TY - JOUR
T1 - Trends in pediatric epilepsy surgery in Europe between 2008 and 2015
T2 - Country-, center-, and age-specific variation
AU - Barba, Carmen
AU - Cross, Judith Helen
AU - Braun, Kees
AU - Cossu, Massimo
AU - Klotz, Kerstin Alexandra
AU - De Masi, Salvatore
AU - Perez Jiménez, Maria Angeles
AU - Gaily, Eija
AU - Specchio, Nicola
AU - Cabral, Pedro
AU - Toulouse, Joseph
AU - Dimova, Petia
AU - Battaglia, Domenica
AU - Freri, Elena
AU - Consales, Alessandro
AU - Cesaroni, Elisabetta
AU - Tarta-Arsene, Oana
AU - Gil-Nagel, Antonio
AU - Mindruta, Ioana
AU - Di Gennaro, Giancarlo
AU - Giulioni, Marco
AU - Tisdall, Martin M.
AU - Eltze, Christin
AU - Tahir, Muhammad Zubair
AU - Jansen, Floor
AU - van Rijen, Peter
AU - Sanders, Maurits
AU - Tassi, Laura
AU - Francione, Stefano
AU - Lo Russo, Giorgio
AU - Jacobs, Julia
AU - Bast, Thomas
AU - Matta, Giulia
AU - Budke, Marcelo
AU - Fournier del Castillo, Concepción
AU - Metsahonkala, Eeva Liisa
AU - Karppinen, Atte
AU - Ferreira, José Carlos
AU - Minkin, Krasimir
AU - Marras, Carlo Efisio
AU - Arzimanoglou, Alexis
AU - Guerrini, Renzo
N1 - Funding Information:
This survey was conducted in the framework of UTASK and the Commission for Epilepsy Surgery of the Italian League Against Epilepsy. We thank Dr Sergiu Stoica (Brain Institute/Monza Hospital, Bucharest, Romania), Prof Philippe Kahane (University Hospital Center Grenoble, Grenoble, France), and Dr Lorella Minotti (University Hospital Center Grenoble, Grenoble, France) for their support to the work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
Wiley Periodicals, Inc. © 2019 International League Against Epilepsy
PY - 2020/2
Y1 - 2020/2
N2 - OBJECTIVE: To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015.METHODS: We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries.RESULTS: We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time (P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years (P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries (P for trend = .0047) and a significant decrease in unilobar temporal surgeries (P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo-electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015.SIGNIFICANCE: Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures.
AB - OBJECTIVE: To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015.METHODS: We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries.RESULTS: We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time (P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years (P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries (P for trend = .0047) and a significant decrease in unilobar temporal surgeries (P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo-electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015.SIGNIFICANCE: Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures.
KW - children
KW - epilepsy surgery
KW - histopathology
KW - outcome
KW - survey
KW - Seizures/epidemiology
KW - Age Factors
KW - Humans
KW - Child, Preschool
KW - Temporal Lobe/diagnostic imaging
KW - Male
KW - Treatment Outcome
KW - Electroencephalography
KW - Epilepsy/epidemiology
KW - Magnetic Resonance Imaging
KW - Europe/epidemiology
KW - Neurosurgery/statistics & numerical data
KW - Adolescent
KW - Female
KW - Retrospective Studies
KW - Child
KW - Neurosurgical Procedures/statistics & numerical data
UR - https://www.scopus.com/pages/publications/85077375830
U2 - 10.1111/epi.16414
DO - 10.1111/epi.16414
M3 - Article
C2 - 31876960
AN - SCOPUS:85077375830
SN - 0013-9580
VL - 61
SP - 216
EP - 227
JO - Epilepsia
JF - Epilepsia
IS - 2
ER -