Prediagnosis epilepsy and survival in patients with glioma: a nationwide population-based cohort study from 2009 to 2018.

Autor: Marku M; Department of Neurology, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark. mirketa.marku@regionh.dk.; Psychological Aspects of Cancer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark. mirketa.marku@regionh.dk.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. mirketa.marku@regionh.dk., Rasmussen BK; Department of Neurology, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark., Belmonte F; Statistics and Data Analysis Unit, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Hansen S; Department of Oncology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Andersen EAW; Statistics and Data Analysis Unit, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Johansen C; Psychological Aspects of Cancer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.; Cancer Survivorship and Treatment Late Effects (CASTLE), 9601, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Bidstrup PE; Psychological Aspects of Cancer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2022 Feb; Vol. 269 (2), pp. 861-872. Date of Electronic Publication: 2021 Jun 24.
DOI: 10.1007/s00415-021-10668-6
Abstrakt: Objective: Considering that epilepsy is common, and knowledge is lacking on its role especially for the prognosis of high-grade gliomas, the objective of this study was to investigate the association between epilepsy prior to glioma diagnosis and survival among glioma patients.
Methods: In a nationwide population-based cohort study, we included 3763 adult glioma patients diagnosed between 2009 and 2018 according to the Danish Neuro-Oncology Registry. Information on epilepsy was redeemed through Danish Neuro-Oncology Registry, National Patient Registry, and National Prescription Registry. Cox proportional hazard models with 95% confidence intervals (CIs) were applied to examine hazard ratios (HRs) for the association between epilepsy (< 1 year prior to glioma including epilepsy at onset; 1-10 years prior to glioma; no prior epilepsy) and risk of death, and whether it differed according to tumor grade and size, performance status, and treatment modalities.
Results: A 32% decreased risk of death in patients with epilepsy within 1 year prior to glioma compared to no prior epilepsy was found (HR = 0.68; CI 0.63-0.75). A favorable prognosis was seen for epilepsy in all glioma grades: II (HR = 0.55; CI 0.39-0.77), III (HR = 0.59; CI 0.48-0.73), and IV (HR = 0.85; CI 0.77-0.94).
Conclusions: Patients with epilepsy within 1 year prior to glioma diagnosis had significant survival benefits compared to patients with no prior epilepsy. This association was significant for both low-grade gliomas (grade II) and high-grade gliomas (grade III and IV). Survival benefits in glioma patients with epilepsy at onset are possibly primarily attributable to tumor-specific histopathology, molecular biomarkers, and early diagnosis.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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