Satellite lesions of DNET

implications for seizure and tumor control after resection

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: Dysembryoplastic neuroepithelial tumors (DNETs) are a common cause of chronic drug-resistant epilepsy and are known for their favorable surgical outcomes. Nevertheless, the seizure recurrence-free rate is not as favorable if tumorous nodules are present near the main mass. We call these small tumorous nodules in the vicinity of the main mass satellite lesions (SLs). We analyzed tumor and seizure control in the presence and following the subsequent removal of SLs. Methods: We retrospectively reviewed the medical records, radiological data, and surgical procedures to obtain the outcomes of children who underwent resection surgery for DNET. The analyses were designed to address the associations among the demographic, tumor and seizure-related variables. A Cox proportional hazard model was used for the univariate and multivariate analyses. Results: In total, 39 consecutive patients were included (26 males and 13 females). SLs were found in 22 patients (56%). The year-to-year analysis of patients with Engel class I was approximately 80% during the follow-up period. However, the actual seizure recurrence-free survival (RFS) rate was 82, 73 and 70% at the first, second and fifth year, respectively. The patients who initially presented with SLs had 46% seizure recurrence rates, while those without SL had 18% seizure recurrence rates. Conclusions: As the seizure-RFS rate significantly declines over time, a more accurate seizure-free rate analysis using survival curves could be important for determining the outcome of DNET surgery. A thorough review identifying satellite lesions preoperatively and using intraoperative neuronavigation, electrocorticography (ECoG) or intraoperative ultrasonography is warranted to accomplish the wide resection of tumors with accompanying satellite lesions.

Original languageEnglish
Pages (from-to)437-445
Number of pages9
JournalJournal of Neuro-Oncology
Volume143
Issue number3
DOIs
StatePublished - 1 Jul 2019

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Neuroepithelial Neoplasms
Seizures
Neoplasms
Recurrence
Survival Rate
Neuronavigation
Survival Analysis
Proportional Hazards Models
Medical Records
Ultrasonography
Multivariate Analysis
Demography

Keywords

  • Dysembryoplastic neuroepithelial tumor
  • Epilepsy
  • Epilepsy-associated tumor
  • Focal cortical dysplasia
  • Recurrence

Cite this

@article{7b465cf37b6c4bf284d9e43058dc6c27,
title = "Satellite lesions of DNET: implications for seizure and tumor control after resection",
abstract = "Purpose: Dysembryoplastic neuroepithelial tumors (DNETs) are a common cause of chronic drug-resistant epilepsy and are known for their favorable surgical outcomes. Nevertheless, the seizure recurrence-free rate is not as favorable if tumorous nodules are present near the main mass. We call these small tumorous nodules in the vicinity of the main mass satellite lesions (SLs). We analyzed tumor and seizure control in the presence and following the subsequent removal of SLs. Methods: We retrospectively reviewed the medical records, radiological data, and surgical procedures to obtain the outcomes of children who underwent resection surgery for DNET. The analyses were designed to address the associations among the demographic, tumor and seizure-related variables. A Cox proportional hazard model was used for the univariate and multivariate analyses. Results: In total, 39 consecutive patients were included (26 males and 13 females). SLs were found in 22 patients (56{\%}). The year-to-year analysis of patients with Engel class I was approximately 80{\%} during the follow-up period. However, the actual seizure recurrence-free survival (RFS) rate was 82, 73 and 70{\%} at the first, second and fifth year, respectively. The patients who initially presented with SLs had 46{\%} seizure recurrence rates, while those without SL had 18{\%} seizure recurrence rates. Conclusions: As the seizure-RFS rate significantly declines over time, a more accurate seizure-free rate analysis using survival curves could be important for determining the outcome of DNET surgery. A thorough review identifying satellite lesions preoperatively and using intraoperative neuronavigation, electrocorticography (ECoG) or intraoperative ultrasonography is warranted to accomplish the wide resection of tumors with accompanying satellite lesions.",
keywords = "Dysembryoplastic neuroepithelial tumor, Epilepsy, Epilepsy-associated tumor, Focal cortical dysplasia, Recurrence",
author = "Jeyul Yang and Seung-Ki Kim and Kijoong Kim and Chae, {Jong Hee} and Lim, {Byung Chan} and Kyu-Chang Wang and Sung-Hye Park and Phi, {Ji Hoon}",
year = "2019",
month = "7",
day = "1",
doi = "10.1007/s11060-019-03174-3",
language = "English",
volume = "143",
pages = "437--445",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "3",

}

TY - JOUR

T1 - Satellite lesions of DNET

T2 - implications for seizure and tumor control after resection

AU - Yang, Jeyul

AU - Kim, Seung-Ki

AU - Kim, Kijoong

AU - Chae, Jong Hee

AU - Lim, Byung Chan

AU - Wang, Kyu-Chang

AU - Park, Sung-Hye

AU - Phi, Ji Hoon

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose: Dysembryoplastic neuroepithelial tumors (DNETs) are a common cause of chronic drug-resistant epilepsy and are known for their favorable surgical outcomes. Nevertheless, the seizure recurrence-free rate is not as favorable if tumorous nodules are present near the main mass. We call these small tumorous nodules in the vicinity of the main mass satellite lesions (SLs). We analyzed tumor and seizure control in the presence and following the subsequent removal of SLs. Methods: We retrospectively reviewed the medical records, radiological data, and surgical procedures to obtain the outcomes of children who underwent resection surgery for DNET. The analyses were designed to address the associations among the demographic, tumor and seizure-related variables. A Cox proportional hazard model was used for the univariate and multivariate analyses. Results: In total, 39 consecutive patients were included (26 males and 13 females). SLs were found in 22 patients (56%). The year-to-year analysis of patients with Engel class I was approximately 80% during the follow-up period. However, the actual seizure recurrence-free survival (RFS) rate was 82, 73 and 70% at the first, second and fifth year, respectively. The patients who initially presented with SLs had 46% seizure recurrence rates, while those without SL had 18% seizure recurrence rates. Conclusions: As the seizure-RFS rate significantly declines over time, a more accurate seizure-free rate analysis using survival curves could be important for determining the outcome of DNET surgery. A thorough review identifying satellite lesions preoperatively and using intraoperative neuronavigation, electrocorticography (ECoG) or intraoperative ultrasonography is warranted to accomplish the wide resection of tumors with accompanying satellite lesions.

AB - Purpose: Dysembryoplastic neuroepithelial tumors (DNETs) are a common cause of chronic drug-resistant epilepsy and are known for their favorable surgical outcomes. Nevertheless, the seizure recurrence-free rate is not as favorable if tumorous nodules are present near the main mass. We call these small tumorous nodules in the vicinity of the main mass satellite lesions (SLs). We analyzed tumor and seizure control in the presence and following the subsequent removal of SLs. Methods: We retrospectively reviewed the medical records, radiological data, and surgical procedures to obtain the outcomes of children who underwent resection surgery for DNET. The analyses were designed to address the associations among the demographic, tumor and seizure-related variables. A Cox proportional hazard model was used for the univariate and multivariate analyses. Results: In total, 39 consecutive patients were included (26 males and 13 females). SLs were found in 22 patients (56%). The year-to-year analysis of patients with Engel class I was approximately 80% during the follow-up period. However, the actual seizure recurrence-free survival (RFS) rate was 82, 73 and 70% at the first, second and fifth year, respectively. The patients who initially presented with SLs had 46% seizure recurrence rates, while those without SL had 18% seizure recurrence rates. Conclusions: As the seizure-RFS rate significantly declines over time, a more accurate seizure-free rate analysis using survival curves could be important for determining the outcome of DNET surgery. A thorough review identifying satellite lesions preoperatively and using intraoperative neuronavigation, electrocorticography (ECoG) or intraoperative ultrasonography is warranted to accomplish the wide resection of tumors with accompanying satellite lesions.

KW - Dysembryoplastic neuroepithelial tumor

KW - Epilepsy

KW - Epilepsy-associated tumor

KW - Focal cortical dysplasia

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=85065231486&partnerID=8YFLogxK

U2 - 10.1007/s11060-019-03174-3

DO - 10.1007/s11060-019-03174-3

M3 - Article

VL - 143

SP - 437

EP - 445

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 3

ER -