{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:17:04Z","timestamp":1788599824177,"version":"build-2803163510"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pro-tumorigenic electrochemical synapses between neurons and brain tumour cells in preclinical studies suggest unfavourable effects of epilepsy on patient survival. We investigated associations of epilepsy and survival in three cohorts of brain tumour patients (meningioma, glioblastoma and brain metastases). Cohorts were segregated into three groups for comparative analyses: (i) no epilepsy; (ii) epilepsy without status epilepticus; and (iii) status epilepticus. Status epilepticus was considered a surrogate of extensive neuronal hyperexcitability. The main outcome was progression-free survival (meningioma) and overall survival (glioblastoma and brain metastases), adjusted for established prognostic factors and onset of epilepsy by time-dependent multivariate Cox modelling. The primary analysis population comprised 1792 patients (742 meningioma, 249 glioblastoma, 801 brain metastases). Epilepsy was associated with favourable prognostic factors. However, on multivariate analyses, status epilepticus was associated with inferior overall survival of patients with glioblastoma [status epilepticus versus no epilepsy multivariate hazard ratio (HR) 3.72, confidence interval (CI) 1.78\u20137.76, P &amp;lt; 0.001] and brain metastases (status epilepticus versus no epilepsy HR 2.30, CI 1.10\u20134.79, P = 0.026). Among brain metastases patients, but not among patients with meningioma or glioblastoma, epilepsy was similarly associated with inferior overall survival (epilepsy versus no epilepsy HR 2.16, CI 1.60\u20132.93, P &amp;lt; 0.001). We conclude that epilepsy may convey inferior survival of patients with malignant brain tumours.<\/jats:p>","DOI":"10.1093\/brain\/awab188","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T19:53:47Z","timestamp":1620330827000},"page":"3322-3327","source":"Crossref","is-referenced-by-count":35,"title":["Survival of brain tumour patients with epilepsy"],"prefix":"10.1093","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0571-9423","authenticated-orcid":false,"given":"Maximilian","family":"Mastall","sequence":"first","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9024-8736","authenticated-orcid":false,"given":"Fabian","family":"Wolpert","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothee","family":"Gramatzki","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Imbach","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Schmick","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hertler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1748-174X","authenticated-orcid":false,"given":"Michael","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6254-4204","authenticated-orcid":false,"given":"Hans-Georg","family":"Wirsching","sequence":"additional","affiliation":[{"name":"Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University and University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"issue":"7775","key":"2021121702003444800_awab188-B1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1038\/s41586-019-1576-6","article-title":"Synaptic proximity enables NMDAR signalling to promote brain metastasis","volume":"573","author":"Zeng","year":"2019","journal-title":"Nature"},{"issue":"7775","key":"2021121702003444800_awab188-B2","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1038\/s41586-019-1563-y","article-title":"Electrical and synaptic integration of glioma into neural circuits","volume":"573","author":"Venkatesh","year":"2019","journal-title":"Nature"},{"issue":"7775","key":"2021121702003444800_awab188-B3","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1038\/s41586-019-1564-x","article-title":"Glutamatergic synaptic input to glioma cells drives brain tumour progression","volume":"573","author":"Venkataramani","year":"2019","journal-title":"Nature"},{"issue":"9","key":"2021121702003444800_awab188-B4","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/S1470-2045(12)70266-8","article-title":"Epilepsy meets cancer: When, why, and what to do about it?","volume":"13","author":"Weller","year":"2012","journal-title":"Lancet Oncol"},{"key":"2021121702003444800_awab188-B5","first-page":"v1","article-title":"CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016","author":"Ostrom","year":"2019"},{"key":"2021121702003444800_awab188-B6","first-page":"1002","article-title":"Predicting outcome of epilepsy after meningioma resection","author":"Wirsching","year":"2016"},{"issue":"6","key":"2021121702003444800_awab188-B7","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1093\/annonc\/mdy106","article-title":"Bevacizumab may improve quality of life, but not overall survival in glioblastoma: An epidemiological study","volume":"29","author":"Gramatzki","year":"2018","journal-title":"Ann Oncol"},{"key":"2021121702003444800_awab188-B8","first-page":"1073","article-title":"Glioblastoma in adults: A Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions","author":"Wen","year":"2020"},{"key":"2021121702003444800_awab188-B9","first-page":"718","article-title":"Risk factors for the development of epilepsy in patients with brain metastases","author":"Wolpert","year":"2020"},{"issue":"6","key":"2021121702003444800_awab188-B10","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization classification of tumors of the central nervous system: A summary","volume":"131","author":"Louis","year":"2016","journal-title":"Acta Neuropathol"},{"issue":"4","key":"2021121702003444800_awab188-B11","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/epi.12550","article-title":"ILAE official report: A practical clinical definition of epilepsy","volume":"55","author":"Fisher","year":"2014","journal-title":"Epilepsia"},{"issue":"10","key":"2021121702003444800_awab188-B12","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1111\/epi.13121","article-title":"A definition and classification of status epilepticus\u2013Report of the ILAE Task Force on Classification of Status Epilepticus","volume":"56","author":"Trinka","year":"2015","journal-title":"Epilepsia"},{"key":"2021121702003444800_awab188-B13","first-page":"700","article-title":"Prognostic relevance of epilepsy at presentation in glioblastoma patients","author":"Berendsen","year":"2016"},{"issue":"1","key":"2021121702003444800_awab188-B14","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/neuonc\/now190","article-title":"Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials","volume":"19","author":"Avila","year":"2017","journal-title":"Neuro Oncol"},{"key":"2021121702003444800_awab188-B15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.seizure.2016.12.012","article-title":"Epilepsy-related brain tumors","volume":"44","author":"Ert\u00fcrk \u00c7etin","year":"2017","journal-title":"Seizure"}],"container-title":["Brain"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/brain\/advance-article-pdf\/doi\/10.1093\/brain\/awab188\/40494980\/awab188.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/brain\/article-pdf\/144\/11\/3322\/41794497\/awab188.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/brain\/article-pdf\/144\/11\/3322\/41794497\/awab188.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T02:01:29Z","timestamp":1639706489000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/brain\/article\/144\/11\/3322\/6273580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,11]]},"references-count":15,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,5,11]]},"published-print":{"date-parts":[[2021,12,16]]}},"URL":"https:\/\/doi.org\/10.1093\/brain\/awab188","relation":{},"ISSN":["0006-8950","1460-2156"],"issn-type":[{"value":"0006-8950","type":"print"},{"value":"1460-2156","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,5,11]]}}}