Comparison of the real-world effectiveness of vertical versus lateral functional hemispherotomy techniques for pediatric drug-resistant epilepsy: A post hoc analysis of the HOPS study

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dc.contributor.authorFallah, Aria
dc.contributor.authorLewis, Evan
dc.contributor.authorIbrahim, George M.
dc.contributor.authorKola, Olivia
dc.contributor.authorTseng, Chi-Hong
dc.contributor.authorHarris, William B.
dc.contributor.authorChen, Jia-Shu
dc.contributor.authorLin, Kao-Min
dc.contributor.authorCai, Li-Xin
dc.contributor.authorLiu, Qing-Zhu
dc.contributor.authorLin, Jiu-Luan
dc.contributor.authorZhou, Wen-Jing
dc.contributor.authorMathern, Gary W.
dc.contributor.authorSmyth, Matthew D.
dc.contributor.authorO'Neill, Brent R.
dc.contributor.authorDudley, Roy W. R.
dc.contributor.authorRagheb, John
dc.contributor.authorBhatia, Sanjiv
dc.contributor.authorDelev, Daniel
dc.contributor.authorRamantani, Georgia
dc.contributor.authorZentner, Josef
dc.contributor.authorWang, Anthony C.
dc.contributor.authorDorfer, Christian
dc.contributor.authorFeucht, Martha
dc.contributor.authorCzech, Thomas
dc.contributor.authorBollo, Robert J.
dc.contributor.authorIssabekov, Galymzhan
dc.contributor.authorZhu, Hongwei
dc.contributor.authorConnolly, Mary
dc.contributor.authorSteinbok, Paul
dc.contributor.authorZhang, Jian-Guo
dc.contributor.authorZhang, Kai
dc.contributor.authorHidalgo, Eveline Teresa
dc.contributor.authorWeiner, Howard L.
dc.contributor.authorWong-Kisiel, Lily
dc.contributor.authorLapalme-Remis, Samuel
dc.contributor.authorTripathi, Manjari
dc.contributor.authorChandra, Poodipedi Sarat
dc.contributor.authorHader, Walter
dc.contributor.authorWang, Feng-Peng
dc.contributor.authorYao, Yi
dc.contributor.authorChampagne, Pierre-Olivier
dc.contributor.authorBrunette-Clement, Tristan
dc.contributor.authorGuo, Qiang
dc.contributor.authorLi, Shao-Chun
dc.contributor.authorBudke, Marcelo
dc.contributor.authorPerez-Jimenez, Maria Angeles
dc.contributor.authorRaftopoulos, Christian
dc.contributor.authorFinet, Patrice
dc.contributor.authorMichel, Pauline
dc.contributor.authorSchaller, Karl
dc.contributor.authorStienen, Martin N.
dc.contributor.authorBaro, Valentina
dc.contributor.authorMalone, Christian Cantillano
dc.contributor.authorPociecha, Juan
dc.contributor.authorChamorro, Noelia
dc.contributor.authorMuro, Valeria L.
dc.contributor.authorvon Lehe, Marec
dc.contributor.authorVieker, Silvia
dc.contributor.authorOluigbo, Chima
dc.contributor.authorGaillard, William D.
dc.contributor.authorAl-Khateeb, Mashael
dc.contributor.authorAl Otaibi, Faisal
dc.contributor.authorKrayenbuhl, Niklaus
dc.contributor.authorBolton, Jeffrey
dc.contributor.authorPearl, Phillip L.
dc.contributor.authorWeil, Alexander G.
dc.date.accessioned2025-01-20T22:08:58Z
dc.date.available2025-01-20T22:08:58Z
dc.date.issued2021
dc.description.abstractObjective This study was undertaken to determine whether the vertical parasagittal approach or the lateral peri-insular/peri-Sylvian approach to hemispheric surgery is the superior technique in achieving long-term seizure freedom. Methods We conducted a post hoc subgroup analysis of the HOPS (Hemispheric Surgery Outcome Prediction Scale) study, an international, multicenter, retrospective cohort study that identified predictors of seizure freedom through logistic regression modeling. Only patients undergoing vertical parasagittal, lateral peri-insular/peri-Sylvian, or lateral trans-Sylvian hemispherotomy were included in this post hoc analysis. Differences in seizure freedom rates were assessed using a time-to-event method and calculated using the Kaplan-Meier survival method. Results Data for 672 participants across 23 centers were collected on the specific hemispherotomy approach. Of these, 72 (10.7%) underwent vertical parasagittal hemispherotomy and 600 (89.3%) underwent lateral peri-insular/peri-Sylvian or trans-Sylvian hemispherotomy. Seizure freedom was obtained in 62.4% (95% confidence interval [CI] = 53.5%-70.2%) of the entire cohort at 10-year follow-up. Seizure freedom was 88.8% (95% CI = 78.9%-94.3%) at 1-year follow-up and persisted at 85.5% (95% CI = 74.7%-92.0%) across 5- and 10-year follow-up in the vertical subgroup. In contrast, seizure freedom decreased from 89.2% (95% CI = 86.3%-91.5%) at 1-year to 72.1% (95% CI = 66.9%-76.7%) at 5-year to 57.2% (95% CI = 46.6%-66.4%) at 10-year follow-up for the lateral subgroup. Log-rank test found that vertical hemispherotomy was associated with durable seizure-free progression compared to the lateral approach (p = .01). Patients undergoing the lateral hemispherotomy technique had a shorter time-to-seizure recurrence (hazard ratio = 2.56, 95% CI = 1.08-6.04, p = .03) and increased seizure recurrence odds (odds ratio = 3.67, 95% CI = 1.05-12.86, p = .04) compared to those undergoing the vertical hemispherotomy technique. Significance This pilot study demonstrated more durable seizure freedom of the vertical technique compared to lateral hemispherotomy techniques. Further studies, such as prospective expertise-based observational studies or a randomized clinical trial, are required to determine whether a vertical approach to hemispheric surgery provides superior long-term seizure outcomes.
dc.fuente.origenWOS
dc.identifier.doi10.1111/epi.17021
dc.identifier.eissn1528-1167
dc.identifier.issn0013-9580
dc.identifier.urihttps://doi.org/10.1111/epi.17021
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94316
dc.identifier.wosidWOS:000694979600001
dc.issue.numero11
dc.language.isoen
dc.pagina.final2718
dc.pagina.inicio2707
dc.revistaEpilepsia
dc.rightsacceso restringido
dc.subjecthemispherectomy
dc.subjecthemispherotomy
dc.subjectseizure outcomes
dc.subjecttechnique
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleComparison of the real-world effectiveness of vertical versus lateral functional hemispherotomy techniques for pediatric drug-resistant epilepsy: A post hoc analysis of the HOPS study
dc.typeartículo
dc.volumen62
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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