Interleukin-6 but not tumour necrosis factor-alpha predicts survival in patients with advanced cancer

Support Care Cancer. 2013 Nov;21(11):3071-7. doi: 10.1007/s00520-013-1878-4. Epub 2013 Jul 5.

Abstract

Purpose: The purpose of this study was to evaluate the prognostic role of interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) in the survival of patients with advanced cancer.

Methods: In this prospective cohort study between three hospice and palliative care centres in South Korea, we followed 98 advanced cancer patients until death or the end of the study. Approximately 60 % of the patients had poor functional status (Eastern Cooperative Oncology Group score ≥3). We investigated the symptoms of cancer cachexia anorexia syndrome, possible cytokine-related confounders such as infection and medication records. Influence from clinical variables was adjusted using the Cox proportional hazard model.

Results: The median survival time was 27 days. On multivariate analysis, elevated IL-6 (hazard ratio, 2.139; p = 0.003) was found to be an independent significant prognostic factor. TNF-α was not a significant factor. Poor performance status and male gender were also independently related to shortened survival.

Conclusions: IL-6 level can be a useful indicator of survival time of patients with advanced cancer at the very end of life. In contrast, the prognostic role of TNF-α requires further study.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anorexia / metabolism
  • Anorexia / mortality
  • Cachexia / metabolism
  • Cachexia / mortality
  • Female
  • Hospices
  • Humans
  • Interleukin-6 / blood*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms / metabolism*
  • Neoplasms / mortality*
  • Palliative Care
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Risk Factors
  • Tumor Necrosis Factor-alpha / blood*

Substances

  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha