1526P - Hyponatraemia as a marker of inferior outcomes in small cell lung cancer (SCLC)

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Small-Cell Lung Cancer
Presenter Niamh Coleman
Authors N. Coleman1, J. Clince2, W.M. Grogan2, O.S. Breathnach3
  • 1Dept Of Medical Oncology, Beaumont Hospital Cancer Centre, 9 - Dublin/IE
  • 2Medical Oncology, Beaumont Hospital, IE-9 - Dublin/IE
  • 3Medical Oncology, Beaumont Hospital Cancer Centre, 9 - Dublin/IE

Abstract

Introduction

Small cell lung cancer (SCLC) represents approximately 15% of all lung cancer diagnoses and is reducing in incidence. Hyponatremia is a common and debilitating electrolyte disorder, frequently documented in SCLC. Its occurrence is typically attributed to paraneoplastic syndrome- induced syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH). The influence of hyponatremia on the survival of patients with lung cancer remains poorly understood. Aim: The aim of this retrospective study is to investigate clinical features and the prognostic value of hyponatremia in an unselected Irish patient population with small cell lung cancer (SCLC) with limited disease (LD) and extensive disease (ED).

Method

The data of patients diagnosed with SCLC in Beaumont hospital over a 3-year period was analysed retrospectively. Patients were identified from analysis of all lung cancers biopsies via the pathology department databank. Data was collected from clinical notes on identified patients including clinical performance status, serum sodium values, disease stage, chemotherapy regimens and response, radiotherapy, palliative care input and survival.

Results

48 patients (22 male, 26 female) with a median age 64 yrs (range 41-87yrs), 29.17%(n = 14) with limited stage were identified. The standard chemotherapy was carboplatin–etoposide. 7 patients received 2nd line treatment with irinotecan. 16.6% patients did not receive chemotherapy (n = 8) due to poor performance status. Hyponatraemia (plasma sodium [P-Na] <135 mmol/l) was documented in 47.5% of patients (n = 19) receiving chemotherapy. Profound hyponatraemia (P-Na <128mEq/L) was noted in 27.5% of these patients (n = 11). The median survival in limited stage SCLC with profound hyponatraemia was 5.6 months, and 5.87 months in extensive stage SCLC. In patients with normal plasma sodium and non-significant hyponatraemia median survival was 9.125 months.

Conclusions

Hyponatraemia is a common occurrence in patients with SCLC, and one of the most frequent paraneoplastic syndromes noted. Profound hyponatremia is associated with significantly shorter observed median survival and should be considered in generating treatment in patients with SCLC.

Disclosure

All authors have declared no conflicts of interest.