title: Analysis on survival and prognostic factors for cancer patients with malignancy-associated hypercalcemia.
abstract: OBJECTIVE
  To explore the incidence, clinical characteristics, diagnosis and treatment strategies, prognosis of patients with malignancy-associated hypercalcemia (MAH).
  
  
  METHODS
  The data of 115 patients with MAH who were treated at the Medical Oncology Department of Chinese PLA General Hospital from Jan., 2001 to Dec., 2010 was retrospectively reviewed. Survival analysis was performed using the Kaplan-Meier method and the Cox proportional hazard model with statistic software SPSS 18.0.
  
  
  RESULTS
  The patients had blood calcium levels ranging from 2.77 to 4.87 mmol/L. Except for 9 cases who died or were discharged within 5 days after admission, all other patients recovered to normal blood calcium level after treatment with bisphosphonates or intravenous hydration and diuretics; their survival after occurrence of MAH was from 1 day to 4,051 days, and the median survival time was only 50 days. In the log-rank test, the male, renal metastasis, central nervous system symptoms 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 and hypercalcemia 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 was established to predict the patient prognosis and adjust the treatment.
  
  
  CONCLUSIONS
  Cancer patients with MAH have an extremely poor median survival. Some independent factors indicate poor prognosis, including male gender, central nervous system symptoms and hypercalcemia lasting over 140 days after cancer diagnosis. The prognostic score can serve as a reference for MAH prognosis and treatment, worthy of further investigation.
authors.affiliation: Department of Oncology, Chinese PLA General Hospital, Beijing, China E-mail : huyi040@aliyun.com.
authors.forename: Su-Jie
authors.initials: SJ
authors.lastname: Zhang
authors.forename: Yi
authors.initials: Y
authors.lastname: Hu
authors.forename: Jing
authors.initials: J
authors.lastname: Cao
authors.forename: Hai-Li
authors.initials: HL
authors.lastname: Qian
authors.forename: Shun-Chang
authors.initials: SC
authors.lastname: Jiao
authors.forename: Zhe-Feng
authors.initials: ZF
authors.lastname: Liu
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Tao
authors.forename: Lu
authors.initials: L
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000150:complications* / Q000401:mortality* / Q000473:pathology; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate