TABLE 5.
Seizure Outcome After Repeat Surgery for Insular Tumors
| Parameter | No. (%) | Finala seizure outcome | Odds ratio (95% CI) | P-value | |
|---|---|---|---|---|---|
| Engel IA | Engel II-IV | ||||
| N | 22 | 8 (36.4) | 14 (63.6) | ||
| Gender | |||||
| Male | 11 (50.0) | 5 (62.5) | 6 (42.9) | 2.22 (0.37, 13.18) | .6594 |
| Femaleb | 11 (50.0) | 3 (37.5) | 8 (57.1) | ||
| Age at surgery (yr) (median, range) | 36 (24-60) | 34 (24-51) | 37 (26-60) | 0.37 (0.01, 9.18) | .5417 |
| Seizure onset age (yr) (median, range) | 30 (16-53) | 31 (18-51) | 30 (16-53) | 0.66 (0.03, 16.03) | .7974 |
| Seizure duration (mo) (median, range) | 55 (24-151) | 47 (26-120) | 68 (24-151) | 0.10 (0.003, 3.92) | .2190 |
| Seizure type | |||||
| Focal | 19 (86.4) | 5 (62.5) | 14 (100.0) | 0 | .0364 c |
| Sensory | 16 (72.7) | 4 (50.0) | 12 (85.7) | 0.17 (0.02, 1.28) | .0704 |
| Motor | 7 (31.8) | 2 (25.0) | 5 (35.7) | 0.6 (0.09, 4.17) | .3496 |
| Focal + dyscognitive | 7 (31.8) | 3 (37.5) | 5 (62.5) | 1.5 (0.24, 9.46) | .6654 |
| Generalized | 7 (31.8) | 2 (25.0) | 5 (35.7) | 0.6 (0.09, 4.17) | .6757 |
| Auras | 9 (40.9) | 3 (37.5) | 6 (42.9) | 0.8 (0.13, 4.74) | .8058 |
| Number of AEDs preop (median, range) | 2 (1-4) | 1.5 (1-3) | 2 (1-4) | 0.62 (0.02, 20.94) | .7920 |
| Side of lesion | |||||
| Left | 13 (59.1) | 4 (50.0) | 9 (64.3) | 0.56 (0.10, 3.25) | .5121 |
| Rightb | 9 (40.9) | 4 (44.4) | 5 (55.6) | ||
| Size of lesion (cm3) (median, range) | 19.8 (0.6-83.4) | 19.7 (7.1-83.4) | 19.8 (0.6-79.5) | 2.65 (0.17, 40.79) | .4853 |
| Imaging features | |||||
| Hemorrhage | 5 (22.7) | 2 (25.0) | 3 (21.4) | 1.22 (0.16, 9.47) | .8475 |
| Enhancement | 7 (31.8) | 3 (37.5) | 4 (28.6) | 1.50 (0.24, 9.46) | .6654 |
| Tumor pathology | |||||
| Diffuse astrocytoma | 1 (4.6) | 0 (0) | 1 (100) | <0.0001 (0, na) | .9941 |
| Oligodendroglioma | 5 (22.7) | 2 (40.0) | 3 (60.0) | 1.33 (0.11, 15.70) | .8192 |
| Oligoastrocytoma | 5 (22.7) | 2 (40.0) | 3 (60.0) | 1.33 (0.11, 15, 70) | .8192 |
| Anaplastic astrocytoma | 5 (22.73) | 2 (40.0) | 3 (60.0) | 1.33 (0.11, 15.70) | .8192 |
| Glioblastomab | 6 (27.3) | 2 (33.3) | 4 (66.7) | ||
| WHO grade | |||||
| II | 11 (50.0) | 4 (50.0) | 7 (50.0) | 1.14 (0.14, 9.23) | .9006 |
| III | 5 (22.7) | 2 (25.0) | 3 (21.4) | 0.8192 (0.11, 15.70) | .8192 |
| IVb | 6 (27.3) | 2 (25.0) | 4 (28.6) | ||
| Awake surgery | 10 (45.5) | 3 (37.5) | 7 (50.0) | 0.6 (0.10, 3.54) | .5711 |
| Language mapping | 10 (45.5) | 3 (37.5) | 7 (50.0) | 0.6 (0.10, 3.54) | .5711 |
| Motor mapping | 17 (77.3) | 5 (62.5) | 12 (85.7) | 0.28 (0.04, 2.20) | .2113 |
| EOR (%) (median, range) | 74 (7.5-100) | 70 (7.5-100) | 80 (10-100) | 0.34 (0.01, 8.25) | .5043 |
| Residual tumor volume (cm3) (median, range) | 6.0 (0-77.2) | 5.9 (0-77.2) | 6.9 (0-32.0) | 8.49 (0.09, 763.6) | .3515 |
| Morbidities | 2 (9.1) | 0 (0) | 2 (14.3) | 0 (na) | .5152 |
| Number of AEDs postop (median, range) | 2 (1-3) | 1.5 (1-3) | 2 (1-3) | 0.22 (3.90, 4.58) | .2844 |
| Follow-up duration (mo) (median, range) | 32 (7-101) | 30 (7-42) | 32 (12-101) | 0.03 (0.002, 3.61) | .1505 |
aFinal seizure outcome at last follow-up or prior to repeat surgery. Sz free = Engel IA; Residual sz = Engel IB-IV.
Odds ratio > 1 = higher likelihood of becoming seizure free. Baseline variable in each category for odds ratio calculation is indicated by b, otherwise presence of a variable is compared to those without. Odds ratios are calculated for the entire range of values in continuous variables.
cIndicates significant P-value.
Fisher's exact test was used for categorical variables and logistic regression was used for continuous variables.