title: Poor survival outcome with moderate and severe hypercalcemia in gynecologic malignancy patients.
abstract: OBJECTIVE
  Determine the incidence of hypercalcemia in gynecologic malignancy patients and their survival outcome.
  
  
  METHODS
  Single-institution retrospective clinical study.
  
  
  METHODS
  We used Fisher exact test, Kaplan-Meier survival curves, and Cox proportional hazards model to analyze demographic and clinical data from gynecologic malignancy patients with hypercalcemia who had been treated at The University of Texas M.D. Anderson Cancer Center from September 1997 to August 2006.
  
  
  RESULTS
  Of the 5260 gynecologic malignancy patients, 268 had hypercalcemia (5%). Of the 268, 12 were excluded because of hyperparathyroidism or coexisting malignancies; thus, 256 patients were included in the study. Most patients (82%) had mild hypercalcemia. Severity of hypercalcemia was associated with disease stage (P = 0.0019), use of hypercalcemia treatment (P < 0.0001), and survival duration (P < 0.0001). The median survival duration of patients who had not been treated for hypercalcemia was 432 days compared with 106 days in patients who had been treated. The shorter survival duration of treated patients seems to result from their disease status and hypercalcemia severity rather than whether they were treated for hypercalcemia.
  
  
  CONCLUSIONS
  Moderate and severe hypercalcemia is associated with poorer survival duration in gynecologic malignancy patients. Early detection and treatment of hypercalcemia in these patients may prolong survival. To our knowledge, this is the first study of hypercalcemia in patients with general gynecologic malignancy.
authors.affiliation: Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-1439, USA.
authors.forename: Atthapon
authors.initials: A
authors.lastname: Jaishuen
authors.forename: Camilo
authors.initials: C
authors.lastname: Jimenez
authors.forename: Nakarin
authors.initials: N
authors.lastname: Sirisabya
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.forename: Diana L
authors.initials: DL
authors.lastname: Urbauer
authors.forename: John J
authors.initials: JJ
authors.lastname: Kavanagh
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000401:mortality*; D006801:Humans; D006934:Hypercalcemia / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis