Prognostic Impact of Hypochloremia in Patients With Stage I to III Colorectal Cancer After Radical Resection

Abstract

BACKGROUND: Recent studies have suggested that electrolyte disorders might be a negative prognostic factor for some diseases. OBJECTIVE: The purpose of this study was to systematically evaluate the prognostic role of electrolyte disorders in patients with stage I to III colorectal cancer who received radical surgical resection. DESIGN: This study was retrospectively performed. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: Patients with colorectal cancer who underwent radical resection in between April 2007 and April 2014 were included. MAIN OUTCOME MEASURES: The Kaplan–Meier method was adopted to estimate the overall and disease-free survival with and without propensity score matching. RESULTS: In total, our study recruited 5089 eligible patients. In prematching analysis, patients with hypochloremia showed both shorter overall survival (HR = 0.943 (95% CI, 0.908–0.980); p = 0.003) and disease-free survival (HR = 0.957 (95% CI, 0.933–0.981); p < 0.001) than those with normal serum chloride levels. In postmatching analysis, 770 patients from each group were compared, and the results further confirmed that hypochloremia was significantly associated with worse overall survival (HR = 0.646 (95% CI, 0.489–0.855); p = 0.002) and disease-free survival (HR = 0.782 (95% CI, 0.647–0.944); p = 0.01), with the hypochloremia group as a reference. LIMITATIONS: The study was limited by its retrospective nature. CONCLUSIONS: Hypochloremia diagnosed before treatment can independently prognosticate the overall and disease-free survival for patients with stage I to Ш colorectal cancer after radical resection. Intensive surveillance and management might improve the survival outcome for patients with hypochloremia. See Video Abstract at http://links.lww.com/DCR/A727.

Electrolyte and Renal Disorders in Patients with Newly Diagnosed Glioblastoma

“…The authors found a higher in-hospital mortality in patients with electrolyte disorders compared to patients with normal electrolytes (8). In another investigation among 5,089 patients with colorectal cancer, hypochloremia was associated with a worse overall survival and shorter disease-free survival (9). This study detected hypochloremia to be an independent prognostic factor for OS and 1-YS in GBM patients and is well in line with previous results.…”

“…Several recent studies additionally suggest that electrolyte disorders might be associated with a worse prognosis in a variety of malignancies (8), e.g. in colorectal cancer (9), lung cancer (10) and lymphoma (11,12). To date, data on prevalence and eventual clinical impact of preoperative disturbances in serum electrolytes and renal parameters in GBM patients is scarce.…”

Electrolyte and renal disorders in patients with newly diagnosed glioblastoma

“…The authors found a higher in-hospital mortality in patients with electrolyte disorders compared to patients with normal electrolytes (8). In another investigation among 5,089 patients with colorectal cancer, hypochloremia was associated with a worse overall survival and shorter disease-free survival (9). This study detected hypochloremia to be an independent prognostic factor for OS and 1-YS in GBM patients and is well in line with previous results.…”

“…Several recent studies additionally suggest that electrolyte disorders might be associated with a worse prognosis in a variety of malignancies (8), e.g. in colorectal cancer (9), lung cancer (10) and lymphoma (11,12). To date, data on prevalence and eventual clinical impact of preoperative disturbances in serum electrolytes and renal parameters in GBM patients is scarce.…”

Impact of hypochloremia in resected colorectal cancer patients

“…It is a great honor to comment on the article entitled "Prognostic impact of hypochloremia in patients with stage I to III colorectal cancer after radical resection" by Qingguo Li and his colleagues in the Diseases of Colon and Rectum (1).…”