Open surgery or laser interstitial thermal therapy for low-grade epilepsy-associated tumors of the temporal lobe: A single-institution consecutive series

•This series compares open resection to MRgLITT for temporal LEATs.•Of 14 patients, 7 had 9 resections, 6 had MRgLITT, and 1 had both.•Seizure freedom at one year was 50% (5/10) for resection and 57% (4/7) for MRgLITT.•MRgLITT patients had shorter length of stay and milder adverse events.•In comparable patients, MRgLITT had fewer and milder neuropsychological declines. Outcomes of treating low-grade epilepsy-associated tumors (LEATs) in the temporal lobe with MRI-guided laser interstitial thermal therapy (MRgLITT) remain poorly characterized. This study aimed to compare the safety and effectiveness of treating temporal lobe LEATs with MRgLITT versus open resection in a consecutive single-institution series. We reviewed all adult patients with epilepsy that underwent surgery for temporal lobe LEATs at our institution between 2002 and 2019, during which time we switched from open surgery to MRgLITT. Surgical outcome was categorized by Engel classification at >12mo follow-up and Kaplan–Meir analysis of seizure freedom. We recorded hospital length of stay, adverse events, and available neuropsychological results. Of 14 total patients, 7 underwent 9 open resections, 6 patients underwent MRgLITT alone, and 1 patient underwent an open resection followed by MRgLITT. Baseline group demographics differed and were notable for preoperative duration of epilepsy of 9.0 years (range 1–36) for open resection versus 14.0 years (range 2–34) for MRgLITT. Median length of stay was one day shorter for MRgLITT compared to open resection (p=