The analysis of risk factors and survival outcome for Chinese high-grade glioma patients with epilepsy.

OBJECTIVE: To evaluate the risk factors of tumor related epilepsy (TRE) and the relationship between TRE and functional/survival outcomes in high-grade glioma (HGG) patients.

METHOD: The clinical data of 587 patients with HGG were retrospectively analyzed. Chi-square test and logistic multiple regression analysis were used to analyze factors associated with TRE. Logistic and Cox regression were used to analyze factors that may influence functional and survival outcomes.

RESULT: Glioma location in temporal (odds ratio (OR) 0.439, P = 0.04) and parietal lobes (OR 0.092, P = 0.02) were independent protective factors of preoperative epilepsy, compared to gliomas of frontal lobe. Preoperative epilepsy (OR 9.290，P < 0.001) and dominant hemispheric location (OR 2.616, P = 0.04) were independent risk factors of postoperative epilepsy. On univariate analysis, patients with preoperative epilepsy had longer progression-free survival (PFS) (P = 0.001) and overall survival (OS) (P < 0.001). On multivariate analysis, further confirmed that preoperative epilepsy was an independent protective factor of OS (HR 0.587, P = 0.008).

CONCLUSION: In HGG patients, preoperative epilepsy is significantly associated with tumor involvement of the frontal lobe, while postoperative epilepsy is associated with preoperative epilepsy and dominant hemispheric location. Also, HGG patients with preoperative epilepsy have better PFS and OS.