[Hypercalcemia and squamous cell carcinoma of the upper respiratory-digestive tracts. Incidence and prognosis].
We performed a retrospective analysis on all head and neck cancers with hypercalcemia seen between January 1988 and June 1993 at the Centre Oscar-Lambret, cancer center of northern France. Hypercalcemia, non albumin-corrected, higher than 2.60 mmol/l was observed in 173 of 3,394 consecutive patients (5%). Median age of patients with hypercalcemia was 53 years and 97% of these patients were males. All patients with hypercalcemia had advanced or recurrent and/or metastatic squamous cell carcinoma of head and neck (SCCHN); 31 of them were not pretreated. There was no significant difference in histology between patients with or without hypercalcemia, but hypercalcemia was most commonly associated with lesions of the oropharynx (p = 0.00001). The median of calcemia was of 2.83 mmol/l (2.61-4.70). Gastrointestinal and neurologic symptoms respectively occurred in 24% and in 14% of patients and bone metastases in 25% of patients. Median survival after the first determination of hypercalcemia was of 7 weeks (0-128) for the overall group of 173 patients and of 12 weeks (1-128) for those 31 patients with hypercalcemia at initial diagnosis. Prognosis associated factors were: efficacy of antitumour treatment, performance status and hypercalcemia superior or not to 3 mmol/l. We concluded that hypercalcemia in head and neck cancer is usually a late manifestation associated with advanced, recurrent and/or metastatic disease and carries a poor prognosis. The prolongation of survival can be obtained in some patients if an effective antitumour treatment is feasible.
Centre Oscar-Lambret, Lille, France.
M
M
Degardin
M
M
Nguyen
D
D
Beaurin
A
A
Lesoin
C
C
Fournier
J L
JL
Lefebvre
P
P
Cappelaere
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D006934:Hypercalcemia / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
Hypercalcémie et carcinomes épidermoïdes des voies aérodigestives supérieures. Fréquence et valeur pronostique.