Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>Tumor‐related temporal lobe epilepsy (TLE) has a high likelihood of medical intractability and requires surgical treatment. The aims of this study were to analyze the long‐term surgical outcomes of and to present appropriate surgical strategies for tumor‐related TLE.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>The clinical data of 87 consecutive patients diagnosed with tumor‐related TLE were analyzed. The median age at surgery was 22 years. Sixteen patients had a tumor confined to the amygdala or the parahippocampal gyrus, and 10 of them received a tailored lesionectomy without hippocampectomy. The surgical outcome was evaluated based on 3 aspects: seizure control, tumor control, and discontinuation of antiepileptic drugs (AEDs).</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>The actuarial seizure and tumor control rates at the fifth year postoperatively were 79% and 90%, respectively. Seizure control was highly correlated with tumor control. The following factors were found to be significantly associated with poor seizure control: duration of epilepsy >10 years, presence of a remote focus on surface electroencephalography, and incomplete tumor removal. The actuarial AED maintenance rates were 47% at the second year and 11% at the fifth year. The median time to AED discontinuation was 22 months. A younger age at surgery was found to be significantly associated with an increased chance of AED discontinuation. Tailored resection focusing on the tumor resulted in a favorable outcome, even for tumors confined to the amygdala or the parahippocampal gyrus.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>Surgical treatment of tumor‐related TLE resulted in long‐term seizure control in the majority of patients. Maximal tumor removal can be recommended for tumor‐related TLE. Cancer 2009. © 2009 American Cancer Society.</jats:p></jats:sec>