Syndrome of inappropriate antidiuresis in prostate adenocarcinoma with neuroendocrine differentiation: a case report and literature review

Syndrome of inappropriate antidiuresis (SIAD) is a common paraneoplastic syndrome commonly associated with thoracic malignancies, gastrointestinal cancers and kidney tumors. It is defined as hyponatremia in euvolemic patients, often due to abnormal secretion of antidiuretic hormone by tumor cells. Tolvaptan, a vasopressin-2-receptor antagonist, is currently recommended for patients affected by SIAD with mild or moderate symptoms. Among patients with prostatic cancer, SIAD represents a rare condition but it is frequently associated with poorly differentiated adenocarcinoma or pure small-cell carcinoma histotype. We report a case of SIAD appeared at disease progression in a 60-year-old male patient with acinar adenocarcinoma with neuroendocrine differentiation together with a literature review

Syndrome of inappropriate antidiuresis in prostate adenocarcinoma with neuroendocrine differentiation: a case report and literature review

Syndrome of inappropriate antidiuresis (SIAD) is a common paraneoplastic syndrome commonly associated with thoracic malignancies, gastrointestinal cancers and kidney tumors. It is defined as hyponatremia in euvolemic patients, often due to abnormal secretion of antidiuretic hormone by tumor cells. Tolvaptan, a vasopressin-2-receptor antagonist, is currently recommended for patients affected by SIAD with mild or moderate symptoms. Among patients with prostatic cancer, SIAD represents a rare condition but it is frequently associated with poorly differentiated adenocarcinoma or pure small-cell carcinoma histotype. We report a case of SIAD appeared at disease progression in a 60-year-old male patient with acinar adenocarcinoma with neuroendocrine differentiation together with a literature review

Managing hyponatremia in lung cancer: latest evidence and clinical implications

Hyponatremia is the most common electrolyte disorder in lung cancer patients. This condition may be related to many causes including incidental medications, concurrent diseases and side effects of antineoplastic treatments or the disease itself. Although not frequently life-threatening, it is usually associated with prolonged hospitalization, delays in scheduled chemotherapy, worsening of patient performance status and quality of life and may also negatively affect treatment response and survival. Most of the available data focus on thoracic tumors, especially small-cell lung cancer (SCLC), where hyponatremia is frequently related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Few studies specifically focus on non-small cell lung cancer (NSCLC) patients. Hyponatremia treatment needs to be personalized based on severity and duration of sodium serum reduction, extracellular fluid volume and etiology. However, literature data highlight the importance of early correction of the serum concentration levels. To achieve this the main options are fluid restriction, hypertonic saline, loop diuretics, isotonic saline, tolvaptan and urea. The aim of this review is to analyze the role of hyponatremia in lung cancer patients, evaluating causes, diagnosis, management and clinical implications

Hyponatremia in cancer patients: Time for a new approach

Hyponatremia is a common electrolyte disorder in cancer patients. It may be related to cancer, to anti-cancer therapy or to other concomitant treatments. In this setting hyponatremia is often caused by the syndrome of inappropriate anti-diuretic hormone secretion, which is due to the ectopic production of antidiuretic hormone (vasopressin), to extracellular fluid depletion, to renal toxicity caused by chemotherapy or to other underlying conditions.Recent studies suggested that hyponatremia might be considered a negative prognostic factor for cancer patients therefore its early detection, monitoring and management might improve the patient's outcome.Treatment of hyponatremia depends on patient's symptoms severity, onset timing and extracellular volume status.In this review we summarize the main causes of hyponatremia in cancer patients and its management, including the available treatment options

Agnese Savini, Rossana Berardi, Paola Mazzanti, Miriam Caramanti, Matteo Santoni, Mariagrazia De Lisa, Francesca Morgese, Silvia Rinaldi, Mariangela Torniai, Ilaria Fiordoliva, Azzurra Onofri, Stefano Cascinu. Squamous cell carcinoma of the lung: clinical criteria for treatment strategy.

Aim: Primary lung cancer is the leading cause of human cancer deaths worldwide, and squamous cell carcinoma (SCC) is one of the most frequent histologic subtypes. The aim of our study was to analyze clinical factors potentially affecting the overall outcome of advanced lung SCC patients.Methods: A series of 72 consecutive patients with advanced SCC undergoing chemotherapy at our institution between January 2007 and July 2013 were eligible for our analysis.Results: By univariate analysis, a better overall survival (OS) was related to response to first-line chemotherapy: median OS were 19.7 vs. 7.17 months, respectively, for responders and nonresponders patients (P < 0.0001). Eastern Cooperative Oncology Group performance status, gender, and surgery were other prognostic factors. No significant relationship between OS and smoking status, age, body mass index, or type of treatment was found. In the third-line setting, a better OS was associated with objective response to second-line treatment (P = 0.015).Conclusion: Our results suggest that differences in OS seem strictly associated with clinical response to previous treatments. These data should be considered in the therapeutic strategy and management of patients with SCC of the lung

