Prognosis poor with high IL-6 before colorectal cancer surgery

NEW YORK (Reuters Health), May 16 - Production of high levels of interleukin-6 (IL-6) by mononuclear blood cells in response to lipopolysaccharide (LPS) stimulation in vitro is associated with shorter survival in patients about to undergo primary surgery for colorectal cancer, Swedish investigators have shown.

Dr. Birgitta Clinchy and colleagues at University Hospital Linköping isolated peripheral blood mononuclear cells (PBMC) from 39 patients scheduled for colorectal surgery. The cells were cultured for 24 hours in the presence of autologous serum and LPS.

The investigators report, in the May 1st issue of Cancer, that production of high levels of IL-6 was associated with a poor prognosis.

Eight of the 13 patients who produced more than 5,000 pg/mL of IL-6 preoperatively died from cancer during 54 months of follow-up. There were no cancer-related deaths in the 21 patients who produced 5,000 pg/mL or less IL-6. (Five patients died of other causes during follow-up.)

Dr. Clinchy and colleagues say that high IL-6 production pre-operatively is an independent prognostic factor in survival after surgery for colorectal cancer.

"A determination of high IL-6 production identifies patients at high risk of recurrence," Dr. Clinchy told Reuters Health. "Pre- and/or postoperative medical treatment can be offered to these patients."

Furthermore, "Good risk patients after standard surgery can be identified by LPS-induced IL-6 production. If a more aggressive surgical approach than standard surgery is considered, this can be restricted to patients at high risk of recurrence," which would be those with high LPS-induced IL-6 production.

By Martha Kerr

Last Updated: 2007-05-15 14:11:16 -0400 (Reuters Health)

Cancer 2007;109:1742-1749.

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