Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma

Smirne, Carlo; Grossi, G.; Pinato, David J.; Burlone, Michela Emma; Mauri, Francesco; Januszewski, Adam; Oldani, Alberto; Minisini, Rosalba; Sharma, Rohini; Pirisi, Mario

doi:10.1016/j.dld.2015.03.011

Cited by 34 publications

(48 citation statements)

References 42 publications

(45 reference statements)

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“…Previous studies showed that the RDW increased in patients with malignant tumors, [9–11,15–18] which is consistent with the findings of the present study. Ay et al [15] compared the RDW in patients with benign and malignant tumors of the colon, including 115 patients with colon polyps and 30 with colon cancer.…”

Section: Discussionsupporting

confidence: 93%

“…Related research has mainly focused on endometrial cancer, lung cancer, and liver cancer. [9–11] To the best of our knowledge, however, the relationship between the RDW and ovarian cancer has not yet been described. In the present study, we analyzed the correlation between the RDW and ovarian cancer by observing changes in the RDW in patients with ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%

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The value of red cell distribution width in patients with ovarian cancer

et al. 2017

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Background:The red cell distribution width (RDW) has attracted attention in the diagnosis of malignant tumors. In this study, we analyzed the correlation between the RDW and ovarian cancer by observing changes in the RDW in patients with ovarian cancer.Methods:Patients diagnosed with ovarian cancer at the First Affiliated Hospital of Guangxi Medical University, China, from 2012 to 2016, were retrospectively analyzed. Patients diagnosed with ovarian benign tumors in our hospital during the same period comprised the control group. Differences in relevant indicators were compared between the ovarian cancer and control groups using the Mann–Whitney U test. Differences in the RDW at different stages of ovarian cancer were compared using one-way analysis of variance. Correlations between the RDW and experimental parameters in patients with ovarian cancer were analyzed by Spearman correlation.Results:The RDW, absolute neutrophil count (N), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and cancer antigen 125 (CA-125) concentration were significantly higher in the ovarian cancer than control group. The hemoglobin concentration (Hb) and absolute lymphocyte count (L) were significantly lower in the ovarian cancer than control group. The RDW was significantly different among 4 different stages of ovarian cancer. Correlation analysis demonstrated that the RDW was negatively correlated with the hemoglobin concentration (Hb). The RDW was positively correlated with the cancer stage, NLR, PLR, and CA-125 concentration. The area under the receiver-operating characteristic curve of the RDW was 0.876 (95% confidence interval 0.829–0.923).Conclusion:The RDW is associated with ovarian cancer and is a potential marker of its progression.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The value of red cell distribution width in patients with ovarian cancer

et al. 2017

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“…After removed duplicate and irrelevant papers, a total of 16 articles were included in this analysis. For case ascertainment, fifteen articles [13–27] performed retrospective analysis (3953 participants), and one article [28] had both a retrospective design and a prospectively design in two independent patients population (314 participants). Therefore, a total of 16 articles including 17 studies with 4267 patients were included in this analysis with a median sample size of 179 (from 81 to 938).…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of RDW in cancers: a systematic review and meta-analysis

et al. 2016

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Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.

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“…RDW reflects inflammation-induced erythroid maturation impairment and has clinical utility as a marker of inflammation in both liver disease [15, 16, 17] and cancer [18]. Inflammation is central to liver damage, fibrogenesis and oncogenesis [10, 19], and inflammatory markers have prognostic value in HCC [20, 21].…”

Section: Discussionmentioning

confidence: 99%

“…Several groups have previously shown that inflammatory parameters, including the Inflammation-based Index (IBI) and the neutrophil to lymphocyte ratio (NLR), are associated with worse survival in HCC [11–14]. More recently, we demonstrated that stage-dependent deterioration in red cell distribution width (RDW), a marker of anistocytosis, is associated with overall survival in HCC, with the strongest prognostic role of RDW demonstrated in patients with advanced HCC [15]. Moreover, inflammatory parameters such as RDW are inexpensive and accessible biomarkers for survival prediction in HCC.…”

Section: Introductionmentioning

confidence: 99%

Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib

et al. 2017

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Background and AimsResponse to sorafenib is highly variable in hepatocellular carcinoma (HCC). Baseline inflammatory parameters and treatment toxicities may improve survival prediction in patients on sorafenib therapy.Results442 patients with advanced stage HCC on sorafenib were recruited (follow-up 5096 person-months at risk). 88% had BCLC stage B or greater HCC and 72.3% had Child-Pugh A cirrhosis. On Cox multivariate regression, previously-treated HCC (HR 0.579, 95% CI 0.385-0.872, p=0.009), Cancer of Liver Italian Program (CLIP) score (HR 1.723, 95% CI 1.462-2.047, p<0.0001), baseline red cell distribution width (RDW; HR 1.234, 95% CI 1.115-1.290, p<0.0001) and neutrophil to lymphocyte ratio (NLR; HR 1.218, 95% CI 1.108-1.322, p<0.0001) were significant independent risks for shorter survival, whilst sorafenib-related diarrhoea was associated with prolonged survival (HR 0.533, 95% CI 0.373-0.763, p=0.001). The combination of RD-CLIP score (CLIP score multiplied by RDW) ≥ 70 and no treatment-related diarrhoea had good utility for predicting 3-month survival (AUC of 0.808 (95% CI 0.734-0.882), positive predictive value of 86.4% and negative predictive value of 83.3%), compared with CLIP (AUC=0.642) or BCLC score alone (AUC=0.579). RD-CLIP score ≥ 35 and no treatment-related diarrhoea had an AUC of 0.787 for predicting 12-month survival.MethodsPatients with HCC were consecutively recruited from three tertiary centres (Japan, Italy and UK) and clinical data were prospectively collected. The primary study endpoint was overall survival (OS) after commencing sorafenib.ConclusionThe novel prognostic index of CLIP score combined with inflammatory marker RDW and treatment-related diarrhoea has good accuracy for predicting overall, 3 month and 12 month survival in patients on sorafenib.

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Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma

Abstract: The red cell distribution width is a novel, reproducible, prospectively validated predictor of survival in patients with hepatocellular carcinoma.

Cited by 34 publications

References 42 publications

The value of red cell distribution width in patients with ovarian cancer

The value of red cell distribution width in patients with ovarian cancer

Prognostic value of RDW in cancers: a systematic review and meta-analysis

Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib

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