Factors associated with seizure freedom in the surgical resection of glioneuronal tumors

摘要: Summary Purpose:  Gangliogliomas (GGs) and dysembryoplastic neuroepithelial tumors (DNETs) are low-grade brain of glioneuronal origin that commonly present with seizures. Achieving seizure control in patients remains underappreciated, as tumor-related epilepsy significantly affects patients’ quality-of-life. Methods:  We performed a quantitative comprehensive systematic literature review outcomes after surgical resection GGs DNETs associated evaluated 910 from 39 studies, stratified according to several potential prognostic variables. Key Findings:  Overall, 80% were seizure-free surgery (Engel class I), whereas 20% continued have seizures II–IV). observed higher rates seizure-freedom ≤1 year duration compared those >1 [odds ratio (OR) 9.48; 95% confidence interval (CI) 2.26–39.66], gross-total over subtotal lesionectomy (OR 5.34; CI 3.61–7.89). In addition, the presence secondarily generalized preoperatively predicted lower rate 0.40; 0.24–0.66). Outcomes did not differ between adults children, temporal lobe versus extratemporal tumors, pathologic diagnosis GG DNET, medically controlled refractory seizures, or use electrocorticography (ECoG). Extended hippocampectomy and/or corticectomy, conferred additional benefit. Significance:  These results suggest early operative intervention critically important factors achieving seizure-freedom, thus improving quality-of-life, causing epilepsy.