TY - JOUR
T1 - Trends in pediatric epilepsy surgery in Europe between 2008 and 2015
T2 - Country-, center-, and age-specific variation
AU - European Survey Group
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 - Wiley Periodicals, Inc. © 2019 International League Against Epilepsy.
PY - 2019/12/26
Y1 - 2019/12/26
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.
U2 - 10.1111/epi.16414
DO - 10.1111/epi.16414
M3 - Article
C2 - 31876960
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
ER -