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Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer

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Abstract

Chronic systemic inflammatory response is proposed as an underlying mechanism for development of cancer cachexia. We conducted a prospective study to examine changes in inflammatory biomarkers during the disease course and the relationship between inflammatory biomarkers and cachexia in patients with inoperable pancreatic cancer. Twenty patients, median (range) age 67.5 (35–79) years, 5 females, were followed for median 5.5 (1–12) months. Cachexia was diagnosed according to the 2011 consensus-based classification system (weight loss >5 % past six months, BMI < 20 kg/m2 and weight loss >2 %, or sarcopenia) and the modified Glasgow Prognostic score (mGPS) that combines CRP and albumin levels. Inflammatory biomarkers were measured by enzyme immunoassays. The patients had increased levels of most inflammatory biomarkers, albeit not all statistically significant, both at study entry and close to death, indicating ongoing inflammation. According to the consensus-based classification system, eleven (55 %) patients were classified as cachectic upon inclusion. They did not differ from non-cachectic patients with regard to inflammatory biomarkers or energy intake. According to the mGPS, seven (35 %) were defined as cachectic and had a higher IL-6 (p < 0.001) than the non-cachectic patients. They also had a slightly, but insignificantly longer survival than non-cachectic patients (p = 0.08). The mGPS should be considered as an additional framework for identification of cancer cachexia.

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Acknowledgments

The entire data collection was carried out at the Departments of Surgery, Oncology and Palliative Care at Oslo University Hospital. Appreciation is expressed to the staff of the study and to patients who participated.

Funding

This study was funded by Oslo and Akershus University College of Applied Sciences and Hole’s trust fund.

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Authors and Affiliations

  1. Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs Plass, 0130, Oslo, Norway

    Asta Bye, Nima Wesseltoft-Rao, Grete Skjegstad & Stine Ulven

  2. Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway

    Asta Bye & Marianne J. Hjermstad

  3. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    Nima Wesseltoft-Rao, Per Ole Iversen, Kirsten B. Holven & Stine Ulven

  4. Department of Hematology, Oslo University Hospital, Oslo, Norway

    Per Ole Iversen

  5. Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway

    Kirsten B. Holven

  6. European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Marianne J. Hjermstad

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  1. Asta Bye
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Correspondence to Asta Bye.

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Bye, A., Wesseltoft-Rao, N., Iversen, P.O. et al. Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer. Med Oncol 33, 54 (2016). https://doi.org/10.1007/s12032-016-0768-2

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