma Survivorsmentioning

confidence: 99%

Genetic secrets of long-term glioblastoma survivors

Jovčevska

2018

Bosn J of Basic Med Sci

View full text Add to dashboard Cite

Glioblastomas account for the majority of primary brain tumors. Although glioblastomas are considered as rare diseases, they represent 60%-70% of all gliomas and in most cases have fatal consequences. Genetic analyses show great heterogeneity both intratumor and intertumor. This notion opens up debates about glioblastoma origin. Different brain cells including astrocytes, neural stem cells, oligodendrocyte precursor cells and glioblastoma stem cells are proposed as capable of initiation and reseeding a tumor; however data is still inconclusive. Due to high mortality rate, long term glioblastoma survivors are defined as patients who live longer than 2 years post diagnosis. Extreme survivors, living 10 years or more after diagnosis, comprise less than 1% of all patients. Molecular testing suggests differences in the genetic profiles of glioblastoma between short and long term survivors. The most informative indicators are IDH mutations and MGMT promotor methylation. Other genes like FBLN4, EMP3, IGFBP-2, IGFBP-3, LGALS3, MAOB, PDPN, SERPING1 and TIMP1 have also been associated with glioblastoma prolonged survival. Emerging evidence proposes roles of different microRNAs in predicting patient survival. Moreover, clinical features like seizures as a symptom at presentation, age at diagnosis, and the extent of the surgical resection are also factors that influence the length of survival. Because of the small number of long term survivors, it is difficult to examine these samples and draw conclusions about the genetics of glioblastoma longevity. To aid in the clinical care, a thorough "omics" approach is necessary for identifying differences between short and long term glioblastoma survivors.

show abstract

“…Several previous reports have addressed the association between SAO occurrence and glioblastoma survival, both with positive 2 , 4–8 and negative 9–17 results. The majority of recent studies has specifically focused on the role of antiepileptic drugs (AED) on the survival effect of SAO.…”

mentioning

confidence: 99%

Preoperative and early postoperative seizures in patients with glioblastoma—two sides of the same coin?

Ahmadipour

Rauschenbach

Santos

et al. 2020

Neuro-Oncology Advances

View full text Add to dashboard Cite

Background Symptomatic epilepsy is a common symptom of glioblastoma, which may occur in different stages of disease. There are discrepant reports on association between early seizures and glioblastoma survival, even less is known about the background of these seizures. We aimed at analyzing the risk factors and clinical impact of perioperative seizures in glioblastoma. Methods All consecutive cases with de-novo glioblastoma treated at our institution between 01/2006 and 12/2018 were eligible for this study. Perioperative seizures were stratified into seizures at onset (SAO) and early postoperative seizures (EPS, ≤21days after surgery). Associations between patients characteristics and overall survival (OS) with SAO and EPS were addressed. Results In the final cohort (n=867), SAO and EPS occurred in 236 (27.2%) and 67 (7.7%) patients respectively. SAO were independently predicted by younger age (p=0.009), higher Karnofsky Performance Scale score (p=0.002), tumor location (parietal lobe, p=0.001), GFAP expression (≥35%, p=0.045) and serum chloride at admission (>102 mmol/l, p=0.004). In turn, EPS were independently associated with tumor location (frontal or temporal lobe, p=0.013) and pathologic laboratory values at admission (hemoglobin<12 g/dL, [p=0.044], CRP>1.0 mg/dL [p=0.036] and GGT>55 U/l [p=0.025]). Finally, SAO were associated with gross-total resection (p=0.006) and longer OS (p=0.030), whereas EPS were related to incomplete resection (p=0.005) and poorer OS (p=0.009). Conclusions In glioblastoma patients, SAO and EPS seem to have quite different triggers and contrary impact on treatment success and OS. The clinical characteristics of SAO and EPS patients might contribute the observed survival differences.

show abstract

Prognostic Factors in Glioblastoma: Is There a Role for Epilepsy?

Cited by 30 publications

References 12 publications

Sex Differences in Predictors of Seizure in Contrast-Enhancing Gliomas at Clinical Presentation: A Network Approach

Sex Differences in Predictors of Seizure in Contrast-Enhancing Gliomas at Clinical Presentation: A Network Approach

Genetic secrets of long-term glioblastoma survivors

Preoperative and early postoperative seizures in patients with glioblastoma—two sides of the same coin?

Contact Info

Product

Resources

About