Relationship between tumour location and preoperative seizure incidence in patients with gliomas: a systematic review and meta-analysis.

Abstract

The aim of this meta-analysis was to assess the relationship between tumour location and preoperative seizure incidence in patients with gliomas. Systematic computerised searches of PubMed and the Web of Knowledge were performed. The meta-analysis of pooled odds ratio (OR) and 95% confidence interval (CI) for preoperative seizure risk, stratified by tumour location, were calculated. Eleven studies with 2,047 patients were included for meta-analysis. For gliomas with or without frontal lobe involvement, the preoperative seizure incidence ranged from 31.7% (19/60) to 85.7% (156/182) and 19.7% (12/61) to 85.7% (12/14), respectively; the pooled OR was 1.560 (95% CI: 1.266-1.923; Z: 4.17; p=0.000). For gliomas with or without temporal lobe involvement, seizure incidence was 22.6% (7/31) to 91.7% (11/12) and 26.7% (24/90) to 78.7% (174/221), respectively; the pooled OR was 1.070 (95% CI: 0.794-1.443; Z: 0.45; p=0.656). For gliomas with or without parietal lobe involvement, seizure incidence was 18.1% (3/16) to 100.0% (3/3) and 26.7% (28/105) to 80.4% (226/281), respectively; the pooled OR was 0.770 (95% CI: 0.570-1.040; Z: 1.71; p=0.088). For gliomas with or without occipital lobe involvement, seizure incidence was 0.0% (0/2) to 100.0% (2/2) and 26.8% (30/112) to 75.7% (56/74), respectively; the pooled OR was 0.336 (95% CI: 0.164-0.686; Z: 2.99; p=0.003). For gliomas with or without insula lobe involvement, seizure incidence was 34.8% (8/23) to 72.0% (77/107) and 34.3% (60/175) to 81.3% (247/304), respectively; the pooled OR was 1.058 (95% CI: 0.765-1.463; Z: 0.34; p=0.732). No significant publication bias was found. Our meta-analysis indicates that frontal lobe gliomas are related to a higher preoperative seizure incidence, while occipital lobe gliomas are related to a lower incidence.