Pretreatment Level of Red Cell Distribution Width as a Prognostic Indicator for Survival in a Large Cohort Study of Male Laryngeal Squamous Carcinoma

Abstract

Objective: High levels of red cell distribution width (RDW) may be associated with adverse outcomes in patients with cancer. The purpose of the present study was to investigate the prognostic impact of pretreatment RDW levels on overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) in a large cohort of male laryngeal squamous cell cancer (LSCC) patients. Methods: A total of 809 LSCC patients who were treated between 2007 and 2011 at the Eye & ENT Hospital of Fudan University were enrolled and evaluated retrospectively. OS, CSS, and DFS were analyzed using the Kaplan–Meier method. To evaluate the prognostic significance of RDW levels, univariate, and multivariate Cox analyses were applied. Results: Higher pretreatment RDW levels were significantly associated with high death events, red blood cell count, hemoglobin, radiotherapy, operation therapy, and advanced tumor stage ( p < 0.05). From the univariate analysis, we observed that the higher (13.2–13.5%) and the highest (>13.5%) quartiles of RDW level were consistent factors for poor OS, CSS, and DFS in LSCC patients. In the multivariate analysis, after adjusting for confounding factors, the higher and highest quartiles of RDW levels were identified as independent prognostic factors in male LSCC patients. Conclusion: Higher pretreatment RDW levels were demonstrated to be associated with poor clinical outcome in male LSCC patients and might be novel markers for patient stratification in LSCC management.

Prognostic significance of red cell distribution width in bladder cancer

“…RDW is conventionally used to evaluate hematological diseases, especially anemia (13). In recent years, RDW has been reported as a biomarker of carcinoma (14)(15)(16)(17). However, the correlation of RDW with bladder cancer is still not clear.…”

The prognostic value of red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in radiotherapy for oropharyngeal cancer

“…Moreover, the cut-off values are significantly different. For example, in the aforementioned studies, the authors used the cut-off values of 13.2% [ 24 ] and 15% [ 25 ] for RDW, and 2.32 [ 26 ], 2.2 [ 27 ], 1.81 [ 28 ] and 3.9 [ 29 ] for NLR.…”

Association Between Pre-Treatment and Post-Treatment 3-Month Red Cell Distribution Width with Three-Year Prognosis of Prostate Cancer

“…Several previous studies that have investigated the relationship between pre-treatment RDW and prognosis in various types of cancer 9,11,[15][16][17][18] have consistently reported that RDW could be a useful marker for poor prognosis prediction in patients with cancer. In line with these findings, our study also found that a high pretreatment RDW level is a poor prognostic factor for OS and CSS in patients with prostate cancer.…”

“… 25 Meanwhile, the heterogeneity of red blood cell size (high RDW) correlates with inflammation and undernutrition status. 10 , 11 A higher tumor stage can lead to significant systemic inflammation through the secretion of cytokines and release of tumor-degradation products, which, in turn, increases RDW levels. 19 In our study, we also found an association between increased tumor size, advanced tumor stage, and high RDW levels.…”

“…9 The heterogeneity of red blood cell size has also been found to correlate with inflammation and undernutrition status. 10,11 Recently, numerous studies have proposed RDW as a strong, independent risk factor for death [12][13][14] and a prognostic factor for different types of cancers. 9,15,16 A population-based study by Borné et al 13 found that a high RDW level was associated with an increased incidence of fatal coronary events.…”