caa a22 4500 60549181X CHVBK 20210128100511.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10147-014-0713-3 doi (NATIONALLICENCE)springer-10.1007/s10147-014-0713-3 Hyponatremia as a powerful prognostic predictor for Japanese patients with clear cell renal cell carcinoma treated with a tyrosine kinase inhibitor [Elektronische Daten] [Junya Furukawa, Hideaki Miyake, Yuji Kusuda, Masato Fujisawa] Background: We aimed to evaluate the prognostic significance of hyponatremia in patients with metastatic clear cell renal cell carcinoma (RCC) treated with a tyrosine kinase inhibitor (TKI). Methods: This study included a total of 209 consecutive Japanese patients undergoing radical nephrectomy who were subsequently treated with either sunitinib or sorafenib as a first-line therapy for metastatic clear cell RCC. In this series, normal natremia and hyponatremia prior to the introduction of TKI was defined as a serum sodium level >136 and ≤136mEq/L, respectively. Results: Patients were classified into 165 (78.9%) with normal natremia and 44 (21.1%) with hyponatremia. Progression-free survival (PFS) in the hyponatremia group (median 10.0months) was significantly poorer than that in the normal natremia group (median 28.4months). Overall survival (OS) in the hyponatremia group (median 20.9months) was significantly poorer than that in the normal natremia group (median 38.5months). Multivariate analyses identified hyponatremia, in addition to the existence of sarcomatoid components in radical nephrectomy specimens, high serum C-reactive protein levels, and low serum albumin levels, as poor prognostic factors for both PFS and OS. There were significant differences in both PFS and OS according to the number of these 4 independent risk factors that were positive (negative for any risk factors vs positive for 1 or 2 risk factors vs positive for 3 or 4 risk factors). Conclusions: Hyponatremia appears to be one of the most powerful prognostic predictors in Japanese patients treated with a TKI as a first-line agent against metastatic clear cell RCC. Japan Society of Clinical Oncology, 2014 Renal cell carcinoma nationallicence Hyponatremia nationallicence Sorafenib nationallicence Sunitinib nationallicence Furukawa Junya Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut Miyake Hideaki Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut Kusuda Yuji Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut Fujisawa Masato Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 351-357 1341-9625 20:2<351 2015 20 10147 https://doi.org/10.1007/s10147-014-0713-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-014-0713-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Furukawa Junya Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Miyake Hideaki Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Kusuda Yuji Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Fujisawa Masato Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 351-357 1341-9625 20:2<351 2015 20 10147