Skip to main content
Erschienen in: Supportive Care in Cancer 4/2019

08.11.2018 | Original Article

The prognostic and predictive role of hyponatremia in patients with advanced non-small cell lung cancer (NSCLC) with bone metastases

Erschienen in: Supportive Care in Cancer | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Hyponatremia and bone metastasis (BMs) are known as negative prognostic factors in patients affected by metastatic non-small cell lung cancer (NSCLC). Hyponatremia is associated with higher risk of osteoporosis and bone fracture, but no data are available about the relationship between hyponatremia and bone metastasis. This study aims to analyze the prognostic impact of hyponatremia in NSCLC patients with bone metastases.

Methods

We retrospectively collected data about advanced NSCLC patients. Survival curves were estimated using Kaplan–Meier method, and comparisons were made using chi-square test.

Results

Six hundred forty-seven patients were enrolled into the study. BMs were present in 264 patients (41%) at diagnosis, while hyponatremia appeared in 237 (37%) patients during the first-line treatment. Patients without BMs had a median overall survival (mOS) of 15.9 months (95% CI 14.1–17.9) versus 11.4 months (95% CI 9.4–13.4) for patients with BMs (p = 0.001). Eunatremic patients had a better outcome (mOS 16.3 months, 95% CI 14.6–18.0 vs 10.3 months, 95% I 7.6–12.8, p = 0.003). Considering the two variables, patients with BMs and hyponatremia had a mOS of 10.1 months (95% CI 4.3–15.9), patients with hyponatremia without BMs 11.9 months (95% CI 11.4–12.4), while mOS was 13.1 months (95% CI 12.0–14.2) for eunatremic patients with BMs versus 17.1 months (95% CI 15.2–19.1) in eunatremic patients without BMs (p = 0.0020). Hyponatremic patients developed metachronous BMs significantly earlier (3.73 vs 5.76 months, p = 0.0187).

