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Risk factors analysis and a nomogram model establishment for late postoperative seizures in patients with meningioma
Affiliation:1. Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, No. 190, Jiannan East Road, Mianyang 621000, China;2. Department of Neurosurgery, Clinical Medical College of Yangzhou University, No. 98 Nantong West Road, Yangzhou 225001, China;3. Graduate School of Da Lian Medical University, No. 9 West Section of Lushun South Road, Da Lian 116044, China;1. Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea;2. Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea;3. Department of Neurology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea;4. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Department of Radiation Oncology, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France;2. Institute of Radiation Oncology, Sapienza University, Sant''Andrea Hospital, Roma, Italy;3. Department of Radiation Oncology, University of Florida, Gainesville, FL, USA;4. Département of Neuropathology, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France;5. Department of Neurosurgery, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France;1. Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea;2. Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Abstract:BackgroundPostoperative seizures (Sz) following surgical resection of intracranial meningiomas negatively impacts the quality of life of patients. However, there is still unclear with respect to the risk factors of and long-term freedom to Sz in patients with meningiomas. This study aimed to identify independent predictors and develop a nomogram model of late postoperative Sz to optimize postoperative surveillance.MethodsWe retrospectively analyzed 318 meningioma patients who underwent surgical resection at the Subei People’s Hospital of Jiangsu province from January 2014 to December 2018. Then, clinical data were collected for further analysis and nomogram construction.ResultsIn our cohort, 62 patients (19.50%) experienced preoperative Sz, 12 patients (3.77%) experienced early postoperative Sz, and 56 patients (17.61%) experienced late preoperative Sz. Multivariate logistic regression analysis revealed that preoperative Sz, convexity location, tumor maximal size ≥3.5 cm, medical/surgical complications and tumor recurrence/progression were independent predictors of late postoperative Sz. A nomogram was developed by employing these five significant predictive factors. Statistical analysis showed that this model had a good discrimination performance. Among 32 patients who had more than one year follow up period form first late postoperative Sz, 17 (53.13%) patients experienced good Sz control. The probability of Sz freedom in the 2-year follow-up was roughly 75.2% among patients with preoperative Sz, and 84.8% among patients without preoperative Sz.ConclusionsThis nomogram model will be useful to assist clinicians to assess late postoperative Sz occurrence, identify high-risk patients early and schedule AEDs treatment, but further external validations are needed.
Keywords:Meningioma  Seizure  Risk factors  Nomogram  Surgery
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