Interleukin-8 and clinical symptoms can be prognostic indicators for advanced cancer patients with cachexia

OBJECTIVES: Prognostic prediction is a significant tool for selecting appropriate treatment in advanced cancer patients with cachexia, at a time when it is important to offer high-quality palliative care and improve quality of life until death. In this retrospective study, we investigated the prognostic potential of serum cytokine level and various clinical symptoms by analyzing the pathological conditions and metabolic dynamics of cachexia in advanced cancer patients. METHODS: One hundred and fifty-three advanced cancer patients who underwent palliative care and died at the Department of Surgery and Palliative Medicine, Fujita Health University Nanakuri Memorial Hospital between 1 January 2004 and 30 June 2007 were eligible for the study. We simultaneously assessed their blood factors and clinical symptoms at admission. All patients were divided into two groups according to median survival time to analyze the risk factors for prognosis. RESULTS: Multivariate analysis revealed the following independent prognostic factors: interleukin (IL)-8 (odds ratio [OR]=4.17, 95% confidence interval [CI]=1.52–11.41, p=0.002), general fatigue (OR=1.22, 95%CI=1.03–1.45, p=0.019), anorexia (OR=1.19, 95%CI=1.04–1.37, p=0.008), dyspnea (OR=1.19, 95%CI=1.02–1.38, p=0.024), depression (OR=1.28, 95%CI=1.11–1.47, p<0.001), nausea (OR=1.25, 95%CI=1.05–1.48, p=0.007), dry mouth (OR=1.19, 95%CI=1.01–1.40, p=0.032), and overall assessment score (OR=1.05, 95%CI=1.02–1.09, p<0.001). Patients with low IL-8 (<1.347 pg/ml) and low overall assessment score (<26) had significantly better prognosis (both p<0.0001). CONCLUSIONS: High IL-8 level and clinical symptoms can be prognostic indicators for advanced cancer patients with cachexia.