title: Interleukin-6 but not tumour necrosis factor-alpha predicts survival in patients with advanced cancer.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Medicine, Dongguk University, Seoul, South Korea.
authors.forename: Sang-Yeon
authors.initials: SY
authors.lastname: Suh
authors.forename: Youn Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Yeom
authors.forename: Sang Mi
authors.initials: SM
authors.lastname: Kwak
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Yoon
authors.forename: Dae Gyun
authors.initials: DG
authors.lastname: Kim
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Koh
authors.forename: Jeanno
authors.initials: J
authors.lastname: Park
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Ah-Ram
authors.initials: AR
authors.lastname: Seo
authors.forename: Hong-Yup
authors.initials: HY
authors.lastname: Ahn
authors.forename: Eunji
authors.initials: E
authors.lastname: Yim
mesh_terms: D000368:Aged; D000855:Anorexia / Q000378:metabolism / Q000401:mortality; D002100:Cachexia / Q000378:metabolism / Q000401:mortality; D005260:Female; D006738:Hospices; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000378:metabolism* / Q000401:mortality*; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha