The occurrence of hyponatremia and its importance as a prognostic factor in a cross-section of cancer patients

BMC Cancer

Research Article

Jorge J. Castillo¹  Lois E. Lamerato²  Ilya G. Glezerman³  Joseph Chiodo⁴  Susan H. Boklage⁴  Kathy L. Schulman⁵  Beni A. Tidwell⁵ 

[1] Dana-Farber Cancer Institute, 450 Brookline Ave, M221, 02215, Boston, MA, USA;Henry Ford Health System, Detroit, USA;Memorial Sloan-Kettering Cancer Center, New York, NY, USA;Otsuka America Pharmaceutical, Inc, Princeton, NJ, USA;Outcomes Research Solutions, Inc, Waltham, MA, USA;

关键词: Hyponatremia;    Euvolemic;    Hypervolemic;    Cancer;    Survival;   

DOI  :  10.1186/s12885-016-2610-9

 received in 2016-04-12, accepted in 2016-07-25,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHyponatremia is prognostic of higher mortality in some cancers but has not been well studied in others. We used a longitudinal design to determine the incidence and prognostic importance of euvolemic and hypervolemic hyponatremia in patients following diagnosis with lymphoma, breast (BC), colorectal (CRC), small cell lung (SCLC), or non-small cell lung cancer (NSCLC).MethodsMedical record and tumor registry data from two large integrated delivery networks were combined for patients diagnosed with lymphoma, BC, CRC, or lung cancers (2002–2010) who had ≥1 administration of radiation/chemotherapy within 6 months of diagnosis and no evidence of hypovolemic hyponatremia. Hyponatremia incidence was measured per 1000 person-years (PY). Cox proportional hazard models assessed the prognostic value of hyponatremia as a time-varying covariate on overall survival (OS) and progression-free survival (PFS).ResultsHyponatremia incidence (%, rate) was 76 % each, 1193 and 2311 per 1000 PY, among NSCLC and SCLC patients, respectively; 37 %, 169 in BC; 64 %, 637 in CRC, and 60 %, 395 in lymphoma. Hyponatremia was negatively associated with OS in BC (HR 3.7; P = <.01), CRC (HR 2.4; P < .01), lung cancer (HR 2.4; P < .01), and lymphoma (HR 4.5; P < .01). Hyponatremia was marginally associated with shorter PFS (HR 1.3, P = .07) across cancer types.ConclusionsThe incidence of hyponatremia is higher than previously reported in lung cancer, is high in lymphoma, BC, and CRC and is a negative prognostic indicator for survival. Hyponatremia incidence in malignancy may be underestimated. The effects of hyponatremia correction on survival in cancer patients require further study.

【 授权许可】

CC BY   
© The Author(s). 2016