Analysis on Survival and Prognostic Factors for Cancer Patients with Malignancy-associated Hypercalcemia

Objective: To explore the incidence, clinical characteristics, diagnosis and treatment strategies, prognosisof patients with malignancy-associated hypercalcemia (MAH).
Methods: The data of 115 patients with MAHwho were treated at the Medical Oncology Department of Chinese PLA General Hospital from Jan., 2001 toDec., 2010 was retrospectively reviewed. Survival analysis was performed using the Kaplan-Meier method andthe Cox proportional hazard model with statistic software SPSS 18.0.
Results: The patients had blood calciumlevels ranging from 2.77 to 4.87 mmol/L. Except for 9 cases who died or were discharged within 5 days afteradmission, all other patients recovered to normal blood calcium level after treatment with bisphosphonates orintravenous hydration and diuretics; their survival after occurrence of MAH was from 1 day to 4,051 days, andthe median survival time was only 50 days. In the log-rank test, the male, renal metastasis, central nervous systemsymptoms and hypercalcemia occurring over 140 days after cancer diagnosis were predictors of poor survival(P=0.002, P=0.046, P=0.000, P=0.009). In the COX analysis, being male, central nervous system symptoms andhypercalcemia lasting over 140 days after cancer diagnosis were independent prognostic factors for survival time(RR=2.131, P=0.027; RR=3.054, P=0.002; RR=2.403, P=0.001). According to these factors, a score system wasestablished to predict the patient prognosis and adjust the treatment.
Conclusion: Cancer patients with MAHhave an extremely poor median survival. Some independent factors indicate poor prognosis, including malegender, central nervous system symptoms and hypercalcemia lasting over 140 days after cancer diagnosis. Theprognostic score can serve as a reference for MAH prognosis and treatment, worthy of further investigation.