Clinical Relevance of Red Blood Cell Distribution Width (RDW) in Endometrial Cancer: A Retrospective Single-Center Experience from Korea

Eoh, Kyung Jin; Lee, Taekyung; Nam, Eun Ji; Kim, Sang Wun; Kim, Young-Tae

doi:10.3390/cancers15153984

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Specifically, the percentages of patients with high RDW were 14.4% in stage I, 32.2% in stage II, 37.6% in stage III, and 39.4% in stage IV. This suggests a potential role for RDW as a prognostic marker in EC [17].…”

Section: Discussionmentioning

confidence: 84%

Clinical Correlations between Serological Markers and Endometrial Cancer

Marin,

Filipescu,

Petca

et al. 2024

Cancers

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Background: Endometrial cancer is associated with changes in blood cell counts and with high levels of inflammatory markers, thus reflecting the tumor’s impact on various biological processes and suggesting their potential as biomarkers for endometrial cancer diagnosis, prognosis, and treatment response. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in peripheral blood sampled preoperatively from patients have been reported to be independently associated with the prognosis of different types of malignancies. Objectives: This study aimed to compare several blood markers—red blood cells, white blood cells, platelet parameters, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, C-reactive protein, and fibrinogen—in patients with benign or malignant endometrial tumors. Material and methods: Our retrospective study included 670 patients (192 diagnosed with endometrial cancer and 478 with endometrial hyperplasia), and we compared the serological parameters discussed above with those sampled the day before surgery. Results: Analysis of complete blood count indices revealed no significant differences in red blood cell or total white blood cell parameters between the endometrial cancer group and the endometrial hyperplasia group. However, a distinct pattern emerged in the white blood cell differential. The endometrial cancer group showed a statistically significant decrease in lymphocyte count compared with the endometrial hyperplasia group. In contrast, the endometrial cancer group showed significantly higher mean platelet counts and increased mean platelet volume compared with controls. Furthermore, the endometrial cancer group demonstrated a marked inflammatory response, as evidenced by significantly elevated levels of C-reactive protein, fibrinogen, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio compared with the endometrial hyperplasia group. Conclusions: The current research revealed statistically significant differences in multiple serological biomarkers between the two groups. These findings support the initial hypothesis regarding the potential utility of these biomarkers in endometrial cancer diagnosis, prognosis, and treatment response, highlighting the existence of biomarkers affordable for analysis under any health system, regardless of the country’s level of development.

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Section: Discussionmentioning

confidence: 84%

Clinical Correlations between Serological Markers and Endometrial Cancer

Marin,

Filipescu,

Petca

et al. 2024

Cancers

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“…Complete blood count-based biomarkers have been shown to correlate well with clinical outcomes in numerous chronic [ 5 , 6 , 7 , 8 , 9 , 10 ], infectious [ 11 , 12 , 13 , 14 , 15 ], and surgical conditions [ 16 , 17 , 18 , 19 , 20 ], as well as in cancer [ 21 , 22 , 23 , 24 , 25 , 26 ]. In particular, the potential role of the red cell distribution width (RDW), a biomarker of the heterogeneity of red blood cells’ size, in predicting adverse events and survival currently represents a topic of intense research in numerous clinical conditions [ 27 , 28 ], including malignancies such as colorectal cancer [ 29 , 30 , 31 ], esophageal cancer [ 32 , 33 ], lung cancer [ 34 , 35 ], breast cancer [ 36 , 37 ], and other malignancies [ 38 , 39 , 40 , 41 , 42 ]. In addition, several studies have shown that alterations in the RDW correlate with liver function and prognosis in numerous hepatic cancer-predisposing conditions, such as hepatitis B, chronic liver disease, and fibrosis [ 43 , 44 , 45 , 46 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma

