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Malignancy-Related Hypercalcemia in Advanced Solid Tumors: Survival Outcomes
Ricardo Emanuel de Oliveira Ramos1, Milena Perez Mak1, Michel Fabiano Silva Alves1
1All authors: Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.
Journal of Global Oncology
|December 16, 2017
Summary
Malignancy-related hypercalcemia (MRH) still indicates a poor prognosis despite modern treatments. However, contemporary cancer chemotherapy significantly improves survival for selected patients with MRH.
Area of Science:
- Oncology
- Internal Medicine
Background:
- Malignancy-related hypercalcemia (MRH) is a serious complication of cancer, historically associated with poor outcomes.
- Advances in bisphosphonates (BPs), cancer therapies, and supportive care may have influenced the prognosis of MRH.
Purpose of the Study:
- To evaluate the overall survival (OS) of patients with MRH in a contemporary clinical setting.
- To identify prognostic factors influencing survival in patients with MRH.
Main Methods:
- Retrospective analysis of 306 solid cancer patients hospitalized for symptomatic hypercalcemia.
- Multivariable Cox proportional hazards regression was used to identify prognostic factors.
- Serum calcium levels, performance status, and treatment history were analyzed.
Main Results:
- Median OS was 40 days; 83% received BPs without survival benefit.
- Poor prognostic factors included high performance status, altered mental status, elevated C-reactive protein, low albumin, and low BMI.
- Subsequent chemotherapy (CT) significantly improved median OS from 25 to 144 days (HR, 0.24; P < .001).
Conclusions:
- MRH remains a significant indicator of poor prognosis in the current era.
- Contemporary cancer chemotherapy offers a survival advantage for selected MRH patients.
- Targeted treatment strategies for MRH patients may improve outcomes.
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