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Cancer-associated hypercalcemia treated with intravenous diphosphonates: a survival and prognostic factor analysis

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Abstract

Background

Cancer-associated hypercalcemia (CAH) is the most frequent metabolic disorder in cancer patients. We retrospectively reviewed the outcome and prognostic factors for patients with CAH being treated with standard intravenous disphosphonates.

Materials and methods

Two hundred sixty patients were reviewed. Overall survival and prognostic factors were analyzed. Relative risks (RR) for early death (within 60 days) were assessed (Fischer exact test and logistic regression model).

Results

Median survival was 64 days (range, 12–1,955+). Multivariate analysis identified the following factors as poor survival predictors: serum corrected calcium >2.83 mmol/l [hazard ratio (HR) = HR 2.21], albuminemia <35.5 (HR 2.41), squamous cell carcinoma (HR 2.64), bone metastasis (HR 1.44), and liver metastasis (HR 2..22). One hundred twenty-one patients died within 60 days. For those patients, the logistic regression model identified four independent predicting factors for early death: calcemia >2.83 mmol/l (RR 5.07), hypoalbuminemia (RR 7.42), liver metastasis (RR 4.34), and squamous cell carcinomas (RR 2.21).

Discussion

Despite intravenous diphosphonate, CAH is still associated with poor outcome. Simple bedside parameters may estimate the risk of early deaths.

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Correspondence to Nicolas Penel.

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Penel, N., Dewas, S., Doutrelant, P. et al. Cancer-associated hypercalcemia treated with intravenous diphosphonates: a survival and prognostic factor analysis. Support Care Cancer 16, 387–392 (2008). https://doi.org/10.1007/s00520-007-0322-z

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  • DOI: https://doi.org/10.1007/s00520-007-0322-z

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