학술논문
Status epilepticus in patients with brain tumors and metastases: A multicenter cohort study of 208 patients and literature review.
Document Type
Academic Journal
Author
Rickel JK; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt, Germany.; Zeeb D; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Department of Neurosurgery, Philipps-University Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Knake S; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt, Germany.; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Urban H; Dr Senckenberg Institute of Neurooncology, University Hospital and Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Konczalla J; Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Weber KJ; Frankturt Cancer Institute (FCI), Goethe-University Frankfurt, Frankfurt, Germany.; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany.; Institute of Neurology (Edinger-Institute), Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Zeiner PS; Dr Senckenberg Institute of Neurooncology, University Hospital and Goethe-University Frankfurt, Frankfurt, Germany.; Frankturt Cancer Institute (FCI), Goethe-University Frankfurt, Frankfurt, Germany.; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Pagenstecher A; Institute of Neuropathology, Philipps-University Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Hattingen E; Institute of Neuroradiology, Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Kemmling A; Department of Neuroradiology, Philipps-University Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Fokas E; Frankturt Cancer Institute (FCI), Goethe-University Frankfurt, Frankfurt, Germany.; Department of Radiotherapy and Oncology, Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Adeberg S; Department of Radiation Oncology, UKGM Marburg, Marburg, Germany.; Marburg Ion-Beam Therapy Center (MIT), Department of Radiation Oncology, UKGM Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Wolff R; Gamma Knife Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Sebastian M; Hematology/Oncology, Department of Medicine II, University Hospital Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Rusch T; Department of Hematology, Oncology & Immunology, Philipps-University Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Ronellenfitsch MW; Dr Senckenberg Institute of Neurooncology, University Hospital and Goethe-University Frankfurt, Frankfurt, Germany.; Frankturt Cancer Institute (FCI), Goethe-University Frankfurt, Frankfurt, Germany.; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Menzler K; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Habermehl L; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Möller L; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Czabanka M; Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Nimsky C; Department of Neurosurgery, Philipps-University Marburg, Marburg, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Timmermann L; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.; Grefkes C; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.; Steinbach JP; Dr Senckenberg Institute of Neurooncology, University Hospital and Goethe-University Frankfurt, Frankfurt, Germany.; Frankturt Cancer Institute (FCI), Goethe-University Frankfurt, Frankfurt, Germany.; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany.; University Cancer Center (UCT) Frankfurt-Marburg, Frankfurt, Marburg, Germany.; Rosenow F; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt, Germany.; Kämppi L; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.; Epilepsia Helsinki, European Reference Network EpiCARE, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.; Strzelczyk A; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany. strzelczyk@med.uni-frankfurt.de.; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt, Germany. strzelczyk@med.uni-frankfurt.de.; Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany. strzelczyk@med.uni-frankfurt.de.
Source
Publisher: BMC Country of Publication: England NLM ID: 101767802 Publication Model: Electronic Cited Medium: Internet ISSN: 2524-3489 (Electronic) Linking ISSN: 25243489 NLM ISO Abbreviation: Neurol Res Pract Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Objective: Brain tumors and metastases account for approximately 10% of all status epilepticus (SE) cases. This study described the clinical characteristics, treatment, and short- and long-term outcomes of this population.
Methods: This retrospective, multi-center cohort study analyzed all brain tumor patients treated for SE at the university hospitals of Frankfurt and Marburg between 2011 and 2017.
Results: The 208 patients (mean 61.5 ± 14.7 years of age; 51% male) presented with adult-type diffuse gliomas (55.8%), metastatic entities (25.5%), intracranial extradural tumors (14.4%), or other tumors (4.3%). The radiological criteria for tumor progression were evidenced in 128 (61.5%) patients, while 57 (27.4%) were newly diagnosed with tumor at admission and 113 (54.3%) had refractory SE. The mean hospital length of stay (LOS) was 14.8 days (median 12.0, range 1-57), 171 (82.2%) patients required intensive care (mean LOS 8.9 days, median 5, range 1-46), and 44 (21.2%) were administered mechanical ventilation. All patients exhibited significant functional status decline (modified Rankin Scale) post-SE at discharge (p < 0.001). Mortality at discharge was 17.3% (n = 36), with the greatest occurring in patients with metastatic disease (26.4%, p = 0.031) and those that met the radiological criteria for tumor progression (25%, p < 0.001). Long-term mortality at one year (65.9%) was highest in those diagnosed with adult-type diffuse gliomas (68.1%) and metastatic disease (79.2%). Refractory status epilepticus cases showed lower survival rates than non-refractory SE patients (log-rank p = 0.02) and those with signs of tumor progression (log-rank p = 0.001).
Conclusions: SE occurrence contributed to a decline in functional status in all cases, regardless of tumor type, tumor progression status, and SE refractoriness, while long-term mortality was increased in those with malignant tumor entities, tumor progressions, and refractory SE. SE prevention may preserve functional status and improve survival in individuals with brain tumors.
(© 2024. The Author(s).)
Methods: This retrospective, multi-center cohort study analyzed all brain tumor patients treated for SE at the university hospitals of Frankfurt and Marburg between 2011 and 2017.
Results: The 208 patients (mean 61.5 ± 14.7 years of age; 51% male) presented with adult-type diffuse gliomas (55.8%), metastatic entities (25.5%), intracranial extradural tumors (14.4%), or other tumors (4.3%). The radiological criteria for tumor progression were evidenced in 128 (61.5%) patients, while 57 (27.4%) were newly diagnosed with tumor at admission and 113 (54.3%) had refractory SE. The mean hospital length of stay (LOS) was 14.8 days (median 12.0, range 1-57), 171 (82.2%) patients required intensive care (mean LOS 8.9 days, median 5, range 1-46), and 44 (21.2%) were administered mechanical ventilation. All patients exhibited significant functional status decline (modified Rankin Scale) post-SE at discharge (p < 0.001). Mortality at discharge was 17.3% (n = 36), with the greatest occurring in patients with metastatic disease (26.4%, p = 0.031) and those that met the radiological criteria for tumor progression (25%, p < 0.001). Long-term mortality at one year (65.9%) was highest in those diagnosed with adult-type diffuse gliomas (68.1%) and metastatic disease (79.2%). Refractory status epilepticus cases showed lower survival rates than non-refractory SE patients (log-rank p = 0.02) and those with signs of tumor progression (log-rank p = 0.001).
Conclusions: SE occurrence contributed to a decline in functional status in all cases, regardless of tumor type, tumor progression status, and SE refractoriness, while long-term mortality was increased in those with malignant tumor entities, tumor progressions, and refractory SE. SE prevention may preserve functional status and improve survival in individuals with brain tumors.
(© 2024. The Author(s).)