Tumor burden as possible biomarker of outcome in advanced NSCLC patients treated with immunotherapy: a single center, retrospective, real-world analysis

none11Aim: The role of tumor burden (TB) for patients with non-small cell lung cancer (NSCLC) receiving immunotherapy is still unknown. The aim of this analysis was to analyze the prognostic value of TB in a real-world sample of advanced NSCLC patients. Methods: Sixty-five consecutive patients with advanced NSCLC treated with immunotherapy as first or second line therapy were retrospectively analyzed between August 2015 and February 2018. TB was recorded at baseline considering sites and number of metastases, thoracic vs. extrathoracic disease, measurable disease (MD) vs. not-MD (NMD) and evaluating dimensional aspects as maximum lesion diameter (cut-off = 6.3 cm), sum of the 5 major lesions diameters (cut-off = 14.3 cm), and number of sites of metastases (cut-off > 4). All cut-offs were calculated by receiver operating characteristic curves. Median overall survival (OS) was estimated using Kaplan-Meier method. A Cox regression model was carried out for univariate and multivariate analyses. Results: Median age was 70 years and most patients (86.2%) had a good performance status (PS-Eastern Cooperative Oncology Group 4 were negative prognostic factors (P < 0.0001). Conclusions: This study underlines the negative prognostic impact of specific metastatic sites, presence of NMD and extrathoracic disease in advanced NSCLC patients treated with immunotherapy. However, TB does not appear to affect the outcome of these patients.restrictedEdoardo Lenci; Giulia Marcantognini; Valeria Cognigni; Alessio Lupi; Silvia Rinaldi; Luca Cantini; Ilaria Fiordoliva; Anna Lisa Carloni; Lina Zuccatosta; Stefano Gasparini; Rossana BerardiLenci, Edoardo; Marcantognini, Giulia; Cognigni, Valeria; Lupi, Alessio; Rinaldi, Silvia; Cantini, Luca; Fiordoliva, Ilaria; Lisa Carloni, Anna; Zuccatosta, Lina; Gasparini, Stefano; Berardi, Rossan

Squamous cell carcinoma of the lung: clinical criteria for treatment strategy

Aim: Primary lung cancer is the leading cause of human cancer deaths worldwide, and squamous cell carcinoma (SCC) is one of the most frequent histologic subtypes. The aim of our study was to analyze clinical factors potentially affecting the overall outcome of advanced lung SCC patients.Methods: A series of 72 consecutive patients with advanced SCC undergoing chemotherapy at our institution between January 2007 and July 2013 were eligible for our analysis.Results: By univariate analysis, a better overall survival (OS) was related to response to first-line chemotherapy: median OS were 19.7 vs. 7.17 months, respectively, for responders and nonresponders patients (P &lt; 0.0001). Eastern Cooperative Oncology Group performance status, gender, and surgery were other prognostic factors. No significant relationship between OS and smoking status, age, body mass index, or type of treatment was found. In the third-line setting, a better OS was associated with objective response to second-line treatment (P = 0.015).Conclusion: Our results suggest that differences in OS seem strictly associated with clinical response to previous treatments. These data should be considered in the therapeutic strategy and management of patients with SCC of the lung

Pre-treatment systemic immune-inflammation represents a prognostic factor in patients with advanced non-small cell lung cancer

Background: Inflammation plays an important role in pathogenesis, development and progression of lung cancer. The aim of the study is to assess the prognostic role of Systemic Immune-Inflammation Index (SID, obtained by analyzing the neutrophil, lymphocyte and platelet counts, and to design prognostic models for patients receiving first-line chemo- or targeted therapy for advanced non-small cell lung cancer (NSCLC).Methods: We conducted an analysis on 311 patients with advanced NSCLC, treated with first line chemoor targeted therapy till June 2015 at our Institution. Patients were stratified in two groups with SII >= 1,270 (Group A) vs. SII = 1,270 (Group A), whilst 132 had lower SII (Group B). The median OS was 12.4 months in Group A and 21.7 months in Group B (P= 2 and SII >1,270 were predictors of worst OS, whilst IV tumor stage was only slightly significant (P=0.08). Otherwise, only wild-type EGFR status and SII >= 1,270 were independent prognostic factors for worst PFS.Conclusions: Pre-treatment SII is an independent prognostic factor for patients with advanced NSCLC treated with first-line therapies