Long-term antiseizure medication use in patients after meningioma resection: identifying predictors for successful weaning and failures.
J Neurooncol
; 165(1): 201-207, 2023 Oct.
Article
em En
| MEDLINE
| ID: mdl-37874438
ABSTRACT
OBJECTIVE:
To define risk factors for meningioma-related seizures and predictors of successful weaning of antiseizure medications following meningioma resection.METHODS:
This is a retrospective study of 95 patients who underwent meningioma resection at a single institution. Primary outcome analyzed was ability to achieve seizure freedom without the use of anti-seizure medication at 6-months, 1-year, and last known follow up. Secondary outcome was postoperative seizure freedom.RESULTS:
Preoperative seizures (OR 11.63, 95% CI [3.64, 37.17], p < 0.0001), non-skull base tumor location (OR 3.01, 95% CI [1.29, 7.02], p = 0.0128), and modified STAMPE score of 3-5 (OR 5.42, 95% CI [2.18, 13.52], p = 0.0003) were associated with greater likelihood of remaining on antiseizure medication at 6-month follow up. Preoperative seizures (OR 4.93, 95% CI [2.00, 12.16 ], p = 0.0008), intratumoral calcifications (OR 4.19, 95% CI [1.61, 14.46], p = 0.0055), modified STAMPE score of 3-5 (OR 5.42, CI [2.18, 13.52], p = 0.0003), and Ki67 greater than 7% (OR 5.68, CI [1.61, 20.10], p = 0.0060) were significant risk factors for inability to discontinue ASMs by last follow up. Preoperative seizures (OR 4.33, 95% CI [1.59, 11.85], p = 0.0050) and modified STAMPE score of 3-5 (OR 6.09, 95% CI [2.16, 17.20], p = 0.0007) were significant risk factors for postoperative seizures.CONCLUSIONS:
Preoperative seizures, modified STAMPE2 score of 3-5, non-skull base tumor location, intratumoral calcifications, and Ki67 > 7% were significant risk factors for inability to achieve seizure freedom without ASMs. In addition, the modified STAMPE2 score successfully predicted increased seizure risk following meningioma resection for patients with a score of 3 or higher.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Meníngeas
/
Meningioma
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article