MALIGNANT HYPERCALCEMIA - PROGNOSTIC FACTORS FROM 51 PATIENTS HOSPITALIZED IN AN INTERNAL-MEDICINE DEPARTMENT

In our Internal Medicine department, we conducted a retrospective stud y of prognostic factors in patients with malignant hypercalcaemia. The records of 51 patients who had both hypercalcaemia and a histological ly proven cancer were analyzed ; 42 had a solid tumour and 9 had a mye loma. In 61 % of the patients cancer had been revealed by hypercalcaem ia. The main warning signs were alteration of the general condition (6 8.6 %), pain in the bones (54.9 %) and polyuria with dehydration (58.8 %). Osteolysis was observed in 75 % of the cases. The overall median survival was 86 days. Patients with myelomia had a significantly longe r survival than patients with other tumours (312 versus 60 days ; p < 0.05). Patients who had received a causal treatment had a longer survi val (176 versus 36 days, p < 0.001). In patients with solid tumours we found a negative correlation between survival and initial calcaemia, and a positive correlation between phosphoraemia, albuminaemia and sur vival. Multivariate analysis showed that the initial calcaemia level a nd the possibility of causal treatment were the two cardinal prognosti c factors. Although the overall survival rate is mediocre, we believe that hospitalization of patients with malignant hypercalcaemia is just ified for their better survival comfort and for the possibility of dis covering a neoplasia that could benefit from an effective causal treat ment, which is the principal factor of improved prognosis.