Abstract
Previous works linked low sodium concentration with mortality risk in cancer. We aimed at weighing the prognostic impact of hyponatremia in all consecutive patients with metastatic solid tumors admitted in a two-years period at our medical oncology department. Patients were included in two cohorts based on serum sodium concentration on admission. A total of 1025 patients were included, of whom 279 (27.2%) were found to be hyponatremic. The highest prevalence of hyponatremia was observed in biliary tract (51%), prostate (45%) and small-cell lung cancer (38.9%). With a median follow-up of 26.9 months, median OS was 2 months and 13.2 months for the hyponatremia versus control cohort, respectively (HR, 2.65; P < 0.001). In the multivariable model, hyponatremia was independently associated with poorer OS (HR, 1.66; P < 0.001). According to the multivariable model, a nomogram system was developed and validated in an external set of patients. We weighed over time the influence of hyponatremia on survival of patients with metastatic solid tumors and pointed out the possibility to exploit serum sodium assessment to design integrated prognostic tools. Our study also highlights the need for a deeper characterization of the biological role of extracellular sodium levels in tumor development and progression.
Highlights
Previous works linked low sodium concentration with mortality risk in cancer
The highest prevalence of hyponatremia was observed in biliary tract cancer (BTC) (25 out of 49 patients, 51.0%), prostate cancer (PC) (9 out of 20 patients, 45.0%) and small cell lung cancer (SCLC) (14 out of 36 patients, 38.9%) (Table 1)
We investigated the prognostic impact of hyponatremia in a heterogeneous population of hospitalized patients with metastatic or relapsed solid tumors admitted to a tertiary medical oncology department in a two-years period
Summary
We aimed at weighing the prognostic impact of hyponatremia in all consecutive patients with metastatic solid tumors admitted in a two-years period at our medical oncology department. We weighed over time the influence of hyponatremia on survival of patients with metastatic solid tumors and pointed out the possibility to exploit serum sodium assessment to design integrated prognostic tools. Hyponatremia, as defined by a serum sodium concentration lower than 135 mEq/L, is the electrolyte alteration most frequently found in hospitalized patients, and a common finding at admission in Oncology Units[1,2]. Previous studies showed an association between hyponatremia and poor patients’ survival in the metastatic setting[11,18,19,20], the conclusions of these studies are intrinsically biased by small sample size, inclusion of patients with different www.nature.com/scientificreports/. We aimed at weighing the prognostic impact of hyponatremia in a large cohort of hospitalized patients with advanced solid tumors
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