Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study

Carmen Barba; Nicola Specchio; Renzo Guerrini; Laura Tassi; Salvatore De Masi; Francesco Cardinale; Simona Pellacani; Luca De Palma; Domenica Battaglia; Gianpiero Tamburrini; Giuseppe Didato; Elena Freri; Alessandro Consales; Paolo Nozza; Nelia Zamponi; Elisabetta Cesaroni; Giancarlo Di Gennaro; Vincenzo Esposito; Marco Giulioni; Paolo Tinuper; Gabriella Colicchio; Raffaele Rocchi; Guido Rubboli; Flavio Giordano; Giorgio Lo Russo; Carlo Efisio Marras; Massimo Cossu

doi:10.1016/j.yebeh.2017.08.010

Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study

Carmen Barba^*, Nicola Specchio, Renzo Guerrini, Laura Tassi, Salvatore De Masi, Francesco Cardinale, Simona Pellacani, Luca De Palma, Domenica Battaglia, Gianpiero Tamburrini, Giuseppe Didato, Elena Freri, Alessandro Consales, Paolo Nozza, Nelia Zamponi, Elisabetta Cesaroni, Giancarlo Di Gennaro, Vincenzo Esposito, Marco Giulioni, Paolo TinuperGabriella Colicchio, Raffaele Rocchi, Guido Rubboli, Flavio Giordano, Giorgio Lo Russo, Carlo Efisio Marras, Massimo Cossu

^*Corresponding author for this work

Department of Clinical Medicine

14 Citations (Scopus)

Abstract

Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Results Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (< 50 surgeries/year) versus high-volume centers. There was a high variability across centers concerning pre- and postsurgical evaluation protocols, depending on local expertise and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome.

Original language	English
Journal	Epilepsy and Behavior
Volume	75
Pages (from-to)	151-157
ISSN	1525-5050
DOIs	https://doi.org/10.1016/j.yebeh.2017.08.010
Publication status	Published - Oct 2017

Keywords

Children
Epilepsy surgery
Evaluation protocol
Surgical approach
Survey

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10.1016/j.yebeh.2017.08.010

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Barba, C., Specchio, N., Guerrini, R., Tassi, L., De Masi, S., Cardinale, F., Pellacani, S., De Palma, L., Battaglia, D., Tamburrini, G., Didato, G., Freri, E., Consales, A., Nozza, P., Zamponi, N., Cesaroni, E., Di Gennaro, G., Esposito, V., Giulioni, M., ... Cossu, M. (2017). Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study. Epilepsy and Behavior, 75, 151-157. https://doi.org/10.1016/j.yebeh.2017.08.010

Barba, C, Specchio, N, Guerrini, R, Tassi, L, De Masi, S, Cardinale, F, Pellacani, S, De Palma, L, Battaglia, D, Tamburrini, G, Didato, G, Freri, E, Consales, A, Nozza, P, Zamponi, N, Cesaroni, E, Di Gennaro, G, Esposito, V, Giulioni, M, Tinuper, P, Colicchio, G, Rocchi, R, Rubboli, G, Giordano, F, Russo, GL, Marras, CE & Cossu, M 2017, 'Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study', Epilepsy and Behavior, vol. 75, pp. 151-157. https://doi.org/10.1016/j.yebeh.2017.08.010

@article{16df285130b3479296394f45fd21eb4b,

title = "Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study",

abstract = "Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Results Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (< 50 surgeries/year) versus high-volume centers. There was a high variability across centers concerning pre- and postsurgical evaluation protocols, depending on local expertise and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome.",

keywords = "Children, Epilepsy surgery, Evaluation protocol, Surgical approach, Survey",

author = "Carmen Barba and Nicola Specchio and Renzo Guerrini and Laura Tassi and {De Masi}, Salvatore and Francesco Cardinale and Simona Pellacani and {De Palma}, Luca and Domenica Battaglia and Gianpiero Tamburrini and Giuseppe Didato and Elena Freri and Alessandro Consales and Paolo Nozza and Nelia Zamponi and Elisabetta Cesaroni and {Di Gennaro}, Giancarlo and Vincenzo Esposito and Marco Giulioni and Paolo Tinuper and Gabriella Colicchio and Raffaele Rocchi and Guido Rubboli and Flavio Giordano and Russo, {Giorgio Lo} and Marras, {Carlo Efisio} and Massimo Cossu",

year = "2017",

month = oct,

doi = "10.1016/j.yebeh.2017.08.010",

language = "English",

volume = "75",

pages = "151--157",

journal = "Epilepsy and Behavior",

issn = "1525-5050",

publisher = "Academic Press",

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TY - JOUR

T1 - Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014

T2 - A nationwide multicenter study

AU - Barba, Carmen

AU - Specchio, Nicola

AU - Guerrini, Renzo

AU - Tassi, Laura

AU - De Masi, Salvatore

AU - Cardinale, Francesco

AU - Pellacani, Simona

AU - De Palma, Luca

AU - Battaglia, Domenica

AU - Tamburrini, Gianpiero

AU - Didato, Giuseppe

AU - Freri, Elena

AU - Consales, Alessandro

AU - Nozza, Paolo

AU - Zamponi, Nelia

AU - Cesaroni, Elisabetta

AU - Di Gennaro, Giancarlo

AU - Esposito, Vincenzo

AU - Giulioni, Marco

AU - Tinuper, Paolo

AU - Colicchio, Gabriella

AU - Rocchi, Raffaele

AU - Rubboli, Guido

AU - Giordano, Flavio

AU - Russo, Giorgio Lo

AU - Marras, Carlo Efisio

AU - Cossu, Massimo

PY - 2017/10

Y1 - 2017/10

N2 - Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Results Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (< 50 surgeries/year) versus high-volume centers. There was a high variability across centers concerning pre- and postsurgical evaluation protocols, depending on local expertise and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome.

AB - Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Results Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (< 50 surgeries/year) versus high-volume centers. There was a high variability across centers concerning pre- and postsurgical evaluation protocols, depending on local expertise and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome.

KW - Children

KW - Epilepsy surgery

KW - Evaluation protocol

KW - Surgical approach

KW - Survey

U2 - 10.1016/j.yebeh.2017.08.010

DO - 10.1016/j.yebeh.2017.08.010

M3 - Journal article

C2 - 28866334

AN - SCOPUS:85029582743

SN - 1525-5050

VL - 75

SP - 151

EP - 157

JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

ER -

Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study

Abstract

Keywords

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