title: Hypercalcemia in advanced head and neck squamous cell carcinoma: prevalence and potential impact on palliative care.
abstract: Hypercalcemia is common in patients with advanced head and neck squamous cell carcinoma (HNSCC). In this study, hypercalcemia was detected in 46 (51%) of 90 eligible patients with HNSCC over 4 years. Compared with nonhypercalcemics, hypercalcemics were more likely to be referred to palliative care, while they were inpatients (P = 0.004). During the last 3 months of follow-up, hypercalcemic patients were more likely than nonhypercalcemics to be hospitalized for > or = 14 days (P = 0.01) and to visit the emergency room more than once (P = 0.04). The median survival from the first hypercalcemic episode was 74 days (95% CI, 0-234). With data calculated from the date of referral to palliative care, hypercalcemics had a shorter survival than did nonhypercalcemics (43 vs 128 days, respectively; P = 0.046). Early detection and management of hypercalcemia in patients with HNSCC may improve the chance of preventing distressing symptoms and reducing unnecessary frequent emergency room visits and lengthy hospitalization.
authors.affiliation: Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. alsirafy@gmail.com
authors.forename: Samy A
authors.initials: SA
authors.lastname: Alsirafy
authors.forename: Mahmoud Y
authors.initials: MY
authors.lastname: Sroor
authors.forename: Mohammad Z
authors.initials: MZ
authors.lastname: Al-Shahri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult