Defining benchmark outcomes for mesial temporal lobe epilepsy surgery: A global multicenter analysis of 1119 cases

作者：Richard Drexler, Franz Ricklefs, Sharona Ben‐Haim, Anna Rada, Friedrich G. Wörmann, Thomas Cloppenborg, Christian G. Bien, Matthias Simon, Thilo Kalbhenn, Albert Colon, Kim Rijkers, Olaf Schijns, Valeri Borger, Rainer Surges, Hartmut Vatter, Michele Rizzi, Marco de Curtis, Giuseppe Didato, Nicolò Castelli, Alexandre Carpentier, Bertrand Mathon, Clarissa Lin Yasuda, Fernando Cendes, P. Sarat Chandra, Manjari Tripathi, Hans Clusmann, Daniel Delev, Marc Guénot, Claire Haegelen, Hélène Catenoix, Johannes Lang, Hajo M. Hamer, Sebastian Brandner, Katrin Walther, Jason S. Hauptmann, Rosalind L. Jeffree, Josua Kegele, Eliane Weinbrenner, Georgios Naros, Julia Velz, Niklaus Krayenbühl, Julia Onken, Ulf C. Schneider, Martin Holtkamp, Karl Rössler, Andrea Spyrantis, Adam Strzelczyk, Felix Rosenow, Stefan Stodieck, Mario Alonso‐Vanegas, Jörg Wellmer, Tim Wehner, Lasse Dührsen, Jens Gempt, Thomas Sauvigny · 发表于：Epilepsia · 年份：2024 · DOI：10.1111/epi.17923 · 被引用次数：9 · 研究领域：Epilepsy research and treatment、Pharmacological Effects and Toxicity Studies、Head and Neck Surgical Oncology

OBJECTIVE: Benchmarking has been proposed to reflect surgical quality and represents the highest standard reference values for desirable results. We sought to determine benchmark outcomes in patients after surgery for drug-resistant mesial temporal lobe epilepsy (MTLE). METHODS: This retrospective multicenter study included patients who underwent MTLE surgery at 19 expert centers on five continents. Benchmarks were defined for 15 endpoints covering surgery and epilepsy outcome at discharge, 1 year after surgery, and the last available follow-up. Patients were risk-stratified by applying outcome-relevant comorbidities, and benchmarks were calculated for low-risk ("benchmark") cases. Respective measures were derived from the median value at each center, and the 75th percentile was considered the benchmark cutoff. RESULTS: A total of 1119 patients with a mean age (range) of 36.7 (1-74) years and a male-to-female ratio of 1:1.1 were included. Most patients (59.2%) underwent anterior temporal lobe resection with amygdalohippocampectomy. The overall rate of complications or neurological deficits was 14.4%, with no in-hospital death. After risk stratification, 377 (33.7%) benchmark cases of 1119 patients were identified, representing 13.6%-72.9% of cases per center and leaving 742 patients in the high-risk cohort. Benchmark cutoffs for any complication, clinically apparent stroke, and reoperation rate at discharge were ≤24.6%, ≤.5%, and ≤3.9%, respectively. A favorable seizure outco...