Correlation of preoperative seizures with clinicopathological factors and prognosis in anaplastic gliomas: A report of 198 patients from China

PURPOSE Seizures are a common manifestation of many diseases and play an important role in the clinical presentation and quality of life (QOL) in patients with gliomas. The purpose of the present study was to investigate the possible correlation between tumor-related seizures and clinicopathological factors that influence preoperative seizure characteristics and relevant survival outcomes. METHODS We retrospectively investigated the correlation of preoperative seizures with clinicopathological factors and prognosis in a cohort of 198 Chinese patients with anaplastic gliomas. Univariate and multivariate logistic regression analyses were used to identify factors associated with preoperative seizures. Survival function curves were calculated using the Kaplan-Meier method. RESULTS Of the 198 patients, 68 (34.3%) patients had preoperative seizures. Among the patients with seizures, 26 (38.2%) had generalized seizures, 38 (55.9%) had simple partial seizures, and four (5.9%) complex seizures. There was a higher proportion of epidermal growth factor receptor (EGFR) amplification, frontal lobe involvement, left cerebral hemisphere involvement, and lower Ki-67 expression in patients with preoperative seizures in both univariate and multivariate analyses. Patients with preoperative seizures had a longer overall survival (OS) time compared with those without (median: 1924 days vs. 923 days, P=0.048). CONCLUSION The current study updates existing information on tumor-related seizures and clinicopathological factors in anaplastic gliomas, and suggests two putative biomarkers for preoperative seizures; Ki-67 expression and EGFR amplification. These factors may provide insights for developing effective treatment strategies aimed at prolonging patient survival.