Recommended Citation
Castillo JJ, Glezerman IG, Boklage SH, Chiodo J, 3rd, Tidwell BA, Lamerato LE, and Schulman KL. The occurrence of hyponatremia and its importance as a prognostic factor in a cross-section of cancer patients. BMC Cancer 2016; 16(1):564.
Document Type
Article
Publication Date
7-29-2016
Publication Title
BMC cancer
Abstract
BACKGROUND: Hyponatremia 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).
METHODS: Medical 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).
RESULTS: Hyponatremia 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.
CONCLUSIONS: The 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.
Medical Subject Headings
Adult; Aged; Breast Neoplasms; Carcinoma, Non-Small-Cell Lung; Chemoradiotherapy; Colorectal Neoplasms; Female; Humans; Hyponatremia; Incidence; Longitudinal Studies; Lung Neoplasms; Lymphoma; Male; Middle Aged; Neoplasms; Prognosis; Proportional Hazards Models; Retrospective Studies; Small Cell Lung Carcinoma; United States
PubMed ID
27473121
Volume
16
First Page
564
Last Page
564
