Ist die Hyponatriämie (HN) ein Prognosefaktor f̈r das Gesamtberleben der Patienten mit Lungenkarzinom?

Abstract

Hyponatremia is frequently observed on the basis of syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) in patients suffering from lung cancer. This electrolyte imbalance is associated with higher mortality and morbidity. If hyponatremia influences survival of lung cancer remains controversial. In the current study we retrospectively analysed if survival is directly impacted by hyponatremia and evaluated if hyponatremia is a prognostic marker for lung cancer. We analysed 2048 patients with lung cancer without and 97 (4.7%) with hyponatremia in a single center study (ELK Berlin/Tumor-Centre- Buch, Germany). Median survival in lung cancer with hyponatremia was reduced compared to normonatremic median survival (10.081.68 vs. 12.120.48 month, overall survival (OS) after 2 years was 24.4%5.8 vs. 30.8%1.3, p=0.08). Sodium levels below 125mmol/l were associated with reduced survival (OS (2 years) 11.8%6.9 vs. 34.3%8.5, p=0.12). Correction of plasma sodium above 138mmol/l was correlated to extended median survival (13.321.44 month, p=0.007) while median survival was only 5.16 month (p=0.007) if plasma sodium could not be elevated above 138mmol/l. The occurrence of hyponatremia was associated with advanced disease (tumor stage IIIb+IV, UICC version 7). These data suggest that hyponatremia can influence survival of patients with lung cancer. The degree of hyponatremia (lowest plasma sodium) and its normalization (maximal plasma sodium) can modify median survival. In summary, the data indicate that plasma sodium could be a relevant prognostic marker of survival for lung cancer. © Georg Thieme Verlag KG Stuttgart - New York.