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This tool estimates the risk of seizure recurrence and Chance of an Occurrence of a Seizure in the next Year (COSY) following frontal lobectomy surgery for tumor-related epilepsy. It is intended to support clinicians in assessing individualized recurrence risks and guiding postoperative care decisions for patients undergoing this procedure.

Variables Used:

Frontal Lobectomy Surgery:

This variable defines whether a patient underwent a frontal lobectomy (Yes/No). Surgery outcomes were analyzed in the context of tumor-related epilepsy in low-grade glial or glioneuronal tumors.

Further Variables not included in the prediction model:

Frontal lobectomy outcomes are influenced by several critical factors. Tumor type plays a significant role, with included cases involving low-grade glial or glioneuronal tumors such as oligodendrogliomas (50.4%), astrocytomas, gangliogliomas, and dysembryoplastic neuroepithelial tumors (DNETs). The extent of resection (EOR) is a pivotal variable, as gross total resection (GTR) is associated with significantly higher odds of seizure freedom (OR = 8.77, 95% CI: 1.99–47.91, p = 0.006). Additionally, awake surgery, often performed for tumors near eloquent brain areas, is another positive predictive factor for seizure freedom (OR = 9.94, 95% CI: 1.93–87.81, p = 0.015). The time interval post-surgery, measured in months, allows tracking of the probability of seizure freedom over periods of up to 120 months, providing a longitudinal perspective on surgical outcomes.

Outputs:

Risk of Seizure Recurrence: Provides individualized seizure recurrence risk estimates over time after a frontal lobectomy.

• Example: After surgery, 92.6% of patients remained seizure-free at three months, and 85.5% remained seizure-free at 27.3 months.

COSY: Highlights the dynamic chance of seizure probability following surgery.