Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin

Wenli Liu, Aiham Qdaisat, Pamela T. Soliman, Lois Ramondetta, Gabriel Lopez, Santhosshi Narayanan, Shouhao Zhou, Lorenzo Cohen, Eduardo Bruera, Sai Ching J. Yeung

Research output: Contribution to journalArticle

Abstract

Background: Hypomagnesemia is a known side effect of several antineoplastic agents, but its impact on outcomes of patients with cancer is not well understood. We examined whether magnesium abnormalities affect survival in patients with ovarian cancer who receive chemotherapy containing carboplatin. Materials and Methods: We included patients with advanced ovarian cancer who had undergone surgery and chemotherapy between January 1, 2004, and December 31, 2014, at our institution. Inclusion criteria were age 18 years or older, pathology of high-grade serous carcinoma, first treatment (surgery or chemotherapy) within 60 days of diagnosis, and chemotherapy containing carboplatin. The final cohort consisted of 229 patients. Vital signs and laboratory tests were recorded at baseline and during the treatment course. The associations between magnesium abnormalities (and other clinical characteristics) and survival were analyzed. Results: The median patient age was 64 years. Higher baseline heart rate (beats per minute; hazard ratio [HR] = 1.02, p =.002) and greater frequency of hypomagnesemia during the treatment course (HR = 1.05, p =.002) were significantly associated with shorter survival independent of completeness of tumor reduction (HR = 1.60, p =.02), and International Federation of Gynecology and Obstetrics stage (HR = 1.63, p =.01). Conclusion: Baseline heart rate and the frequency of hypomagnesemia episodes during treatment are prognostic of survival for patients with advanced ovarian cancer receiving carboplatin-containing chemotherapy and tumor reductive surgery. Future research is needed for strategies to detect and prevent hypomagnesemia in this patient population. Implications for Practice: Despite standard laboratory tests and intravenous magnesium replacement prior to each cycle of chemotherapy, hypomagnesemia remains a common side effect of platinum-based chemotherapy. This study revealed that frequent occurrence of hypomagnesemia during the course of treatment including carboplatin-containing chemotherapy and tumor reductive surgery was strongly predictive of shorter survival in patients with advanced ovarian cancer. Strategies to effectively mitigate hypomagnesemia, such as more frequent detection, dietary recommendations, and timely replacement, should be considered in the overall cancer treatment plan for these patients.

Original languageEnglish (US)
Pages (from-to)e312-e317
JournalOncologist
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2019

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Carboplatin
Ovarian Neoplasms
Drug Therapy
Survival
Magnesium
Neoplasms
Therapeutics
Heart Rate
Vital Signs
Platinum
Gynecology
Antineoplastic Agents
Obstetrics
Pathology
Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Liu, W., Qdaisat, A., Soliman, P. T., Ramondetta, L., Lopez, G., Narayanan, S., ... Yeung, S. C. J. (2019). Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin. Oncologist, 24(6), e312-e317. https://doi.org/10.1634/theoncologist.2018-0465
Liu, Wenli ; Qdaisat, Aiham ; Soliman, Pamela T. ; Ramondetta, Lois ; Lopez, Gabriel ; Narayanan, Santhosshi ; Zhou, Shouhao ; Cohen, Lorenzo ; Bruera, Eduardo ; Yeung, Sai Ching J. / Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin. In: Oncologist. 2019 ; Vol. 24, No. 6. pp. e312-e317.
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title = "Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin",
abstract = "Background: Hypomagnesemia is a known side effect of several antineoplastic agents, but its impact on outcomes of patients with cancer is not well understood. We examined whether magnesium abnormalities affect survival in patients with ovarian cancer who receive chemotherapy containing carboplatin. Materials and Methods: We included patients with advanced ovarian cancer who had undergone surgery and chemotherapy between January 1, 2004, and December 31, 2014, at our institution. Inclusion criteria were age 18 years or older, pathology of high-grade serous carcinoma, first treatment (surgery or chemotherapy) within 60 days of diagnosis, and chemotherapy containing carboplatin. The final cohort consisted of 229 patients. Vital signs and laboratory tests were recorded at baseline and during the treatment course. The associations between magnesium abnormalities (and other clinical characteristics) and survival were analyzed. Results: The median patient age was 64 years. Higher baseline heart rate (beats per minute; hazard ratio [HR] = 1.02, p =.002) and greater frequency of hypomagnesemia during the treatment course (HR = 1.05, p =.002) were significantly associated with shorter survival independent of completeness of tumor reduction (HR = 1.60, p =.02), and International Federation of Gynecology and Obstetrics stage (HR = 1.63, p =.01). Conclusion: Baseline heart rate and the frequency of hypomagnesemia episodes during treatment are prognostic of survival for patients with advanced ovarian cancer receiving carboplatin-containing chemotherapy and tumor reductive surgery. Future research is needed for strategies to detect and prevent hypomagnesemia in this patient population. Implications for Practice: Despite standard laboratory tests and intravenous magnesium replacement prior to each cycle of chemotherapy, hypomagnesemia remains a common side effect of platinum-based chemotherapy. This study revealed that frequent occurrence of hypomagnesemia during the course of treatment including carboplatin-containing chemotherapy and tumor reductive surgery was strongly predictive of shorter survival in patients with advanced ovarian cancer. Strategies to effectively mitigate hypomagnesemia, such as more frequent detection, dietary recommendations, and timely replacement, should be considered in the overall cancer treatment plan for these patients.",
author = "Wenli Liu and Aiham Qdaisat and Soliman, {Pamela T.} and Lois Ramondetta and Gabriel Lopez and Santhosshi Narayanan and Shouhao Zhou and Lorenzo Cohen and Eduardo Bruera and Yeung, {Sai Ching J.}",
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Liu, W, Qdaisat, A, Soliman, PT, Ramondetta, L, Lopez, G, Narayanan, S, Zhou, S, Cohen, L, Bruera, E & Yeung, SCJ 2019, 'Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin', Oncologist, vol. 24, no. 6, pp. e312-e317. https://doi.org/10.1634/theoncologist.2018-0465

Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin. / Liu, Wenli; Qdaisat, Aiham; Soliman, Pamela T.; Ramondetta, Lois; Lopez, Gabriel; Narayanan, Santhosshi; Zhou, Shouhao; Cohen, Lorenzo; Bruera, Eduardo; Yeung, Sai Ching J.

In: Oncologist, Vol. 24, No. 6, 01.06.2019, p. e312-e317.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hypomagnesemia and Survival in Patients with Ovarian Cancer Who Received Chemotherapy with Carboplatin

AU - Liu, Wenli

AU - Qdaisat, Aiham

AU - Soliman, Pamela T.

AU - Ramondetta, Lois

AU - Lopez, Gabriel

AU - Narayanan, Santhosshi

AU - Zhou, Shouhao

AU - Cohen, Lorenzo

AU - Bruera, Eduardo

AU - Yeung, Sai Ching J.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Hypomagnesemia is a known side effect of several antineoplastic agents, but its impact on outcomes of patients with cancer is not well understood. We examined whether magnesium abnormalities affect survival in patients with ovarian cancer who receive chemotherapy containing carboplatin. Materials and Methods: We included patients with advanced ovarian cancer who had undergone surgery and chemotherapy between January 1, 2004, and December 31, 2014, at our institution. Inclusion criteria were age 18 years or older, pathology of high-grade serous carcinoma, first treatment (surgery or chemotherapy) within 60 days of diagnosis, and chemotherapy containing carboplatin. The final cohort consisted of 229 patients. Vital signs and laboratory tests were recorded at baseline and during the treatment course. The associations between magnesium abnormalities (and other clinical characteristics) and survival were analyzed. Results: The median patient age was 64 years. Higher baseline heart rate (beats per minute; hazard ratio [HR] = 1.02, p =.002) and greater frequency of hypomagnesemia during the treatment course (HR = 1.05, p =.002) were significantly associated with shorter survival independent of completeness of tumor reduction (HR = 1.60, p =.02), and International Federation of Gynecology and Obstetrics stage (HR = 1.63, p =.01). Conclusion: Baseline heart rate and the frequency of hypomagnesemia episodes during treatment are prognostic of survival for patients with advanced ovarian cancer receiving carboplatin-containing chemotherapy and tumor reductive surgery. Future research is needed for strategies to detect and prevent hypomagnesemia in this patient population. Implications for Practice: Despite standard laboratory tests and intravenous magnesium replacement prior to each cycle of chemotherapy, hypomagnesemia remains a common side effect of platinum-based chemotherapy. This study revealed that frequent occurrence of hypomagnesemia during the course of treatment including carboplatin-containing chemotherapy and tumor reductive surgery was strongly predictive of shorter survival in patients with advanced ovarian cancer. Strategies to effectively mitigate hypomagnesemia, such as more frequent detection, dietary recommendations, and timely replacement, should be considered in the overall cancer treatment plan for these patients.

AB - Background: Hypomagnesemia is a known side effect of several antineoplastic agents, but its impact on outcomes of patients with cancer is not well understood. We examined whether magnesium abnormalities affect survival in patients with ovarian cancer who receive chemotherapy containing carboplatin. Materials and Methods: We included patients with advanced ovarian cancer who had undergone surgery and chemotherapy between January 1, 2004, and December 31, 2014, at our institution. Inclusion criteria were age 18 years or older, pathology of high-grade serous carcinoma, first treatment (surgery or chemotherapy) within 60 days of diagnosis, and chemotherapy containing carboplatin. The final cohort consisted of 229 patients. Vital signs and laboratory tests were recorded at baseline and during the treatment course. The associations between magnesium abnormalities (and other clinical characteristics) and survival were analyzed. Results: The median patient age was 64 years. Higher baseline heart rate (beats per minute; hazard ratio [HR] = 1.02, p =.002) and greater frequency of hypomagnesemia during the treatment course (HR = 1.05, p =.002) were significantly associated with shorter survival independent of completeness of tumor reduction (HR = 1.60, p =.02), and International Federation of Gynecology and Obstetrics stage (HR = 1.63, p =.01). Conclusion: Baseline heart rate and the frequency of hypomagnesemia episodes during treatment are prognostic of survival for patients with advanced ovarian cancer receiving carboplatin-containing chemotherapy and tumor reductive surgery. Future research is needed for strategies to detect and prevent hypomagnesemia in this patient population. Implications for Practice: Despite standard laboratory tests and intravenous magnesium replacement prior to each cycle of chemotherapy, hypomagnesemia remains a common side effect of platinum-based chemotherapy. This study revealed that frequent occurrence of hypomagnesemia during the course of treatment including carboplatin-containing chemotherapy and tumor reductive surgery was strongly predictive of shorter survival in patients with advanced ovarian cancer. Strategies to effectively mitigate hypomagnesemia, such as more frequent detection, dietary recommendations, and timely replacement, should be considered in the overall cancer treatment plan for these patients.

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