Kuang Suhui, Zhang Shaohui, Cui Zhiqiang, Ge Ming, Yuan Liu, Wang Jiaqi, Wei Zhirong, Xu Jinshan, Zhai Feng, Liang Shuli
Functional Neurosurgery Department, National Children's Health Center of China, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Neurosurgery Department, Fourth Medical Center, PLA General Hospital, Beijing, China.
Ther Adv Neurol Disord. 2024 Mar 22;17:17562864241237851. doi: 10.1177/17562864241237851. eCollection 2024.
Low-grade epilepsy-associated brain tumors (LEATs) are found to be the second most common lesion-related epilepsy. Malignant potential of LEATs is very low and the overall survival is good, so the focus of treatment is focused more on seizure outcome rather than oncological prognosis.
This study was conducted to evaluate the risk factors of seizure outcomes after resection in patients with LEATs.
A retrospective study.
A retrospective analysis of patients with LEATs who underwent resective surgery in our three epilepsy centers between October 2010 and April 2023 with a minimum follow-up of 1 year. Demography, clinical characters, neurophysiology, and molecular neuropathology were assessed for association with postoperative seizure outcomes at 1-, 2-, and 5-year follow-up. Synthetic minority oversampling technique (SMOTE) algorithm model was performed to handle the imbalance of data distribution. Gaussian Naïve Bayes (GNB) algorithms were created as a basis for classifying outcomes according to observation indicators.
A total of 111 patients were enrolled in the cohort. The most common pathology was ganglioglioma ( = 37, 33.3%). The percentage of patients with seizure freedom was 91.0% (101/111) at 1-year follow-up, 87.5% (77/88) at 2-year follow-up, and 79.1% (53/67) at 5-year follow-up. Partial resection had a significantly poor seizure outcome compared to total resection and supratotal resection ( < 0.05). The epileptiform discharge on post-resective intraoperative electrocorticography (ECoG) or postoperative scalp electroencephalography (EEG) were negative factors on postoperative seizure freedom at 1-, 2-, or 5-year follow-ups ( < 0.05). The area under the receiver-operating characteristic curve value of the GNB-SMOTE model was 0.95 (95% CI, 0.876-1.000), 0.892 (95% CI, 0.656-0.934), and 0.786 (95% CI, 0.491-0.937) at 1-, 2-, and 5-year follow-up, respectively.
The partial resection, post-resective intraoperative ECoG, and postoperative scalp EEG were valuable indicators of poor seizure outcomes. The utilization of post-resective intraoperative ECoG is beneficial to improve seizure outcomes. Based on the data diversity and completeness of three medical centers, a multivariate correlation analysis model was established based on GNB algorithm.
低度癫痫相关脑肿瘤（LEATs）是第二常见的病变相关性癫痫。LEATs的恶性潜能非常低，总体生存率良好，因此治疗重点更多地放在癫痫发作结果而非肿瘤预后上。
本研究旨在评估LEATs患者切除术后癫痫发作结果的危险因素。
一项回顾性研究。
对2010年10月至2023年4月期间在我们三个癫痫中心接受切除手术且随访至少1年的LEATs患者进行回顾性分析。评估人口统计学、临床特征、神经生理学和分子神经病理学与术后1年、2年和5年随访时癫痫发作结果的相关性。采用合成少数过采样技术（SMOTE）算法模型处理数据分布不平衡问题。创建高斯朴素贝叶斯（GNB）算法作为根据观察指标对结果进行分类的基础。
该队列共纳入111例患者。最常见的病理类型是神经节细胞胶质瘤（n = 37，33.3%）。1年随访时癫痫发作缓解患者的比例为91.0%（101/111），2年随访时为87.5%（77/88），5年随访时为79.1%（53/67）。与全切和次全切相比，部分切除的癫痫发作结果明显较差（P < 0.05）。切除术后术中皮质脑电图（ECoG）或术后头皮脑电图（EEG）上的癫痫样放电是术后1年、2年或5年随访时癫痫发作缓解的负性因素（P < 0.05）。GNB - SMOTE模型在1年、2年和5年随访时的受试者操作特征曲线下面积值分别为0.95（95%CI，0.876 - 1.000）、0.892（95%CI，0.656 - 0.934）和0.786（95%CI，0.491 - 0.937）。
部分切除、切除术后术中ECoG和术后头皮EEG是癫痫发作结果不佳的有价值指标。切除术后术中ECoG的应用有利于改善癫痫发作结果。基于三个医学中心的数据多样性和完整性，建立了基于GNB算法的多变量相关性分析模型。
