Cancer-induced cachexia is the most common paraneoplastic syndrome and is recognized as an indicator of poor prognosis. Cachexia often occurs in advanced pancreatic cancer, but its mechanism has not been fully elucidated. A number of hormones and cytokines are associated with cachexia. We investigated the role of fasting hormones and pro-inflammatory cytokines in cachexia patients with pancreatic cancer.Methods
We enrolled patients with advanced pancreatic cancer in two groups, those with or without cachexia. Eligibility criteria for the cachexia group were >10% weight loss in 6 months, grade 1–4 anorexia, and PS 1-4. Eligibility criteria for the non-cachexia group were <5% weight loss in 6 months, serum albumin >3.5 mg/dl, grade 0-1 anorexia and PS 0-2. We compared patient characteristics and clinical data of the two groups, and measured the plasma level of IL-6, TNF-α and leptin.Results
From December 2009 to July 2011, 21 patients (median age, 65 years; range, 36–77 years) were enrolled. In all, 16 (76.2%) patients were male, and 10 (47.6%) patients had stage IVA disease, and the rest had stage IVB disease. In the cachexia group (n = 9), median body weight loss was greater (15.5% versus 2.5%), PS (0, 1, 2, 3) was poorer (n = 0, 5, 3, 1 versus 4, 8, 0, 0) and anorexia (Grade 0, 1, 2, 3) was more severe (n = 0, 8, 0, 1 versus 5, 7, 0, 0) than in the non-cachexia group (n = 12). The median IL-6 level and TNF-α levels appeared higher and leptin concentration appeared lower in the cachexia group albeit without statistical significance (13.8 versus 6.8 pg/ml, P = 0.34; 7.1 versus 3.3 pg/ml, P = 0.27; 2.4 versus 4.0 ng/ml, P = 0.27).Conclusions
In our study, the plasma level of IL-6, TNF-α and leptin appeared to be associated with cachexia in patients with advanced pancreatic cancer. Metabolomic analyses are underway.