Tumor-induced hypercalcemia: predictors of early mortality.

OBJECTIVE: To delineate the demographics and predictors of early mortality associated with tumor-induced hypercalcemia (TIH) amongst cancer patients in Pakistan. SETTING: A tertiary care hospital in Pakistan. PATIENTS AND METHODS: Retrospective analysis of patients with cancers, presenting with TIH and admitted to the hospital between January 1988 and December 1997, was carried out. RESULTS: Eighty-four patients (56 males and 28 females) were diagnosed to have TIH. The mean age at the time of presentation was 55 +/- 14 years. Twenty-five percent of the patients each had multiple myeloma and hepatocellular carcinoma whereas 20% of the patients had underlying breast cancer. Other malignancies included lung cancer, gall bladder cancer and colorectal carcinomas. Univariate analysis revealed male sex (p < 0.04), underlying diagnosis other than multiple myeloma (p < 0.025) and a high TLC (p < 0.05) at presentation, as predictors of an early mortality. CONCLUSION: Multiple myeloma, hepatoma and breast carcinoma were common cancers causing TIH. One-third patients died within first few days. Male sex, a high white cell count and an underlying diagnosis other than multiple myeloma predicted early mortality.