Abstract 293P
Background
The annual incidence of malignant brain tumors is 7.08 per 100,000 inhabitants in Italy and epilepsy is one of the most common presenting symptoms. Patients with brain tumor-related epilepsy (BTRE) suffer from two challenging pathologies simultaneously: glioma and epilepsy. The pathogenesis of BTRE is not fully described. The integration of molecular data and histology changed the diagnostic approach and prognostic characterization for patients with brain tumors. The aim of this study is to explore the associations between histo-molecular patterns and epilepsy features, in a group of patients suffering from brain tumors.
Methods
We evaluated a retrospective cohort of 151 consecutive glioma patients (males 93, mean age: 57±8,48), with 66 (43.7%) suffering from BTRE. The association between tumor (tumor location, histopathological subtype, synaptophysin and GFAP expression, ATRX, p53 and IDH status, ki67 index, MGMT gene promoter methylation and 19/19q status) and epilepsy (seizures’ type and clinical characteristics) features were examined by Pearson's chi-squared test. Survival data were analyzed by applying Kaplan-Meier curves and Cox proportional hazards models. All the statistical analyses were performed by R-3.4.1 software.
Results
Negative synaptophysin was significantly associated with the presence of epilepsy (p<0.05). There was no significant association between MGMT methylation, ATRX and1p/19q deletion and the presence of epilepsy. Progression-free survival (PFS) and overall survival (OS) were significantly associated with well-known prognostic and diagnostic molecular markers, such ATRX, MGMT, IDH1 and 1p/19q as expected from literature data. Moreover, it was found that patients with no epilepsy had worse OS (HR 1.86; p=0.052).
Conclusions
The present study demonstrates no statistical significant relationship between epilepsy and the main brain tumor molecular markers. Our results suggest that the lack of expression of synaptophysin, may be implicated in epileptogenesis. Moreover, in our sample the presence of epilepsy tended to be associated with a better prognosis. More studies will be needed in the future to confirm the role of molecular markers in BTRE.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.