Prognostic value of normal sodium levels in patients with metastatic renal cell carcinoma receiving tyrosine kinase inhibitors

作者：Giandomenico Roviello, Martina Catalano, Ugo De Giorgi, Marco Maruzzo, Sebastiano Buti, Elisabetta Gambale, Giuseppe Procopio, Carlotta Ottanelli, Enrico Caliman, Luca Isella, Pierangela Sepe, Nicole Brighi, Matteo Santoni, Luca Galli, Raffaele Conca, Laura Doni, Lorenzo Antonuzzo · 发表于：Frontiers in Oncology · 年份：2022 · DOI：10.3389/fonc.2022.918413 · 被引用次数：13 · 研究领域：Electrolyte and hormonal disorders、Sodium Intake and Health、Ion Transport and Channel Regulation

Background Although serum sodium concentration, particularly hyponatremia, has been shown to be a prognostic marker of survival in metastatic renal cell carcinoma (mRCC), the impact of normal sodium levels has not been investigated. Herein, we investigate the influence of normonatremia in mRCC patients treated with tyrosine kinase inhibitors (TKIs). Materials and methods For this retrospective study, the clinical and biochemical data of patients treated with first-line TKIs for mRCC were available from seven Italian cancer centers. We collected natremia levels at baseline and first evaluation after treatment excluding patients with sodium levels outside the normal range (<135 or >145 mEq/L). The remaining patients were subdivided into two groups according to the median sodium value: natremia patients with <140 mEq/L (n = 132) and baseline natremia patients with ≥140 mEq/L (n = 185). Subsequently, we analyzed the impact of sodium levels on response rate (RR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). PFS and OS were estimated through the Kaplan–Meier method, and differences between groups were examined by the log-rank test. Univariate and multivariate Cox regression analyses were applied to evaluate the prognostic factors for PFS and OS. Results Of the 368 patients, 317 were included in the analysis, 73.1% were men, and the median age was 67 years (range 36–89). When comparing patients with baseline natremia ≥140 mEq/L (n = 185) to...