Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Itami Municipal Hospital, Itami, Hyogo, Japan.
Dig Dis Sci. 2021 May;66(5):1720-1729. doi: 10.1007/s10620-020-06380-6. Epub 2020 Jun 17.
Although the serum sodium level has been reported to be a prognostic and predictive marker for the therapeutic effects of lung cancer and renal cell carcinoma treated with molecular targeted therapy, the serum sodium level has not been investigated in hepatocellular carcinoma (HCC) patients treated with sorafenib. The aim of our analysis was to assess the prognostic role of serum sodium levels in these patients.
We retrospectively analyzed 341 HCC patients treated with sorafenib between 2009 and 2012 in our hospital and other related institutions.
A total of 178 patients were enrolled in this study. The median age was 72 years (44-88), and 148 patients (83%) were male. The median overall survival (OS) was 12.9 months, and the median time to progression (TTP) was 3.1 months. Hyponatremia (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.26-2.52), a lower sodium level (HR 1.57, 95% CI 1.07-2.80), and a high level of α-fetoprotein (AFP) (≥ 200 ng/mL) (HR 1.78, 95% CI 1.26-2.52) were independent prognostic factors for TTP. We also categorized the patients into three groups according to serum sodium and AFP levels: Group A (n = 39) (serum sodium > 140 mEq/L, AFP < 200 ng/mL), Group C (n = 58) (serum sodium ≤ 140 mEq/L, AFP ≥ 200 ng/mL), and Group B (n = 81) (other patients). Significantly longer TTP and OS were observed in the following order: Groups A, C, and B.
Serum sodium levels are associated with the effectiveness of sorafenib. The serum sodium level can predict the therapeutic effect of sorafenib in advanced HCC patients.
虽然血清钠水平已被报道为接受分子靶向治疗的肺癌和肾细胞癌患者的预后和预测标志物，但在接受索拉非尼治疗的肝细胞癌（HCC）患者中尚未研究血清钠水平。我们分析的目的是评估血清钠水平在这些患者中的预后作用。
我们回顾性分析了 2009 年至 2012 年期间在我院和其他相关机构接受索拉非尼治疗的 341 例 HCC 患者。
共有 178 例患者纳入本研究。中位年龄为 72 岁（44-88 岁），148 例（83%）为男性。中位总生存期（OS）为 12.9 个月，中位无进展生存期（TTP）为 3.1 个月。低钠血症（危险比（HR）1.78，95%置信区间（CI）1.26-2.52）、较低的钠水平（HR 1.57，95%CI 1.07-2.80）和高水平的甲胎蛋白（AFP）（≥200ng/mL）（HR 1.78，95%CI 1.26-2.52）是 TTP 的独立预后因素。我们还根据血清钠和 AFP 水平将患者分为三组：A 组（n=39）（血清钠>140mEq/L，AFP<200ng/mL），C 组（n=58）（血清钠≤140mEq/L，AFP≥200ng/mL）和 B 组（n=81）（其他患者）。TTP 和 OS 按以下顺序显著延长：A 组、C 组和 B 组。
血清钠水平与索拉非尼的疗效相关。血清钠水平可预测晚期 HCC 患者索拉非尼的治疗效果。
