Significance of Pretreatment Red Blood Cell Distribution Width in Patients with Newly Diagnosed Glioblastoma

Abstract

BackgroundRed blood cell distribution width (RDW) is a parameter of the complete blood count (CBC) test. Recent evidence suggests that pretreatment RDW is associated with patient survival in various malignant tumors. We explored the association of pretreatment RDW and other red blood cell (RBC) parameters with clinical parameters and assessed their prognostic impact on overall survival (OS) in patients with glioblastoma (GBM).Material/MethodsIn total, 109 patients with newly diagnosed GBM were retrospectively reviewed. The Cox proportional hazards regression model and Kaplan-Meier method were used to examine the survival function of pretreatment RDW, mean cell volume (MCV), hemoglobin (HGB), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC count, and hematocrit (HCT) values in patients with newly diagnosed GBM.ResultsUnivariate analysis showed that MCV, MCHC, and RDW were associated with overall survival (OS). However, only RDW remained significant in multivariate analysis. The Kaplan-Meier survival curves showed that patients belonging to the high-RDW group had a worse median OS (293 days versus 375 days, P=0.023) than those belonging to the low-RDW group.ConclusionsThe present study showed that pretreatment RDW was superior to MCV and MCHC as a prognostic predictor of clinical outcome in patients newly diagnosed with GBM. Pretreatment RDW was derived directly from the CBC test, which can be easily performed in clinical practice. Therefore, pretreatment RDW values can provide additional prognostic information for patients with GBM. Further larger and prospective studies are needed to confirm these findings and to investigate the mechanism by which of RDW is associated with prognosis in patients with GBM.

Prognostic Significance of Preoperative Systemic Cellular Inflammatory Markers in Gliomas: A Systematic Review and Meta‐Analysis

“…Higher RDW level indicates greater variation in the size of RBCs, which is associated with worse outcomes in patients with heart failure, stroke, head and neck cancer, and lung cancer. 41 In accordance with previous studies, 12,24 we found that higher RDW was associated with a poorer OS of patients with glioma (HR: 1.40; 95% CI: 1.13-1.74; P = 0.002). It is reported that RDW correlated with IL-6, tumor necrosis factor-alpha, and other circulating cytokines that can affect the tumor cell biological behavior.…”

“…All of the included studies were published in recent years and were from seven different countries, which were retrospectively designed with 17 single‐center trialsand one multicenter trial . There were 15 studies performed multivariate Cox regression analysis and reported adjusted HR . The main features of the selected studies are shown in Table 1 .…”

“…In total, 3,261 patients diagnosed with glioma from 18 studies were included. 9,11,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] All of the included studies were published in recent years and were from seven different countries, which were retrospectively designed with 17 single-center trials 9,11,[18][19][20]22,[24][25][26][27][28][29][30][31][32][33][34] and one multicenter trial. 23 There were 15 studies performed multivariate Cox regression analysis and reported adjusted HR.…”

“…23 There were 15 studies performed multivariate Cox regression analysis and reported adjusted HR. 9,[18][19][20][22][23][24][25][26][27][28]30,31,33,34 The main features of the selected studies are shown in Table 1.…”

“…Compared with a low PNI, a high PNI resulted in a better OS (HR: 0.57; 95% CI: 0.42-0.77; P = 0.0002; Figure 2c). There were three studies 11,19,24 with 506 participants that evaluated the prognostic significance of RDW in gliomas. Patients with a higher RDW had poorer OS rates (HR: 1.40; 95% CI: 1.13-1.74; P = 0.002; Figure 2d).…”