title: Prognostic value of hypercalcaemia and leucocytosis in resected oral squamous cell carcinoma.
abstract: Hypercalcaemia and leucocytosis are common in our patients with progressive oral squamous cell carcinoma (SCC). However, the precise incidence, prognostic value, and correlation with the condition of the tumour remain obscure. A total of 618 patients with oral SCC who were treated primarily between 2007 and 2012 and had serum calcium concentrations and white blood cell count (WCC) measured postoperatively were included in the study. Primary TNM stage, pathological features, and the presence of locoregional recurrence or distant metastasis after comprehensive surgical treatment were recorded. The incidence of hypercalcaemia was 9.1% and that of leucocytosis 7.2%. Hypercalcaemia correlated significantly with size of primary tumour (T status), nodal involvement (N status), TNM stage, perineural invasion, lymphovascular permeation, and recurrence or metastasis of disease. Leucocytosis, however, correlated only with T status, lymphovascular permeation, and recurrence or metastasis. In multivariate analysis of survival, recurrence, metastasis, hypercalcaemia, and leucocytosis were strong independent prognostic factors. Median survival was low if the patient had hypercalcaemia or leucocytosis (179 (range 3-73) days if the patient had distant metastasis, and 43 (range 3-102) days if the patient had locoregional recurrence). The incidence of hypercalcaemia and leucocytosis was high during the course of the disease, and both conditions have an adverse impact on survival from oral SCC. Periodic evaluation of serum calcium concentrations and WCC should be routine during the postoperative period.
authors.affiliation: Division of Oral & Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-Pai Road, Beitou District, Taipei 112, Taiwan, ROC; Faculty of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112, Taiwan, ROC. Electronic address: dryawei@hotmail.com.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Division of Oral & Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-Pai Road, Beitou District, Taipei 112, Taiwan, ROC. Electronic address: ilchen@vghtpe.gov.tw.
authors.forename: I-Ling
authors.initials: IL
authors.lastname: Chen
authors.affiliation: Division of Oral & Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-Pai Road, Beitou District, Taipei 112, Taiwan, ROC. Electronic address: chingabi@gmail.com.
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Lin
authors.affiliation: Division of Oral & Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-Pai Road, Beitou District, Taipei 112, Taiwan, ROC; Faculty of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112, Taiwan, ROC.
authors.forename: Shou-Yen
authors.initials: SY
authors.lastname: Kao
mesh_terms: D002118:Calcium / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D007958:Leukocyte Count; D007964:Leukocytosis / Q000150:complications*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002118:Calcium
keywords: Hypercalcaemia; Leucocytosis; Oral squamous cell carcinoma; Survival