Clinical analysis of 64 patients with lung-cancer-associated hypercalcemia

This study investigated the factors influencing survival time of patients with lung-cancer-associated hypercalcemia.

A total of 64 pathologically confirmed patients with Stage IV lung-cancer-associated hypercalcemia were enrolled from Beijing Hospitals between August 2010 and July 2015. Clinical materials included patients' gender, age, pathological type, highest albumin-corrected calcium level, serum alkaline phosphatase level, creatinine clearance rate, organ (bone, liver, brain, and adrenal gland) metastasis, number of distal metastatic sites, and survival time after diagnosis of hypercalcemia. Univariate and multivariate analyses were performed to screen the risk factors affecting patients' survival.

Albumin-corrected calcium levels of the 64 patients ranged from 2.56 to 4.57 mmol/L, and the median value was 2.76 mmol/L. Survival time after diagnosis of hypercalcemia varied from 1 to 1340 days, and the median survival time was 104 days. Univariate analysis showed that gender, age (>60-year-old), albumin-corrected calcium levels, elevation of alkaline phosphatases, brain metastasis, and number of distal metastatic sites were predictors for poor survival (P = 0.026, P = 0.022, P < 0.001, P = 0.043, P = 0.041, P = 0.003). In Cox proportional hazard model analysis, corrected hypercalcemia levels and alkaline phosphatase levels were determined to be risk factors affecting patients' survival time (hazard ratio [HR] = 6.828, P = 0.000; HR = 1.957, P = 0.026).

Patients with Stage IV lung-cancer-associated moderate and severe hypercalcemia exhibited shorter survival time and poor prognosis. After correction, moderate and severe elevations of hypercalcemia and abnormal elevation of alkaline phosphatase levels were shown to be significant factors shortening patients' survival time.