title: Relationship of the urine cortisol level with the performance status of patients with lung cancer: a retrospective study.
abstract: OBJECTIVE
  Cortisol plays an important role in the physical status of patients with end-stage lung cancer, but the association of urine cortisol levels with TNM stage/performance status (PS) is unclear in patients with advanced lung cancer receiving chemotherapy. The objective of this study was to examine this association.
  
  
  METHODS
  In this single-center, retrospective, observational study, cortisol concentrations in 24-h pooled urine from 22 patients with advanced lung cancer were measured over 2 days. The mean concentration in each patient was compared with PS, TNM stage, and serum sodium and potassium ion levels.
  
  
  RESULTS
  The 24-h urine cortisol levels were higher in PS2 or PS3 cases compared to PS1 (p < 0.05) and increased proportionally with PS. Urine cortisol also increased in N2 or N3 cases compared to N1 (p < 0.01) and also increased in M1 cases (p < 0.05). Urine cortisol levels were negatively correlated with serum sodium (R = -0.49, p < 0.05) and had a tendency for a positive correlation with serum potassium (R = 0.40, p = 0.06).
  
  
  CONCLUSIONS
  The 24-h urine cortisol level increased in patients with advanced lung cancer undergoing chemotherapy. Low serum levels of potassium and high levels of sodium may indicate relative adrenal insufficiency.
authors.affiliation: Toyama Prefectural Central Hospital, 2-2-78 Nishi-Nagae, Toyama City, Toyama, 930-8550, Japan, khiro.tm@gmail.com.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Tomomi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Furuse
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuda
authors.forename: Kotaro
authors.initials: K
authors.lastname: Tokui
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Masaki
authors.forename: Seisuke
authors.initials: S
authors.lastname: Okazawa
authors.forename: Kenta
authors.initials: K
authors.lastname: Kambara
authors.forename: Minehiko
authors.initials: M
authors.lastname: Inomata
authors.forename: Toru
authors.initials: T
authors.lastname: Yamada
authors.forename: Toshiro
authors.initials: T
authors.lastname: Miwa
authors.forename: Shoko
authors.initials: S
authors.lastname: Matsui
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kashii
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Hayashi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Tobe
mesh_terms: D000309:Adrenal Insufficiency / Q000652:urine; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008175:Lung Neoplasms / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D006854:Hydrocortisone