Predicting survival in cancer patients: the role of cachexia and hormonal, nutritional and inflammatory markers

Abstract

BackgroundCancer can lead to weight loss, anorexia, and poor nutritional status, which are associated with decreased survival in cancer patients.MethodsMale cancer patients (n = 136) were followed for a mean time of 4.5 years. Variables were obtained at baseline: cancer stage, albumin, hemoglobin, tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, bioavailable testosterone, appetite questionnaire, and weight change from baseline to 18 months. Primary statistical tests included Kaplan–Meier survival analysis and Cox proportional hazard regression (PHREG).ResultsUnivariate PHREG showed that cancer stage, albumin, hemoglobin, TNF-α, IL-6, and weight change were each significantly associated with mortality risk (P < 0.05), but bioavailable testosterone was not. Multivariate PHREG analysis established that weight change and albumin were jointly statistically significant even after adjusting for stage.ConclusionIn this sample of male oncology patients, cancer stage, serum albumin, and weight loss predicted survival. High levels of inflammatory markers and hemoglobin are associated with increased mortality, but do not significantly improve the ability to predict survival above and beyond cancer stage, albumin, and weight loss.Electronic supplementary materialThe online version of this article (doi:10.1007/s13539-012-0075-5) contains supplementary material, which is available to authorized users.