The Prognostic Role of Inflammation and Hormones in Patients with Metastatic Cancer with Cachexia

Abstract

ABSTRACT Aim: We aimed to investigate the possiple etiologic factors of cachexia. Methods: Forty-six patients diagnosed with cancer cachexia and 34 healthy controls were included in the study. Serum total testosterone, interleukin 1 (IL) alpha and beta, IL 6, tumor necrosis factor (TNF) alpha, orexin, galanin, neuropeptide Y, TNF-like weak inducer of apoptosis (TWEAK) and TNF receptor-associated factor 6 (TRAF 6) and C reactive protein (CRP) levels were investigated. Results: There were 36 male and 10 female patients in the cachexia group, and 24 male and 10 female patients in the control group. There was no statistcally significant difference for age, white blood cell count, and liver functions between the groups.The most common type of cancer in the cachexia group was gstro-esophageal cancers (n = 24); the remaining 7 patients had pacreatic cancer,7 had lung cancer and, 4 had colorectal cancer, 2 had ovarian cancer, 1 had breast cancer and 1 had laryngeal caner. All 46 patients had systemic metastasis at the time of the study and all of the patients died during the study follow up. Median overall survival (OS) of the cachexia group after the diagnosis of cachexia was 8 (1-25) months. There were statistically significant relationships between OS and BMI, serum CRO, TRAF6, albumin and LDH levels in the cachexia group (P= 0.009, 0.0001, 0.017, 0.001 and 0.001, respectively). In addition to cachexia group, serum CRP, testosterone, and TNF alpha levels were statistically significantly correlated with OS in refractory cachexia (P = 0.0001, 0.001 and 0.017, respectively). Conclusions: Although cachexia presents with a multifactorial etiopathogenesis, few of the factors affect the OS. Our novel results were serum CRP, albumin, LDH and TRAF 6 levels have a higher association with OS in patients with cancer cachexia compared with the many other parameters. An ongoing cachexia also called refractory cachexia is a recent definition. This end- stage term of cancer duration may be predicted by decreasing serum testosterone and increasing serum TNF alpha levels,as well as serum CRP levels. Disclosure: All authors have declared no conflicts of interest.