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      Prophylactic AEDs Treatment for Patients With Supratentorial Meningioma Does Not Reduce the Rate of Perioperative Seizures: A Retrospective Single-Center Cohort Study


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          Meningiomas, the most common brain tumor, inevitably require surgical treatment. However, the efficacy of prophylactic antiepileptic drugs (AEDs), in reducing the frequency of new-onset seizures during the perioperative period remains controversial. To further clarify if prophylactic antiepileptic drug treatment for patients with meningioma had value, we reviewed the medical records of 186 supratentorial meningioma patients who were operated at our hospital between 2016 and 2018. SPSS 24.0 software was used for statistical analysis. The results of univariate analysis showed that factors including age, sex, the course of the disease (years), maximum cross-sectional area of the tumor, location of the tumor, multiple or single tumors, adjacent to the cortex, peritumoral brain edema, World Health Organization classification, and peritumoral adhesion were not associated with perioperative seizures ( P >0.05). Furthermore, the results of multivariate analysis revealed hydrocephalus (OR 4.87 P = 0.05) and non-skull base location (OR 1.88 P = 0.04) were significant risk factors for perioperative in-hospital seizures. Prophylactic valproic acid treatment did not contribute to the alleviation of perioperative seizures (OR 1.76 P = 0.04). However, Multivariate logistic regression analyses excluding the patients with seizures before operation confirmed prophylactic valproic acid treatment did not reduce the frequency of seizures during the perioperative period (OR 1.84 P = 0.04). Taken together, the data suggest that prophylactic valproic acid treatment for patients with supratentorial meningioma does not reduce the rate of perioperative seizures.

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          The 2007 WHO Classification of Tumours of the Central Nervous System

          The fourth edition of the World Health Organization (WHO) classification of tumours of the central nervous system, published in 2007, lists several new entities, including angiocentric glioma, papillary glioneuronal tumour, rosette-forming glioneuronal tumour of the fourth ventricle, papillary tumour of the pineal region, pituicytoma and spindle cell oncocytoma of the adenohypophysis. Histological variants were added if there was evidence of a different age distribution, location, genetic profile or clinical behaviour; these included pilomyxoid astrocytoma, anaplastic medulloblastoma and medulloblastoma with extensive nodularity. The WHO grading scheme and the sections on genetic profiles were updated and the rhabdoid tumour predisposition syndrome was added to the list of familial tumour syndromes typically involving the nervous system. As in the previous, 2000 edition of the WHO ‘Blue Book’, the classification is accompanied by a concise commentary on clinico-pathological characteristics of each tumour type. The 2007 WHO classification is based on the consensus of an international Working Group of 25 pathologists and geneticists, as well as contributions from more than 70 international experts overall, and is presented as the standard for the definition of brain tumours to the clinical oncology and cancer research communities world-wide.
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              An overview of meningiomas

              Meningiomas are the most common primary intracranial tumor. Important advances are occurring in meningioma research. These are expected to accelerate, potentially leading to impactful changes on the management of meningiomas in the near and medium term. This review will cover the histo- and molecular pathology of meningiomas, including recent 2016 updates to the WHO classification of CNS tumors. We will discuss clinical and radiographic presentation and therapeutic management. Surgery and radiotherapy, the two longstanding primary therapeutic modalities, will be discussed at length. In addition, data from prior and ongoing investigations of other treatment modalities, including systemic and targeted therapies, will be covered. This review will quickly update the reader on the contemporary management and future directions in meningiomas.

                Author and article information

                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                04 December 2020
                : 10
                [1] 1 Neurosurgical Department, Affiliated Hospital of Guizhou Medical University , Guiyang, China
                [2] 2 School of Public Health, Hangzhou Medical College , Hangzhou, China
                [3] 3 Department of Cardiology, Affiliated Hospital of Hangzhou Normal University , Hangzhou, China
                [4] 4 The Medical Function Laboratory of Experimental Teaching Center of Basic Medicine, Guizhou Medical University , Guiyang, China
                [5] 5 Neurological Department, Affiliated Hospital of Zunyi Medical University , Zunyi, China
                [6] 6 Neurological Department, Affiliated Hospital of Guizhou Medical University , Guiyang, China
                [7] 7 Neurological Department, The First Affiliated Hospital of Chengdu Medical College , Chengdu, China
                Author notes

                Edited by: Hailiang Tang, Huashan Hospital Affiliated to Fudan University, China

                Reviewed by: Quan Cheng, Central South University, China; Subhas K. Konar, National Institute of Mental Health and Neurosciences (NIMHANS), India

                *Correspondence: Zhan-Hui Feng, h9450203@ 123456126.com ; Xun-Tai Ma, maxuntai2002@ 123456126.com

                †These authors have contributed equally to this work

                This article was submitted to Neuro-Oncology and Neurosurgical Oncology, a section of the journal Frontiers in Oncology

                Copyright © 2020 Yang, Cheng, Zhou, Wang, Ye, Xu, Feng and Ma

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                : 01 June 2020
                : 03 November 2020
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 25, Pages: 8, Words: 3392
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Original Research

                Oncology & Radiotherapy
                seizure,operation,prophylactic treatment,antiepileptic drugs,supratentorial meningioma,non-skull base location


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