Malignancy-related hypercalcaemia in cancer: prognosis and survival outcome

Abstract

Objective: This study investigated survival outcome and prognosis factors in a contemporary series of patient with malignancy-related hypocalcaemia.Patients and method: retrospective analysis of 60 in-patients with solid cancer hospitalized at Paholponphrayuhasena during 2016-2020. The univariate and multivariate analysis were performed to evaluate prognostic factor and Kaplan-Meier method present survival outcome.

Results: The patients had mean age 63 years and the majority had squamous cell carcinoma (64%). Lung cancer was the most frequency disease subsequence head & neckand breast cancer. Only 42% received specific treatment, surgery 13%, chemotherapy 12%, radiation 5% and multi-modalities 12%. Mean calcium level was 15.1 mg/dL which 25% found hypocalcaemia concurrent with diagnosis of cancer and 33% had central neurological symptom.  Median overall survival was 1.98 months (95% CI 0.99-2.97). Univariate analysis showed that non-squamous cell (P=0.029), chemotherapy (P=0.008) or multi-modalities treatment (P=0.018), non metastatic cancer (P=0.016) and bisphosphanate (P=0.005) use were predictors of good prognosis. In the multivariate analysis, the chemotherapy (P=0.003) and bisphosphanate use (P=0.033) led to a median overall survival improvement.

Conclusion: Malignancy-related hypocalcaemia remain a marker of poor prognosis. Patients treated with chemotherapy and bisphosphanate had better survival.