Glioma-related epilepsy in patients with newly diagnosed and recurrent glioblastoma, IDH-wildtype: a study under the 2021 WHO CNS tumor classification

TL;DR

This study examines how glioma-related epilepsy affects survival and seizure control in patients with a specific type of brain cancer called IDH-wildtype glioblastoma.

Contribution

The study identifies preoperative glioma-related epilepsy as a prognostic factor and risk indicator for poor seizure control in newly diagnosed IDH-wildtype glioblastoma patients.

Findings

Preoperative glioma-related epilepsy occurs in about 20% of glioblastoma patients.

Younger age is significantly associated with preoperative glioma-related epilepsy in newly diagnosed cases.

Preoperative glioma-related epilepsy is linked to better survival outcomes and increased risk of inadequate postoperative seizure control.

Abstract

The 2021 classification of central nervous system tumors significantly alters the defined category of glioblastoma (GBM). This study aims to evaluate the clinical relevance of glioma-related epilepsy (GRE) in patients with the newly classified GBM, IDH-wildtype.

A single-center retrospective cohort study was performed. The correlation of GRE with clinicopathological features was explored via appropriate inter-group statistical methods. Kaplan-Meier analysis was employed to assess the prognostic value of preoperative GRE with respect to overall survival (OS) and progression-free survival (PFS). Multivariate binary logistic regression analysis was carried out to identify potential risk factors associated with inadequate seizure control.

The final cohort included 294 patients. Preoperative GRE was observed in 22.4% of newly diagnosed and 19.7% of recurrent GBM cases. In patients with newly diagnosed GBM, GRE was significantly associated with younger age (p < 0.001). Moreover, survival analysis confirmed the prognostic significance of preoperative GRE for improved OS and PFS (p = 0.012 and 0.004, respectively) in the same population. Moreover, in newly diagnosed GBM cases, preoperative GRE was identified as the independent risk factor for inadequate postoperative seizure control (OR 4.009, 95% CI 1.447–11.106, p = 0.008).

The current study comprehensively describes the clinical correlations of GRE in GBM, IDH-wildtype. The incidence of preoperative GRE in GBM patients is approximately 20%. Among patients with newly diagnosed GBM, IDH-wildtype, preoperative GRE is more likely to occur in younger individuals and is associated with prolonged survival outcomes. Furthermore, a history of preoperative GRE may increase the risk of inadequate postoperative seizure control in this population.

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