Red blood cell distribution width has a prognostic value for gastric cancer patients after gastrectomy: A pooling-up analysis

Abstract

Our study aims to investigate whether preoperative red blood cell distribution width (RDW) has a prognostic value for patients after gastric cancer (GC) surgery. We searched articles in 3 databases including PubMed, Embase, and the Cochrane Library on May 16th, 2022. The prognostic indicators included overall survival (OS) and disease-free survival (DFS). RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom) and Stata V16.0 were used for statistical analysis. The Risk Of Bias In Non-randomized Studies—of Interventions tool was used to assess risk of bias of the included studies. Ten articles involving 2740 patients were included. RDW was a prognostic factor for OS (hazard ratio = 1.81, 95% confidence interval [CI] = 1.38–2.37, P < .01) and DFS (hazard ratio = 1.99, I 2 = 26%, 95% CI = 1.53–2.58, P < .01) for GC patients. Meanwhile, there were some differences between the high RDW group and the low RDW group. We found more patients older than 60 years old (OR = 2.58, 95% CI = 1.08–6.13, P = .03), larger tumor diameter (OR = 1.95, 95% CI = 1.33–2.85, P < .01) and later T stage (OR = 1.91, 95% CI = 1.07–3.42, P = .03) in the high RDW group than the low RDW group. No statistic difference was found in gender, N stage, tumor node metastasis stage, vascular invasion, differentiation, and adjuvant therapy between the 2 groups (P > .05). RDW was an independent prognostic factor for both OS and DFS of GC patients. High RDW level were strongly associated with poor survival.

Impact of red blood cell distribution width (RDW) on postoperative outcomes in hepatocellular carcinoma (HCC) patients

“…[28] Additionally, RDW has been associated with various cancers. [6–14] However, the specific prognostic impact of RDW on HCC remains unclear, with the underlying mechanisms yet to be fully elucidated.…”

“…Recent studies have highlighted RDW as a potent and independent risk factor for various cancers, including breast, [ 6 , 7 ] lung, [ 8 – 10 ] nasopharyngeal, [ 11 ] esophageal, [ 12 ] and colorectal cancers. [ 13 , 14 ]…”

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

“…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 ].…”