Abstracts

Rationale: Seizures are presenting sign in 25-50 % of gliomas. Tumor Associated Epilepsy "TAE" has significant morbidity and loss of quality of life (QOL). Improving control of TAE may improve QOL and KPS scores. Impact of "tumor associated epilepsy" (TAE) on morbidity of gliomas is significant (Ref). In TAE seizure outcome may be related to multiple variables, e.g. WHO classification, extent of resection, treatment modalities, anti-epileptic drugs (AED), EEG findings and Karnofsky Performance Status (KPS) scores (Table 1). Reference: Shete et all. American Association for Cancer Research, 71: 7568-7575, 2011 Methods: Retrospective chart review study using data from Tumor Conference and Medical Records on 219 subjects with gliomas and TAE seen between 2006-2013 at the University of Minnesota Neurosurgery/Neurology Departments was done.(Table 2) Analysis of variables using chi square testing and p values was performed. We investigated the association of seizure outcome at patients last Neurooncology/ Neurosurgery Clinic visit using Engel's classification I-IV and KPS scores, with multiple clinical variables as described in Table 1. Results: Patients with KPS score of <80, mean age±SD was 50±16 years (p=0.003) and 57.3% were males (p=0.3). In 38.8% of these patients the tumor was located in the frontal region. (p=0.004) 32.5% of the patients had low grade gliomas* (p=0.001). EEG was abnormal in 20.5% (p=0.2) and mortality in this group was 25.6% (p=<0.001). Patients with KPS score of ≥80, mean age±SD was 43±15 (p=0.003) years and 64.0% were males (p=0.3). Tumor location was frontal in 61.6% (p=0.004). 55.6% of the patients had low grade* (p=0.001). EEG was abnormal in 13.1% (p=0.2). There was no mortality associated with this group. 20% had oligodendroglioma with 1p19q deletions. (Table 1) 3% had positive family history of glioma. The patient with gliomas who presented with seizure were 35%. 67% were on monotherapy usually with Keppra while 23% were on combination therapy. (Table 2) *Low grade glioma= WHO I & II Conclusions: Some clinical variables traditionally used to predict outcome, i.e KPS score and Seizure control, in low grade gliomas in this series of 219 patients had statistically significant association. Further studies are needed to look at other clinical parameters, perhaps molecular genotypes, that may better correlate with outcome in so far as seizure control and functionability of glioms patients.