Prognostic significance of increased preoperative red cell distribution width (<scp>RDW</scp>) and changes in <scp>RDW</scp> for colorectal cancer

Lu, Xian; Huang, Xiaofan; Xue, Min; Zhong, Zhenyu; Wang, Ran; Zhang, Wen; Wang, Lili; Qiao, Yuhan; Ling, Fei; Zhang, Qian; Zhang, Yueying

doi:10.1002/cam4.6036

Cited by 11 publications

(4 citation statements)

References 34 publications

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“…In the present study, we showed that the RDW level was higher in the group with liver metastasis than in the group without liver metastasis after colon cancer surgery. This result is consistent with the findings of Lu et al [ 28 ]. These results suggest that preoperative RDW has a certain predictive value for postoperative liver metastasis in colon cancer.…”

Section: Discussionsupporting

confidence: 94%

Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer

Cheng,

Xu,

Liu

et al. 2024

World J Gastrointest Surg

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BACKGROUND Colon cancer is one of the most common malignant tumors of the digestive system. Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer. AIM To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery. METHODS We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People’s Hospital from December 2019 to December 2022. Patients were divided into liver metastasis and non-liver metastasis groups. Sex, age, and other general and clinicopathological data (preoperative blood routine and biochemical test indexes) were compared. The risk factors for liver metastasis were analyzed using single-factor and multifactorial logistic regression. A predictive model was then constructed and evaluated for efficacy. RESULTS Systemic inflammatory index (SII), C-reactive protein/albumin ratio (CAR), red blood cell distribution width (RDW), alanine aminotransferase, preoperative carcinoembryonic antigen level, and lymphatic metastasis were different between groups (P < 0.05). SII, CAR, and RDW were risk factors for liver metastasis after colon cancer surgery (P < 0.05). The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively. The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve, with good agreement. The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases, indicating that the model is safer. CONCLUSION Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII, CAR, and RDW.

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Section: Discussionsupporting

confidence: 94%

Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer

Cheng,

Xu,

Liu

et al. 2024

World J Gastrointest Surg

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“…This suggests high RDW predicts poorer ICI response. Other studies demonstrate similar connections between high pre-treatment RDW and worse cancer prognosis, including colorectal and metastatic renal cell carcinomas [ 24 , 25 ]. As with these studies, our research suggests that high RDW values are associated with a poor prognosis.…”

Section: Discussionmentioning

confidence: 63%

High red blood cell distribution width attenuates the effectiveness of Immune checkpoint inhibitor therapy: An exploratory study using a clinical data warehouse

Matsumoto,

Fukushima,

Kobayashi

et al. 2024

PLoS ONE

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Background Immune checkpoint inhibitors (ICIs) have improved outcomes in cancer treatment but are also associated with adverse events and financial burdens. Identifying accurate biomarkers is crucial for determining which patients are likely to benefit from ICIs. Current markers, such as PD-L1 expression and tumor mutation burden, exhibit limited predictive accuracy. This study utilizes a Clinical Data Warehouse (CDW) to explore the prognostic significance of novel blood-based factors, such as the neutrophil-to-lymphocyte ratio and red cell distribution width (RDW), to enhance the prediction of ICI therapy benefit. Methods This retrospective study utilized an exploratory cohort from the CDW that included a variety of cancers to explore factors associated with pembrolizumab treatment duration, validated in a non-small cell lung cancer (NSCLC) patient cohort from electronic medical records (EMR) and CDW. The CDW contained anonymized data on demographics, diagnoses, medications, and tests for cancer patients treated with ICIs between 2017–2022. Logistic regression identified factors predicting ≤2 or ≥5 pembrolizumab doses as proxies for progression-free survival (PFS), and Receiver Operating Characteristic analysis was used to examine their predictive ability. These factors were validated by correlating doses with PFS in the EMR cohort and re-testing their significance in the CDW cohort with other ICIs. This dual approach utilized the CDW for discovery and EMR/CDW cohorts for validating prognostic biomarkers before ICI treatment. Results A total of 609 cases (428 in the exploratory cohort and 181 in the validation cohort) from CDW and 44 cases from EMR were selected for study. CDW analysis revealed that elevated red cell distribution width (RDW) correlated with receiving ≤2 pembrolizumab doses (p = 0.0008), with an AUC of 0.60 for predicting treatment duration. RDW’s correlation with PFS (r = 0.80, p<0.0001) and its weak association with RDW (r = -0.30, p = 0.049) were confirmed in the EMR cohort. RDW also remained significant in predicting short treatment duration across various ICIs (p = 0.0081). This dual methodology verified pretreatment RDW elevation as a prognostic biomarker for shortened ICI therapy. Conclusion This study suggests the utility of CDWs in identifying prognostic biomarkers for ICI therapy in cancer treatment. Elevated RDW before treatment initiation emerged as a potential biomarker of shorter therapy duration.

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“…Warwick et al examined the data of 917 patients who underwent surgery for non-small-cell lung carcinoma and confirmed that a preoperative RDW-CV of >15.3% was a significant risk factor for postoperative death ( P = 0.001) and survival ( P = 0.0001) [ 24 ]. In colorectal cancer, a high RDW level (≥13.5%) was reported as an additional separate indicator of both cause-specific survival (CSS) and OS [ 25 ], with a significant reduction in 10-year OS among patients with high RDW [ 26 ]. These studies all suggest that RDW is an important biomarker for cancer.…”

Section: Discussionmentioning

confidence: 99%

Association between red cell distribution width and all-cause mortality in patients with breast cancer: A retrospective analysis using MIMIC-IV 2.0

Xiao,

Tan,

Pei

et al. 2024

PLoS ONE

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Purpose Investigating the association between red cell distribution width (RDW) and all-cause mortality in patients with breast cancer, to evaluate the potential clinical prognostic value of RDW. Methods Based on the RDW index, patients with breast cancer in the Medical Information Mart for Intensive Care (MIMIC-IV) database were categorized into quartiles. The primary outcomes included in-hospital mortality from all causes during the first six months, the first year, and the first three years. Cox hazards regression and restricted cubic spline (RCS) models were developed to investigate the effects of RDW on primary outcomes. Results The study included 939 patients (female). The 6-month, 1-year, and 3-year mortality rates were 14.0%, 21.4%, and 28.4%, respectively. Multivariate Cox proportional hazards analyses demonstrated that RDW exhibited an autonomous association with an increased risk of all-cause mortality. After adjusting for confounders, higher RDW quartiles were significantly associated with 6-month mortality (adjusted hazard ratio (HR), 3.197; 95% confidence interval (CI), 1.745–5.762; P < 0.001), 1-year mortality (adjusted HR, 2.978; 95% CI, 1.867–4.748; P < 0.001), and 3-year mortality (adjusted HR, 2.526; 95% CI, 1.701–3.750; P < 0.001). The RCS curves demonstrated that high RDW (> 14.6) was associated with a greater risk of all-cause mortality. Subgroup analyses revealed no statistically significant differences in the interactions between the subgroups. Conclusion The study revealed a highly pronounced relationship between RDW and overall mortality, indicating its potential as an autonomous prognostic factor for increased mortality among patients with breast cancer.

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Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 11 publications

References 34 publications

Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer

Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer

High red blood cell distribution width attenuates the effectiveness of Immune checkpoint inhibitor therapy: An exploratory study using a clinical data warehouse

Association between red cell distribution width and all-cause mortality in patients with breast cancer: A retrospective analysis using MIMIC-IV 2.0

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