Supportive Care in Cancer

, Volume 16, Issue 4, pp 387–392 | Cite as

Cancer-associated hypercalcemia treated with intravenous diphosphonates: a survival and prognostic factor analysis

  • Nicolas PenelEmail author
  • Sylvain Dewas
  • Philippe Doutrelant
  • Stéphanie Clisant
  • Yazdan Yazdanpanah
  • Antoine Adenis
Original Article



Cancer-associated hypercalcemia (CAH) is the most frequent metabolic disorder in cancer patients. We retrospectively reviewed the outcome and prognostic factors for patients with CAH being treated with standard intravenous disphosphonates.

Materials and methods

Two hundred sixty patients were reviewed. Overall survival and prognostic factors were analyzed. Relative risks (RR) for early death (within 60 days) were assessed (Fischer exact test and logistic regression model).


Median survival was 64 days (range, 12–1,955+). Multivariate analysis identified the following factors as poor survival predictors: serum corrected calcium >2.83 mmol/l [hazard ratio (HR) = HR 2.21], albuminemia <35.5 (HR 2.41), squamous cell carcinoma (HR 2.64), bone metastasis (HR 1.44), and liver metastasis (HR 2..22). One hundred twenty-one patients died within 60 days. For those patients, the logistic regression model identified four independent predicting factors for early death: calcemia >2.83 mmol/l (RR 5.07), hypoalbuminemia (RR 7.42), liver metastasis (RR 4.34), and squamous cell carcinomas (RR 2.21).


Despite intravenous diphosphonate, CAH is still associated with poor outcome. Simple bedside parameters may estimate the risk of early deaths.


Cancer Diphosphonates Hypercalcemia Supportive care Prognosis 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Nicolas Penel
    • 1
    • 2
    Email author
  • Sylvain Dewas
    • 1
    • 3
  • Philippe Doutrelant
    • 4
  • Stéphanie Clisant
    • 5
  • Yazdan Yazdanpanah
    • 2
  • Antoine Adenis
    • 6
  1. 1.Département de Cancérologie GénéraleCentre Oscar LambretLilleFrance
  2. 2.Equipe d’Accueil 2694: Santé Publique, Epidémiologie et modélisation des maladies chroniquesUniversité Lille IILilleFrance
  3. 3.Département Universitaire de RadiothérapieCentre Oscar LambretLilleFrance
  4. 4.Laboratoire de BiologieCentre Oscar LambretLilleFrance
  5. 5.Unité de Recherche cliniqueCentre Oscar LambretLilleFrance
  6. 6.Département de Cancérologie Digestive et UrologiqueCentre Oscar LambretLilleFrance

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