gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Article

Send article

Tumour-associated epilepsy in patients with brain metastases – necrosis-to-tumour ratio forecasts postoperative seizure freedom

Tumor-assoziierte Anfallsereignisse bei Patienten mit kranialen Metastasen – die Nekrose-Tumor Ratio als prognostisches Tool der postoperativen Anfallsfreiheit

Meeting Abstract

Search Medline for

  • presenting/speaker Majd Bahna - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Matthias Schneider - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Muriel Heimann - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Rainer Surges - Universitätsklinikum Bonn, Klinik für Epileptologie, Bonn, Deutschland
  • Niklas Schäfer - Universitätsklinikum Bonn, Klinik für Neurologie, Abteilung für klinische Neuroonkologie, Bonn, Deutschland
  • Ulrich Herrlinger - Universitätsklinikum Bonn, Klinik für Neurologie, Abteilung für klinische Neuroonkologie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV293

doi: 10.3205/21dgnc278, urn:nbn:de:0183-21dgnc2780

Published: June 4, 2021

© 2021 Bahna et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Tumor-related epilepsy (TRE) has an excellent outcome in patients with brain metastases (BM) after surgical treatment. Nevertheless, persistent epilepsy has a significant negative impact on the health-related quality of life. Therefore, early identification of potential patients with unfavorable seizure outcome after BM resection seems of utmost importance.

Methods: In a retrospective cohort study, patients with surgically treated BM and TRE were examined at the authors' institution with regard to preoperatively identifiable risk factors for unfavorable seizure outcome. According to the classification of the International League Against Epilepsy (ILAE), seizure outcome was categorized as favorable (ILAE 1) and unfavorable (ILAE 2 - 6) after 3 months in order to avoid potential interference with adjuvant cancer treatment.

Results: Among all 38 patients undergoing neurosurgical treatment for BM with concomitant TRE, 34 patients achieved a favorable seizure outcome (90%). Unfavorable seizure outcome was significantly associated with tumor volume (p=0.012), a midline shift > 7 mm (p=0.025), and a necrosis/tumor volume ratio > 0.2 (p=0.047).

Conclusion: Neurosurgical treatment of brain metastases might yield favorable seizure outcomes in the majority of patients suffering from tumor-associated epilepsy. The present study identifies preoperatively identifiable risk factors for unfavorable seizure outcome in patients with BM and TRE. Subsequently, patients with persistent postoperative epilepsy might benefit from additional neuro-oncological expertise accompanying their further systemic therapy.