Association between IDH1/2 mutation and preoperative seizures in patients with low-grade versus high-grade glioma: a systematic review and meta-analysis.

Association between IDH1/2 mutation and preoperative seizures in patients with low-grade versus high-grade glioma: a systematic review and meta-analysis.

World Neurosurg. 2017 Dec 27;:

Authors: Phan K, Ng W, Lu VM, McDonald KL, Fairhall J, Reddy R, Wilson P

Abstract
BACKGROUND: Seizures are a common presentation of brain tumors particularly in gliomas. Higher incidences of seizure have been reported in low-grade glioma and tumors located within the temporal and insular area. The association between IDH1/2 mutations with preoperative seizures in glioma and the magnitude of this association in low versus high-grade gliomas remains unclear. To clarify this relationship, a systematic review and meta-analysis was performed.
METHOD: Following the PRISMA guidelines and systematic review recommendations, electronic searches were performed on varies journal database and included literature up to May 2017. Data were extracted and pooled via meta-analysis.
RESULTS: 8 studies including 782 IDH1/2 mutation patients were compared with 803 IDH1/2 wild-type patients before surgery. There was a significant difference between seizure incidence in the IDH1 mutation group (61.6%) compared to the IDH1 wild-type group (32.1%) (OR 2.76; 95% CI 1.26-6.02; I2=73%, p = 0.01). Similar findings were observed during the analysis of IDH1/2 mutation (OR 2.74; 95% CI 1.74-4.33; I2=58%, p < 0.0001). The difference remained in both the IDH1 mutation group and the IDH1/2 mutation group within grade II gliomas but not in grade III and IV gliomas. Grade II glioma patients also showed a higher rate of IDH1/2 mutations and seizure compared to grade III or IV patients.
CONCLUSION: This study demonstrated a significant association between the presence of IDH1/2 mutation with the incidence of preoperative seizures. This association is only significant in patients with low-grade glioma (grade II) but not with higher grade (grade III and grade IV gliomas).

PMID: 29288860 [PubMed - as supplied by publisher]

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