Prognosis

Intravenous hydration and pharmacologic therapy for malignancy-associated hypercalcemia can provide transient restoration of normocalcemia. Eradication of underlying malignancy is crucial for permanent reversal of hypercalcemia.

Humoral hypercalcemia of malignancy or local osteolytic hypercalcemia

Intravenous hydration and calcitonin may improve hypercalcemia within the first 24-48 hours of therapy.[1][29][30] Intravenous bisphosphonates are most efficacious and may restore normocalcemia within 10 days of treatment in the majority of patients.[1][27] Duration of effect is variable.[27] Sustained resolution of hypercalcemia requires effective antitumor therapy.

Calcitriol (1,25-dihydroxyvitamin D)-mediated hypercalcemia

Intravenous hydration and calcitonin may transiently improve hypercalcemia within the first 24-48 hours of therapy.[1][29][30] Glucocorticoid therapy requires several days to improve serum calcium levels.[35] Duration of effect has not been extensively studied.

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