Conclusions

Our study showed that hyponatremia is an important prognostic factor and it should be necessarily considered to enhance the management of NSCLC patients with BMs.
Literatur
2.
Zurück zum Zitat Novello S, Barlesi F, Califano R, Cufer T, Ekman S, Levra MG, Kerr K, Popat S, Reck M, Senan S, Simo GV, Vansteenkiste J, Peters S, Guidelines Committee ESMO (2016) Metastatic non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. AnnOncol 27(suppl 5):v1–v27. https://doi.org/10.1093/annonc/mdw326 CrossRef Novello S, Barlesi F, Califano R, Cufer T, Ekman S, Levra MG, Kerr K, Popat S, Reck M, Senan S, Simo GV, Vansteenkiste J, Peters S, Guidelines Committee ESMO (2016) Metastatic non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. AnnOncol 27(suppl 5):v1–v27. https://​doi.​org/​10.​1093/​annonc/​mdw326 CrossRef
3.
Zurück zum Zitat Janssen-Heijnen ML, van Erning FN, de Ruysscher DK,Coebergh JW, Groen HJ (2015) Variation in causes of death in patients with non-small cell lung cancer according to stage and time since diagnosis. Ann Oncol 26: 902–907. https://doi.org/10.1093/annonc/mdv061 Janssen-Heijnen ML, van Erning FN, de Ruysscher DK,Coebergh JW, Groen HJ (2015) Variation in causes of death in patients with non-small cell lung cancer according to stage and time since diagnosis. Ann Oncol 26: 902–907. https://​doi.​org/​10.​1093/​annonc/​mdv061
7.
Zurück zum Zitat Berenson J, Rajdev L, Broder M (2006) Managing bone complications of solid tumors. Cancer Biol Ther 5:1086–1089PubMedCrossRef Berenson J, Rajdev L, Broder M (2006) Managing bone complications of solid tumors. Cancer Biol Ther 5:1086–1089PubMedCrossRef
13.
Zurück zum Zitat Sørensen JB, Andersen MK, Hansen HH (1955) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med 238:97–110CrossRef Sørensen JB, Andersen MK, Hansen HH (1955) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med 238:97–110CrossRef
15.
Zurück zum Zitat Berardi R, Santoni M, Newsom-Davis T, Caramanti M, Rinaldi S, Tiberi M, Morgese F, Torniai M, Pistelli M, Onofri A, Bower M, Cascinu S (2016) Hyponatremia normalization as an independent prognostic factor in patients with advanced non-small cell lung cancer treated with first-line therapy. Oncotarget 8:13372. https://doi.org/10.18632/oncotarget.13372 CrossRef Berardi R, Santoni M, Newsom-Davis T, Caramanti M, Rinaldi S, Tiberi M, Morgese F, Torniai M, Pistelli M, Onofri A, Bower M, Cascinu S (2016) Hyponatremia normalization as an independent prognostic factor in patients with advanced non-small cell lung cancer treated with first-line therapy. Oncotarget 8:13372. https://​doi.​org/​10.​18632/​oncotarget.​13372 CrossRef
22.
Zurück zum Zitat Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A 3rd, Goldstraw P, Rami-Porta R (2015) International Association for Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Board Members, and Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 10(11):1515–1522. https://doi.org/10.1097/JTO.0000000000000673 PubMedCrossRef Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A 3rd, Goldstraw P, Rami-Porta R (2015) International Association for Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Board Members, and Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 10(11):1515–1522. https://​doi.​org/​10.​1097/​JTO.​0000000000000673​ PubMedCrossRef
24.
Zurück zum Zitat Mickey RM, Greenland S (1989) The impact of confounder selection criteria on effect estimation. Am J Epidemiol 129:125–137PubMedCrossRef Mickey RM, Greenland S (1989) The impact of confounder selection criteria on effect estimation. Am J Epidemiol 129:125–137PubMedCrossRef
27.
Zurück zum Zitat Quint LE, Tummala S, Brisson LJ, Francis IR, Krupnick AS, Kazerooni EA, Iannettoni MD, Whyte RI, Orringer MB (1996) Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann Thorac Surg 62:246–250PubMedCrossRef Quint LE, Tummala S, Brisson LJ, Francis IR, Krupnick AS, Kazerooni EA, Iannettoni MD, Whyte RI, Orringer MB (1996) Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann Thorac Surg 62:246–250PubMedCrossRef
29.
Zurück zum Zitat Kosteva J, Langer C (2004) Incidence and distribution of skeletal metastases in NSCLC in the era of PET. Lung Cancer 46(Suppl 1):S45 Kosteva J, Langer C (2004) Incidence and distribution of skeletal metastases in NSCLC in the era of PET. Lung Cancer 46(Suppl 1):S45
31.
Zurück zum Zitat Santini D, Barni S, Intagliata S, Falcone A, Ferraù F, Galetta D, Moscetti L, La Verde N, Ibrahim T, Petrelli F, Vasile E, Ginocchi L, Ottaviani D, Longo F, Ortega C, Russo A, Badalamenti G, Collovà E, Lanzetta G, Mansueto G, Adamo V, De Marinis F, Satolli MA, Cantile F, Mancuso A, Tanca FM, Addeo R, Russano M, Sterpi M, Pantano F, Vincenzi B, Tonini G (2015) Natural history of non-small-cell lung cancer with bone metastases. Sci Rep 22(5):18670. https://doi.org/10.1038/srep18670 CrossRef Santini D, Barni S, Intagliata S, Falcone A, Ferraù F, Galetta D, Moscetti L, La Verde N, Ibrahim T, Petrelli F, Vasile E, Ginocchi L, Ottaviani D, Longo F, Ortega C, Russo A, Badalamenti G, Collovà E, Lanzetta G, Mansueto G, Adamo V, De Marinis F, Satolli MA, Cantile F, Mancuso A, Tanca FM, Addeo R, Russano M, Sterpi M, Pantano F, Vincenzi B, Tonini G (2015) Natural history of non-small-cell lung cancer with bone metastases. Sci Rep 22(5):18670. https://​doi.​org/​10.​1038/​srep18670 CrossRef
32.
Zurück zum Zitat Zhang L, Gong Z (2017) Clinical characteristics and prognostic factors in bone metastases from lung cancer. Med SciMonit 24(23):4087–4094 Zhang L, Gong Z (2017) Clinical characteristics and prognostic factors in bone metastases from lung cancer. Med SciMonit 24(23):4087–4094
38.
Metadaten
Titel
The prognostic and predictive role of hyponatremia in patients with advanced non-small cell lung cancer (NSCLC) with bone metastases
Publikationsdatum
08.11.2018
Erschienen in
Supportive Care in Cancer / Ausgabe 4/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4489-2

Weitere Artikel der Ausgabe 4/2019

Supportive Care in Cancer 4/2019 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.