术前低钠血症在根治性切除胰腺癌患者中的作用。

The Role of Hyponatraemia Before Surgery in Patients With Radical Resected Pancreatic Cancer.

作者信息

Berardi Rossana, Rinaldi Silvia, Belfiori Giulio, Partelli Stefano, Crippa Stefano, Torniai Mariangela, Falconi Massimo

机构信息

Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - GM Lancisi - G Salesi di Ancona, Ancona, Italy.

Vita-Salute San Raffaele University, Milan, Italy.

出版信息

Clin Med Insights Oncol. 2020 Jun 26;14:1179554920936605. doi: 10.1177/1179554920936605. eCollection 2020.

DOI:10.1177/1179554920936605

PMID:32636693

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7322821/

Abstract

OBJECTIVES

Hyponatraemia represents a negative prognostic factor in patients with cancer. The aim of this study was to assess, for the first time, the role of hyponatraemia in patients undergoing radical surgery for pancreatic ductal adenocarcinoma.

METHODS

A total of 89 patients with stage I-III pancreatic ductal adenocarcinoma underwent radical surgery between November 2012 and October 2014. Relapse-free survival (RFS) and disease-specific survival (DSS) were estimated using Kaplan-Meier method. for and Fisher exact test was used to estimate correlation between variables.

RESULTS

In total, 12 patients (14%) presented with hyponatraemia at diagnosis. The median DSS was 20 months in patients with hyponatraemia and not reached in patients with eunatraemia ( < .1073), while a statistical significant difference was observed in terms of median RFS (10 months vs 17 months, respectively; = .0233). Considering clinical features (hyponatraemia, smoke and alcoholic habit, diabetes, pain, and jaundice), patients with 4 or more of these factors had a worse prognosis (mDSS: 30 months vs not reached; hazard ratio [HR]: 0.40, 95% confidence interval [CI] = 0.16-0.80; = .0120).

CONCLUSIONS

The presence of hyponatraemia and its prompt correction at the diagnosis time should be considered for the correct management of patients with pancreatic carcinoma.

摘要

目的

低钠血症是癌症患者的一个不良预后因素。本研究的目的是首次评估低钠血症在接受胰腺导管腺癌根治性手术患者中的作用。

方法

2012年11月至2014年10月期间，共有89例I - III期胰腺导管腺癌患者接受了根治性手术。采用Kaplan - Meier法估计无复发生存期（RFS）和疾病特异性生存期（DSS）。使用Fisher精确检验估计变量之间的相关性。

结果

总共有12例患者（14%）在诊断时出现低钠血症。低钠血症患者的中位DSS为20个月，血钠正常患者未达到（P < 0.1073），而在中位RFS方面观察到统计学显著差异（分别为10个月和17个月；P = 0.0233）。考虑临床特征（低钠血症、吸烟和饮酒习惯、糖尿病、疼痛和黄疸），具有4种或更多这些因素的患者预后较差（mDSS：30个月与未达到；风险比[HR]：0.40，95%置信区间[CI] = 0.16 - 0.80；P = 0.0120）。