The following is a summary of “Interleukin-6 in relation to early recurrence in primary, localized soft tissue sarcoma: an addition for existing risk classification systems?,” published in the July 2024 issue of Surgery by Laan et al.

Inflammatory markers have garnered significant attention as prognostic indicators in cancer. This study aims to assess the prognostic value of interleukin-6 (IL-6), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for predicting aggressive behavior and early recurrence in primary, localized soft tissue sarcoma (STS).

A retrospective review was conducted on 115 patients with STS, with pre-treatment blood levels of IL-6, CRP, NLR, and PLR recorded. Early recurrence was defined as either local or distant disease relapse within the first year post-surgery. Cox regression analysis was employed to identify prognostic factors associated with early recurrence.

The study found elevated IL-6 levels correlated with higher tumor grade, larger tumor size, increased tumor necrosis, and a higher mitotic count. Additionally, elevated NLR was linked to higher tumor grade, while elevated PLR was associated with larger tumor size. Early recurrence occurred in 24 patients (21%). The univariable analysis identified tumor grade (p = 0.029), tumor size (p = 0.030, >10cm vs <5cm), tumor depth (p = 0.036), necrosis on imaging (p = 0.008), mitotic count (p = 0.045, ≥20 mitoses vs 0-9 mitoses), and IL-6 level (p = 0.044) as factors associated with early recurrence. Other factors, such as age at diagnosis, tumor location, necrosis at pathology, (neo)adjuvant radio- or chemotherapy, resection margin, CRP level, NLR, and PLR, were not significantly related to early disease recurrence.

The findings suggest that increased levels of inflammatory markers in STS are indicative of a more aggressive tumor phenotype. Specifically, patients with elevated IL-6 levels may have a higher risk of early disease recurrence, highlighting the potential of IL-6 as a valuable addition to existing risk classification systems for STS.

Source: sciencedirect.com/science/article/abs/pii/S0748798324005821