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Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma

Hyponatremia has been shown to be associated with prognosis in various cancers, but its role in upper tract urothelial carcinoma (UTUC) is largely unidentified. We created an international multiregional cohort of UTUC, consisting of 524 and 213 patients from Taiwan and the U.S., to validate the sign...

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Autores principales: Yeh, Hsin-Chih, Li, Ching-Chia, Wen, Sheng-Chen, Singla, Nirmish, Woldu, Solomon L., Robyak, Haley, Huang, Chun-Nung, Ke, Hung-Lung, Li, Wei-Ming, Lee, Hsiang-Ying, Li, Chia-Yang, Yeh, Bi-Wen, Yang, Sheau-Fang, Tu, Hung-Pin, Shariat, Shahrokh F., Sagalowsky, Arthur I., Raman, Jay D., Lotan, Yair, Hsieh, Jer-Tsong, Margulis, Vitaly, Wu, Wen-Jeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231247/
https://www.ncbi.nlm.nih.gov/pubmed/32340364
http://dx.doi.org/10.3390/jcm9041218
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author Yeh, Hsin-Chih
Li, Ching-Chia
Wen, Sheng-Chen
Singla, Nirmish
Woldu, Solomon L.
Robyak, Haley
Huang, Chun-Nung
Ke, Hung-Lung
Li, Wei-Ming
Lee, Hsiang-Ying
Li, Chia-Yang
Yeh, Bi-Wen
Yang, Sheau-Fang
Tu, Hung-Pin
Shariat, Shahrokh F.
Sagalowsky, Arthur I.
Raman, Jay D.
Lotan, Yair
Hsieh, Jer-Tsong
Margulis, Vitaly
Wu, Wen-Jeng
author_facet Yeh, Hsin-Chih
Li, Ching-Chia
Wen, Sheng-Chen
Singla, Nirmish
Woldu, Solomon L.
Robyak, Haley
Huang, Chun-Nung
Ke, Hung-Lung
Li, Wei-Ming
Lee, Hsiang-Ying
Li, Chia-Yang
Yeh, Bi-Wen
Yang, Sheau-Fang
Tu, Hung-Pin
Shariat, Shahrokh F.
Sagalowsky, Arthur I.
Raman, Jay D.
Lotan, Yair
Hsieh, Jer-Tsong
Margulis, Vitaly
Wu, Wen-Jeng
author_sort Yeh, Hsin-Chih
collection PubMed
description Hyponatremia has been shown to be associated with prognosis in various cancers, but its role in upper tract urothelial carcinoma (UTUC) is largely unidentified. We created an international multiregional cohort of UTUC, consisting of 524 and 213 patients from Taiwan and the U.S., to validate the significance of hyponatremia. Clinicopathologic characteristics were compared according to the presence of hyponatremia. Univariate and multivariate Cox regression models were used to investigate the association of hyponatremia with disease progression and survival. The impact of hyponatremia in patients from distinct regions was also analyzed. Hyponatremia was found in 143 (19.4%) patients. Hyponatremic patients had significantly worse Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.00001) and higher pT stage (p = 0.002). In multivariate analysis, hyponatremia was an independent prognostic factor for progression (HR 1.585, 95% CI 1.115–2.253, p = 0.010), cancer-specific death (HR 2.225, 95% CI 1.457–3.397, p = 0.0002), and overall mortality (HR 1.819, 95% CI 1.299–2.545, p = 0.0005). Kaplan–Meier analysis showed the consistent adverse effect of hyponatremia on all outcomes in patients from Taiwan and the U.S. (all p < 0.05). Hyponatremia is commonly accessible and can serve as a negative marker for both the general health condition and disease severity of UTUC patients. A similar implication of hyponatremia in progression and survival despite patients’ region of presentation suggests its general applicability across different ethnicities.
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spelling pubmed-72312472020-05-22 Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma Yeh, Hsin-Chih Li, Ching-Chia Wen, Sheng-Chen Singla, Nirmish Woldu, Solomon L. Robyak, Haley Huang, Chun-Nung Ke, Hung-Lung Li, Wei-Ming Lee, Hsiang-Ying Li, Chia-Yang Yeh, Bi-Wen Yang, Sheau-Fang Tu, Hung-Pin Shariat, Shahrokh F. Sagalowsky, Arthur I. Raman, Jay D. Lotan, Yair Hsieh, Jer-Tsong Margulis, Vitaly Wu, Wen-Jeng J Clin Med Article Hyponatremia has been shown to be associated with prognosis in various cancers, but its role in upper tract urothelial carcinoma (UTUC) is largely unidentified. We created an international multiregional cohort of UTUC, consisting of 524 and 213 patients from Taiwan and the U.S., to validate the significance of hyponatremia. Clinicopathologic characteristics were compared according to the presence of hyponatremia. Univariate and multivariate Cox regression models were used to investigate the association of hyponatremia with disease progression and survival. The impact of hyponatremia in patients from distinct regions was also analyzed. Hyponatremia was found in 143 (19.4%) patients. Hyponatremic patients had significantly worse Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.00001) and higher pT stage (p = 0.002). In multivariate analysis, hyponatremia was an independent prognostic factor for progression (HR 1.585, 95% CI 1.115–2.253, p = 0.010), cancer-specific death (HR 2.225, 95% CI 1.457–3.397, p = 0.0002), and overall mortality (HR 1.819, 95% CI 1.299–2.545, p = 0.0005). Kaplan–Meier analysis showed the consistent adverse effect of hyponatremia on all outcomes in patients from Taiwan and the U.S. (all p < 0.05). Hyponatremia is commonly accessible and can serve as a negative marker for both the general health condition and disease severity of UTUC patients. A similar implication of hyponatremia in progression and survival despite patients’ region of presentation suggests its general applicability across different ethnicities. MDPI 2020-04-23 /pmc/articles/PMC7231247/ /pubmed/32340364 http://dx.doi.org/10.3390/jcm9041218 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yeh, Hsin-Chih
Li, Ching-Chia
Wen, Sheng-Chen
Singla, Nirmish
Woldu, Solomon L.
Robyak, Haley
Huang, Chun-Nung
Ke, Hung-Lung
Li, Wei-Ming
Lee, Hsiang-Ying
Li, Chia-Yang
Yeh, Bi-Wen
Yang, Sheau-Fang
Tu, Hung-Pin
Shariat, Shahrokh F.
Sagalowsky, Arthur I.
Raman, Jay D.
Lotan, Yair
Hsieh, Jer-Tsong
Margulis, Vitaly
Wu, Wen-Jeng
Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title_full Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title_fullStr Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title_full_unstemmed Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title_short Validation of Hyponatremia as a Prognostic Predictor in Multiregional Upper Tract Urothelial Carcinoma
title_sort validation of hyponatremia as a prognostic predictor in multiregional upper tract urothelial carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231247/
https://www.ncbi.nlm.nih.gov/pubmed/32340364
http://dx.doi.org/10.3390/jcm9041218
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