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. 2016 May;18(5):700-6.
doi: 10.1093/neuonc/nov238. Epub 2015 Sep 29.

Prognostic relevance of epilepsy at presentation in glioblastoma patients

Sharon Berendsen  1 , Meri Varkila  1 , Jérôme Kroonen  1 , Tatjana Seute  1 , Tom J Snijders  1 , Frans Kauw  1 , Wim G M Spliet  1 , Marie Willems  1 , Christophe Poulet  1 , Marike L Broekman  1 , Vincent Bours  1 , Pierre A Robe  1
Affiliations

Prognostic relevance of epilepsy at presentation in glioblastoma patients

Sharon Berendsen et al. Neuro Oncol. 2016 May.

Abstract

Background: Epileptogenic glioblastomas are thought to convey a favorable prognosis, either due to early diagnosis or potential antitumor effects of antiepileptic drugs. We investigated the relationship between survival and epilepsy at presentation, early diagnosis, and antiepileptic drug therapy in glioblastoma patients.

Methods: Multivariable Cox regression was applied to survival data of 647 consecutive patients diagnosed with de novo glioblastoma between 2005 and 2013 in order to investigate the association between epilepsy and survival in glioblastoma patients. In addition, we quantified the association between survival and valproic acid (VPA) treatment.

Results: Epilepsy correlated positively with survival (HR: 0.75 (95% CI: 0.61-0.92), P < .01). This effect is independent of age, sex, performance status, type of surgery, adjuvant therapy, tumor location, and tumor volume, suggesting that this positive correlation cannot be attributed solely to early diagnosis. For patients who presented with epilepsy, the use of the antiepileptic drug VPA did not associate with survival when compared with patients who did not receive VPA treatment.

Conclusion: Epilepsy is an independent prognostic factor for longer survival in glioblastoma patients. This prognostic effect is not solely explained by early diagnosis, and survival is not associated with VPA treatment.

Keywords: epilepsy; glioblastoma; prognosis; survival; valproic acid.

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Figures

Fig. 1.
Fig. 1.
Effect of epilepsy and valproic acid (VPA) on glioblastoma patient survival. (A) Kaplan-Meier plot of patients with (grey, n = 212) and without epilepsy (black, n = 435). Patients with survival >1000 days from surgery were censored. Survival was significantly different between the 2 groups (log-rank test, P < .00005). (B) Kaplan-Meier plot of glioblastoma patients treated with VPA (grey, n = 55) or all other patients with epilepsy (black, n = 157). Patients with survival >1000 days from surgery were censored. Survival was not significantly different between the 2 groups (log-rank test, P = .55).
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