P11.51.B STATUS EPILEPTICUS IN WHO GRADE 2 AND 3 DIFFUSE GLIOMA - PREVALENCE AND PREDICTORS

Abstract

Abstract BACKGROUND Status Epilepticus (SE) is a potentially life-threatening and highly debilitating manifestation of diffuse glioma. Glioma-associated SE has yet been poorly studied; consequently, evidence-based recommendations for clinical management are scarce. Prevalence and predictors of SE might vary across the biomolecular heterogeneity of glioma. We aimed to determine the prevalence of SE in grade 2 and 3 diffuse glioma throughout the disease trajectory, and identify associated baseline determinants (BD) and short-term determinants (STD). MATERIAL AND METHODS We conducted a single-center retrospective cohort-study in a consecutive cohort of patients with WHO grade 2 and 3 glioma, diagnosed between 2010 and 2017. Candidate determinant variables included demographic, clinical and tumor-related variables at first surgery (BD) and epilepsy-associated variables immediately preceding the first SE after diagnosis (STD). Occurrence of BD and STD was correlated to (a) all occurrences of SE and (b) SE with in-hospital treatment separately. A within-patient comparison of STD-frequency between a 30-day hazard period and control period, defined relative to the index-SE, was executed. Univariable and multivariable logistic regression analyses were performed for both BD and STD. RESULTS SE occurred in one third of the total cohort (n=63/197). Nearly 14% had an in-hospital treated SE. We identified several baseline clinical and tumor-related correlates of SE in the univariable analyses, including central, parietal and occipital tumor localization, tumor grade, extent of resection and acute symptomatic seizure occurrence after first surgery. In the multivariable model for all SE, parietal tumor localization and acute symptomatic seizure occurrence after first surgery were associated with an increased risk of SE, whereas baseline Karnofsky Performance Score (KPS) and cognitive disorders were associated with a decreased risk; for in hospital-treated SE, the model was too underpowered for valid analyses. None of the STD were significant predictors of (in-hospital) SE. CONCLUSION One third of patients with grade 2 and 3 diffuse glioma developed a SE at any timepoint after diagnosis. Baseline parietal tumor localization, postsurgical acute symptomatic seizure occurrence, KPS and cognitive status were identified as independent determinants of SE. These explorative findings, if validated, could guide personalized risk stratification, patient counselling and therapeutic decision-making in the clinic.