Preoperative red cell distribution width is associated with postoperative lymphovascular invasion in prostate cancer patients treated with radical prostatectomy: A retrospective study

Abstract

PurposeTo investigate the relationship between baseline clinicopathological and laboratory variables especially hematological parameters and lymphovascular invasion (LVI) in patients who underwent radical prostatectomy (RP).MethodsWe retrospectively evaluated 348 prostate cancer (PCa) patients who underwent RP in our center between May 2018 and June 2021. We divided them into non-LVI and LVI groups based on LVI status, and compared clinicopathological characteristics between non-LVI and LVI groups. Clinicopathological parameters including age, body mass index (BMI), history of hypertension and diabetes mellitus, neoadjuvant hormonal therapy (NHT), pathological stage T (pT) and lymph node status (pN), ISUP (international society of urological pathology) grade, positive surgical margin (PSM) rate, and hematological parameters containing prostate-specific antigen (PSA), whole blood parameters and inflammatory indexes were collected. The association between the clinicopathological parameters and the presence of LVI was identified by multivariate logistic regression analysis.ResultsThe pathological results of the RP specimen consisted of 53 (15.2%) patients with LVI and 295 (84.8%) cases without LVI. The level of PSA, percentages of advanced pT and grade, pN1, and PSM were significantly higher in the LVI group when compared with the non-LVI counterpart (p<0.001, p<0.001, p<0.001, p<0.001, p=0.007, respectively). Among the whole blood parameters, only red cell distribution width (RDW) was significantly different (41.2 ± 2.5 vs. 42.1 ± 3.1, p=0.035). Multivariate regression analysis demonstrated that RDW and NHT were negatively correlated with the presence of LVI (OR = 0.870, p=0.024; OR = 0.410, p=0.025), while PSA, ISUP, and pT were positively correlated with the presence of LVI (OR=1.013, p=0.005; OR =1.589, p=0.001; OR=1.655, p=0.008) after adjusting for confounding factors.ConclusionsRDW rather than other whole blood parameters was independently and negatively associated with the presence of LVI in PCa patients, suggesting that RDW might play an essential role in PCa invasion.

The clinical meaning of lymphovascular invasion: preoperative predictors and postoperative implications in prostate cancer - a retrospective study

“…This approach holds the potential to enhance risk stratification and further refine therapeutic decisionmaking in PCa management. The logistic regression identified preoperative PSA, PPBC, and GGG as robust predictors of LVI, consistent with findings from previous studies (5,15,(25)(26)(27)(28)(29)(30)(31)(32). Notably, we also identified MRI-based cT as a significant predictor of LVI, a factor not previously described in the literature to the best of our knowledge.…”

Causal Associations between Prostate Cancer and Various Hematological Parameters: Insights from Multivariable and Bidirectional Mendelian Randomization Analyses

“…The existing body of research has established various associations between hematological parameters and PCa, highlighting the potential of these indicators in understanding disease progression and prognosis. Wang F et al demonstrated a signi cant correlation between preoperative red cell distribution width (RDW) and lymphovascular invasion in PCa, suggesting RDW's importance in the disease's advancement (Wang et al 2022). Similarly, Albayrak et al found RDW to be predictive of an increased risk of PCa, further underscoring its role in disease progression (Albayrak et al 2014).…”

Preoperative Factors for Lymphovascular Invasion in Prostate Cancer: A Systematic Review and Meta-Analysis

“…One study [10] included 79 PCa patients, although the exact number of LVI-positive patients was not disclosed. Of thirty-nine included papers, seventeen were retrospective and single-center [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], twelve were retrospective and multi-center [28][29][30][31][32][33][34][35][36][37][38][39], eight were prospective and single-center [10,[40][41][42][43][44][45][46], and two were retrospective and database-registry-based [47,48]. Most commonly, LVI was defined as the unequivocal presence of tumor cells within endothelial-lined spaces.…”

“…A total of five studies investigated the correlation between BMI and LVI [17,[25][26][27]39]. Due to substantial diversity of data presentation, one of them was excluded, leaving four studies that made the final meta-analysis [17,25,26,39]. A total of 3999 patients were analyzed, 592 of whom were LVI-positive.…”