Vidili,

Zinellu,

Mangoni

et al. 2024

Medicina

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Background and Objectives. Hepatocellular carcinoma (HCC) and the intrahepatic biliary tract cancers are estimated to rank sixth for incidence among solid cancers worldwide, and third for mortality rates. A critical issue remains the need for accurate biomarkers for risk stratification and overall prognosis. The aim of this study was to investigate the ability of a biomarker of heterogeneity of the size of red blood cells, the red cell distribution width (RDW), to predict survival in patients with HCC. Materials and Methods. A consecutive series of patients with a histologic diagnosis of HCC were included into this study irrespective of their age, stage of the disease, and treatment administered, and followed-up for a period of three years. Demographic, anthropometric [age, sex, body mass index (BMI)], and clinical data (Charlson Comorbidity Index, Child–Pugh score, etc.), along with laboratory tests were retrieved from clinical records. Results. One-hundred and four patients were included in this study. Among them, 54 (69%) were deceased at the end of the follow-up. Higher RDW values, but not other hematological and biochemical parameters, were significantly associated with mortality in both univariate and multivariate analysis. The optimal RDW cut-off value identified with the Youden test for survival was 14.7%, with 65% sensitivity and 74% specificity (AUC = 0.718, 95% CI 0.622–0.802, p < 0.001). Kaplan–Meier survival curves showed significantly lower survival with higher RDW values (HR = 3.5204; 95% CI 1.9680–6.2975, p < 0.0001) with a mean survival of 30.9 ± 9.67 months for patients with RDW ≤ 14.7% and 22.3 ± 11.4 months for patients with RDW > 14.7%. Conclusions. The results of our study showed that RDW can perform better than other blood-based biomarkers in independently predicting prognosis in patients with HCC.

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“…Tumors affecting the bone marrow, as seen in myelodysplastic syndromes and leukemia, can disrupt the normal production of RBCs, manifesting as changes in the RDW and Hb levels, ultimately influencing the Hb/RDW ratio [51]. Furthermore, advanced tumor stages and larger tumor sizes have been linked to changes in the RDW, offering insights into tumor characteristics and progression [52]. Therapies like chemotherapy and radiation, which directly affect bone marrow and the production of RBCs, contribute to the composite nature of the Hb/RDW ratio, making it a valuable indicator of a patient's overall condition [53,54].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, advanced tumor stages and larger tumor sizes have been linked to changes in the RDW, offering insights into tumor characteristics and progression [52]. Therapies like chemotherapy and radiation, which directly affect bone marrow and the production of RBCs, contribute to the composite nature of the Hb/RDW ratio, making it a valuable indicator of a patient's overall condition [53,54].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions

Coradduzza,

Medici,

Chessa

et al. 2023

Medicina

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Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the Hb/RDW ratio in cancer and the implications for clinical practice. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science databases was performed by an independent author between 18 March and 30 March 2023 to collect relevant literature that assessed the prognostic value of the Hb/RDW ratio in cancer. Overall survival (OS), progression-free survival (PFS), and the association of these with the Hb/RDW ratio were considered to be the main endpoints. Results: Thirteen retrospective studies, including 3818 cancer patients, were identified and involved in this review. It was observed that, when patients with a high vs. low Hb/RDW ratio were compared, those with a lower Hb/RDW ratio had significantly poorer outcomes (p < 0.05). In lung cancer patients, a one-unit increase in the Hb/RDW ratio reduces mortality by 1.6 times, whilst in esophageal squamous-cell carcinoma patients, a lower Hb/RDW ratio results in a 1.416-times greater risk of mortality. Conclusions: A low Hb/RDW ratio was associated with poor OS and disease progression in patients with cancer. This blood parameter should be considered a standard biomarker in clinical practice for predicting OS and PFS in cancer patients. Future searches will be necessary to determine and standardize the Hb/RDW cut-off value and to assess whether the Hb/RDW ratio is optimal as an independent prognostic factor or if it requires incorporation into risk assessment models for predicting outcomes in cancer patients.

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Clinical Relevance of Red Blood Cell Distribution Width (RDW) in Endometrial Cancer: A Retrospective Single-Center Experience from Korea

Cited by 6 publications

References 32 publications

Clinical Correlations between Serological Markers and Endometrial Cancer

Clinical Correlations between Serological Markers and Endometrial Cancer

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma

Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions

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