Abstract
Objective: Hyponatremia and hypernatremia are common electrolyte abnormalities in patients with malignancy and have been independently associated with worse survival outcomes. To date, there are no data on the impact of dysnatremia on survival outcomes in patients with neuroendocrine neoplasms (NENs). Design: This study involves retrospective cohort analysis from a tertiary care center of NEN patients treated with peptide receptor radionuclide therapy (PRRT) with a cumulative activity of at least 3.7 GBq 177Lu-DOTATATE between the years 2000 and 2015. Methods: Comparison of overall survival of patients with the occurrence of hyponatremia (serum sodium < 135 mmol/L) or hypernatremia (serum sodium > 145 mmol/L) before starting or during PRRT was perfomed. Results: A total of 649 patients were included. Hyponatremia occurred in 57 patients during the observation period and was associated with a shorter median overall survival (95% CI) of 25 months (14-36) compared to 55 months (48-61) of the 512 normonatremic patients (P < 0.001), adjusted hazard ratio (HR): 1.48 (95% CI: 1.04-2.12). Overall survival time was reduced regardless of whether hyponatremia was present at baseline or during PRRT. In contrast, hypernatremia occurred in 80 patients and was associated with a longer median overall survival (95% CI) of 94 months (47-140) compared with the 512 normonatremic patients (P = 0.018), adjusted HR: 0.61 (95% CI: 0.40-0.92). This association was driven by the patients with hypernatremia during PRRT. No association between dysnatremia and progression-free survival after PRRT was observed. Conclusions: The occurrence of hypo- or hypernatremia in PRRT-treated NET patients is associated with opposing outcomes with regard to overall survival. Sodium levels might have a prognostic role in these patients.
| Original language | English |
|---|---|
| Pages (from-to) | 209-217 |
| Number of pages | 9 |
| Journal | European Journal of Endocrinology |
| Volume | 187 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 2022 |
Bibliographical note
Funding Information:J R: supported by a grant from the Swiss National Science Foundation (P2BSP3-181720). T B: speaker fees, research support and advisory board AAA. N M: no disclosures. R F: research support 阀psen, Strongbridge and Corcept; speaker fees from HRA Pharma, Novartis, 阀psen. W W D H: research support AAA-Novartis, speaker fees from 阀psen, AAA-Novartis, advisory board AAA. J H: speaker fees from 阀psen, advisory board Novartis, 阀psen.
Funding Information:
J R: supported by a grant from the Swiss National Science Foundation (P2BSP3-181720). T B: speaker fees, research support and advisory board AAA. N M: no disclosures. R F: research support Ipsen, Strongbridge and Corcept; speaker fees from HRA Pharma, Novartis, Ipsen. W W D H: research support AAA-Novartis, speaker fees from Ipsen, AAA-Novartis, advisory board AAA. J H: speaker fees from Ipsen, advisory board Novartis, Ipsen.
Publisher Copyright:
© 2022 European Society of Endocrinology Printed in Great Britain.
