the role of serum interleukin-6 levels in prognosticating postoperative complications after cytoreductive surgery for ovarian cancers: a prospective observational study

Background: interleukin-6 (il-6), a pro-inflammatory cytokine, has been associated with adverse prognosis in ovarian cancer. cytoreductive surgery for ovarian cancer has a higher risk of postoperative surgical complications (pocs). we aimed to find out if serum il-6 is elevated preoperatively in patients undergoing cytoreductive surgery for ovarian cancer and if it can predict pocs. we also compared its trend with serum c-reactive protein (crp) in the early postoperative period. materials and methods: fifty-one patients between 18?75 years, posted for elective ovarian cytoreductive surgery at a tertiary cancer hospital were included after taking informed consent. serum il-6 and crp were done the day before surgery and repeated 24 and 72 hours post-surgery. all parameters that affect pocs were captured. pocs were graded using the clavein dindo classification. we recorded the length of the intensive care unit (icu), hospital stay, and 30-day mortality. appropriate statistical tests were used and p value <0.05 was considered significant. results:?out of 51 enrolled patients, 46 were included for data analysis after exclusions. the mean age of patients in this study was 49.76 +/- 12.42 years with a mean surgical duration of 302.39 +/- 127.04 minutes and mean blood loss of 332.6 +/- 274.71 ml. the incidence of pocs in our study was 21.7% (10/46 patients). preoperative il-6 was raised and was able to predict pocs with 70% sensitivity and 86% specificity at a cutoff value of 23.56 pg./ml (r2 = 0.71; auc = 0.79). in patients who developed pocs, il-6 values (1196.7+/-1461.4 pg./ml) peaked at 24 hours whereas crp values (360 +/- 430.1 mg/l) peaked at 72 hours; thus, allowing early prognostication with il-6. the cut-off value of serum il-6 at 24 hours to predict pocs is 480 pg./ml (r2 = 0.50; auc = 0.79) with 80% sensitivity and 89% specificity. two patients died - on postoperative days 5 and 28 respectively. conclusion: preoperative il-6 is raised in patients with ovarian cancer posted for cytoreductive surgery. a cut-off value of 23.56 pg./ml preoperatively and 480 pg./ml at 24 hours after surgery could predict postoperative surgical complications.