Is red cell distribution width a prognostic factor in patients with breast cancer? A meta-analysis

Abstract

PurposeThe current study aimed to investigate whether red blood cell distribution width (RDW) can predict the prognosis of patients with breast cancer (BC).MethodsWe searched four databases, including PubMed, Embase, Cochrane Library databases, and CNKI, from inception to Jun 13, 2022. The primary outcome was overall survival (OS), and the secondary outcome was disease-free survival (DFS). A subgroup analysis was conducted based on different treatments. This meta-analysis was performed with RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom).ResultsA total of seven studies including 4,884 BC patients were identified. The high RDW group had a larger tumor size (OR = 2.12, 95% CI = 1.67 to 2.68, P < 0.01), higher proportions of advanced stage tumors (OR = 1.77, 95% CI = 1.38 to 2.27, P < 0.01), more lymph node metastases (OR = 2.00, 95% CI = 1.58 to 2.51, P < 0.01) and lower HER-2 expression (OR = 0.76, 95% CI = 0.61 to 0.95, P = 0.02). For prognosis, after pooling all the data, we found that the high RDW group was associated with worse OS (HR = 2.12, 95% CI = 1.47 to 3.08, P < 0.01) and DFS (HR = 1.77, 95% CI = 1.32 to 2.37, P < 0.01). The subgroup analysis found that RDW had prognostic significance but only for surgery-only patients (HR = 2.41, 95% CI = 1.67 to 3.49, P < 0.01).ConclusionHigh RDW was associated with worse OS and DFS. Therefore, RDW was a simple predictive factor for the prognosis of BC patients.

RDW-CV / Albumin Ratio Provides Across Cancer Sites Strong Explained Variance in Risk Modelling Using Routinely Available Biomarkers

“…The results show a signi cant association between elevated RDW levels and the composite outcome, consistent with previous studies that have identi ed RDW as a predictor of mortality in various medical conditions [2][3][4][5]. Validation of the RDW as an independent predictor in hospitalized cancer patients underscores its potential utility in risk strati cation.…”

“…Recent studies have evinced its association with mortality in different patient populations [2]. RDW has also been studied as a prognostic factor in lung, gastrointestinal and breast cancer [3,4,5]. However, the utility of RDW in predicting short-term mortality speci cally in hospitalized cancer patients remains uncertain.…”

Pretreatment Circulating Albumin, Platelet, and RDW-SD Associated with Worse Disease-Free Survival in Patients with Breast Cancer

“…Moreover, changes in the distribution of red blood cells may signify alterations in the tumor microenvironment, which plays a crucial role in supporting cancer cell survival and growth. 38 While these are general considerations, the specific biological mechanisms can vary depending on the context of breast cancer recurrence. Further research should be conducted specifically for breast cancer, considering factors such as hormone receptor status, molecular subtypes, and other individual patient characteristics.…”

Association between red cell distribution width-to-albumin ratio and prognostic outcomes in pediatric intensive care unit patients: a retrospective cohort study

“…Consequently, RDW serves as a non-specific marker reflecting inflammation and oxidative stress. RDW has been successfully utilized to prognosticate various diseases, including cardiovascular diseases, kidney diseases, diabetes, tumors, and liver diseases (23)(24)(25)(26).…”