Association of Hyponatremia With Survival in Patients With Castration-resistant Prostate Cancer: A Clinical Commentary

Clin Genitourin Cancer. 2019 Dec;17(6):e1188-e1192. doi: 10.1016/j.clgc.2019.08.001. Epub 2019 Aug 20.

Abstract

Introduction: The aim of this study was to evaluate the prognostic value of hyponatremia in patients with castration-resistant prostate cancer (CRPC) undergoing docetaxel chemotherapy.

Patients and methods: We retrospectively assessed 186 patients who received docetaxel chemotherapy in addition to androgen deprivation for CRPC between 2005 and 2015. We stratified the patients according to their pre-chemotherapy serum sodium level. Hyponatremia was defined as sodium < 135 mmol/L. A Cox proportional regression model was used to estimate overall survival (OS).

Results: The median sodium level was 139 mmol/L (interquartile range, 137-141 mmol/L). Hyponatremia was detected in 13 (6.9%) patients. One-half of the patients died during the studied period. The presence of hyponatremia was associated with a decreased probability of OS (hazard ratio, 2.5; 95% confidence interval, 1.0-6.3; P = .04) in univariate analysis. These findings could not be confirmed in the multivariable OS model (P = .21).

Conclusion: We observed an association between hyponatremia and worse survival outcomes in our patients with CRPC undergoing docetaxel chemotherapy. However, further well-designed studies with full workup of hyponatremia are needed to validate these findings and to identify the underlying causes for this association in patients with CRPC.

Keywords: Hyponatremia; Prognostic; Prostate cancer; Survival.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Docetaxel / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Hyponatremia / blood
  • Hyponatremia / diagnosis
  • Hyponatremia / epidemiology*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / drug therapy
  • Prostatic Neoplasms, Castration-Resistant / mortality*
  • Retrospective Studies
  • Sodium / blood*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Docetaxel
  • Sodium