Hyponatremia associates with poor outcome in metastatic renal cell carcinoma patients treated with everolimus: prognostic impact

Penttilä, Patrick; Bono, Petri; Peltola, Katriina; Donskov, Frede

doi:10.1080/0284186x.2018.1477256

Cited by 12 publications

(10 citation statements)

References 34 publications

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“…Recently, a study performed at two teaching hospitals in Italy and one teaching hospital in England demonstrated that serum [Na + ] normalization during first-line therapy is an independent prognostic factor for OS and PFS in patients with non-small cell lung cancer [37] . Similarly, normalization of serum [Na + ] was associated with a better prognosis in patients with metastatic RCC treated with everolimus [38] . These findings are in agreement with the results of a meta-analysis that analyzed articles reporting the outcome of patients with different diseases in which hyponatremia had been corrected.…”

Section: Why Is Hyponatremia Associated With a Worse Outcome In Cancementioning

confidence: 89%

Prognostic and predictive role of hyponatremia in cancer patients

Peri¹

2019

JCMT

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Hyponatremia is the most frequent electrolyte disorder encountered in hospitalized patients. Several studies have demonstrated that hyponatremia is a negative prognostic factor in different clinical scenarios. Noteworthy, not only severe and acute hyponatremia has been associated with an increased risk of mortality, but also moderate of even mild chronic hyponatremia may increase the risk of death. This has been demonstrated in different categories of patients, including cancer patients. There is growing evidence that both progression free survival and overall survival are significantly reduced in cancer patients with hyponatremia compared to patients with normonatremia. One important, and still open, question is whether the worse outcome associated with hyponatremia in cancer patients is directly attributable to the electrolyte disorder itself or might be a sign of the severity of the underlying disease. With regard to this point, some basic research studies suggested that low sodium concentration stimulates per se cancer cells proliferation and invasiveness. Recent clinical evidence appears to indicate that the correction of hyponatremia is an independent and favourable prognostic factor in cancer patients. Admittedly, robust confirmatory data from clinical practice are needed, in order to validate the hypothesis that cancer patients may die for hyponatremia and not just with hyponatremia.

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Section: Why Is Hyponatremia Associated With a Worse Outcome In Cancementioning

confidence: 89%

Prognostic and predictive role of hyponatremia in cancer patients

Peri¹

2019

JCMT

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“…Low sodium is associated with poor disease-free and overall survival after nephrectomy. It could act as a new independent prognostic and predictive factor in patients with mRCC 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Differential expression of epithelial sodium channels in human RCC associated with the prognosis and tumor stage: Evidence from integrate analysis

et al. 2020

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Background: Epithelial sodium channels are disputed in renal cell carcinoma, but its functions and effects on clinical outcomes are not well understood. Materials and Methods: IHC and PT-PCR were used to detect ENaCα, β, γ, AVPR2, AQP2, and MR expression in the primary tumor and peritumoral tissues. GEPIA online tool was used to analyze the relationship between epithelial sodium channels and clinical-pathological characteristics. Tumor IMmune Estimation Resource online tool was used to investigate the immune profile relevant to epithelial sodium channels expression. Results: Quantitative RT-PCR analysis revealed that ENaCα, β, γ, AQP2, and AVPR2 mRNA were decreased in the RCC, but there was no difference in MR mRNA expression between kidney and RCC ( p =0.238). The IHC analyses showed that the intensely positive staining of ENaCα, β, γ, AVPR2, and AQP in the renal tubular and the attenuated in the RCCs. MR displayed moderate staining in both RCC and normal tissue. With the promotion of staging, the expression of AQP2, AVPR2, and MR reduced gradually and predicted a better prognosis. Although ENaCα, β, and γ were unable to associate with staging, we still observed a high expression of ENaCβ and γ displayed a poorer prognosis of RCC. Conclusions: ENaCs shows an oncogene profile in RCC, drugs targeting epithelial sodium channel should be a possible therapeutic way to treat RCC. AVPR2 and MR exhibit an encouraging immunomodulatory function; patients with low expression of AVPR2 and MR may obtain more benefit from immunotherapy.

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“…Several earlier endeavors have shown the negative prognostic aspect of hyponatremia in a variety of cancers [19,20]. Yoon et al have also demonstrated a relation between hyponatremia and shorter survival time in terminally ill cancer patients [21].…”

Section: Discussionmentioning

confidence: 99%

Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study

Seo

Hwang

Jung

et al. 2020

Preprint

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Abstract Background Although palliative care providers, patients, and their familes rely heavily on accurate prognostication, the prognostic value of electrolyte imbalance has received little attention. Methods As a retrospective review, we screened inpatients with terminal cancer admitted between January 2017 and May 2019 to one hospice-palliative care unit. Clinical characteristics and laboratory results were obtained from medical records for multivariable Cox regression analysis of independant prognostic factors. Results Of the 487 patients who qualified, 15 (3%) were hypernatremic upon admission. Median survival time was 26 days. Parameters associated with shortened survival included male sex, advanced age (> 70 years), lung cancer, poor performance status, elevated inflammatory markers, azotemia, impaired liver function, and hypernatermia. In a multivariable Cox proportional hazards model, male sex (hazard ratio [HR]=1.53, 95% confidence interval [CI]: 1.15–2.04), poor performance status (HR=1.45, 95% CI: 1.09–1.94), leukocytosis (HR=1.98, 95% CI: 1.47–2.66), hypoalbuminemia (HR=2.06, 95% CI: 1.49–2.73) and hypernatremia (HR=1.55, 95% CI: 1.18–2.03) emerged as significant predictors of poor prognosis. Conclusion Hypernatremia may be a useful gauge of prognosis in patients with terminal cancer. Further corroborative studies of large scale and prospective design are needed.

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Hyponatremia associates with poor outcome in metastatic renal cell carcinoma patients treated with everolimus: prognostic impact

Abstract: Hyponatremia associates with poor outcome in mRCC patients treated with everolimus. On-treatment normalization of hyponatremia to normal sodium values associates with favorable outcome.

Cited by 12 publications

References 34 publications

Prognostic and predictive role of hyponatremia in cancer patients

Prognostic and predictive role of hyponatremia in cancer patients

Differential expression of epithelial sodium channels in human RCC associated with the prognosis and tumor stage: Evidence from integrate analysis

Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study

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