Hudson Z, Grosso F, Comins C and Alfredo Addeo
Objectives Malignant pleural mesothelioma (MPM) remains an incurable and with very poor outcome cancer. The median survival is 12 months with first line therapy; a median survival of 24 months at best when treated with multimodal approach (both neoadjuvant chemotherapy and surgery with or without radiation therapy or postoperative chemotherapy). Identifying a possible prognostic marker would seem imperative. Several studies, all with limited numbers of patients, have tried to find a possible valid and reliable prognostic marker. Univariate and multivariate analyses had been performed, yet the majority of the findings remain invalidated in other MPM populations. It has been recently shown that a reduction in serum sodium could have negative effects on hospitalization length, quality of life and prognosis in cancer patients. Materials and methods We therefore performed a retrospective single institute analysis to assess and possibly confirm the prognostic role of hyponatremia in MPM. Results The OS and the PFS in the hyponatremia group are inferior to the patients who had normal serum sodium level throughout the treatment. None of our patients presented with hyponatremia, but having sodium serum level <130 at some point during chemotherapy was a strong indicator of short PFS and a negative prognostic factor. The findings were similar in first and second line setting. Conclusion Further prospective, well designed trial, are warranted to better explore the impact of sodium correction on the PFS and OS of cancer patients and MPM.
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