Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer

Abstract

RDW is a significant factor after risk adjustment, determining in-hospital morbidity, mortality and long-term survival in patients post-potentially curative resections for non-small-cell lung cancer. Further work is needed to elucidate the exact mechanism of RDW impact on in-hospital morbidity, mortality and long-term survival. We speculate that subtle bone marrow dysfunction may be an issue.

Red cell distribution width and cancer

“…However, while in small cell lung cancer (SCLC), RDW seems to have a major role in extensive stage with respect to limited stage (39), in nonsmall cell lung cancer (NSCLC) the association between high RDW and poor prognosis has been consistently revealed in any stage (40). In a large-size single center retrospective study, Warwick and coauthors demonstrated that RDW is a significant determinant not only of OS but also of length of hospital stay, in-hospital morbidity, superficial thoracotomy wound infections need for postoperative respiratory support and in-hospital mortality post-potentially curative resections for non-small-cell lung cancer (41). Studies investigating the prognostic role of RDW in patients with breast cancer are described in Table 4.…”

Association of Perioperative Redox Balance on Long-Term Outcome in Patients Undergoing Lung Resection

“…In the present study, we focused on inflammatory and nutrition predictors (CRP, NLR, RDW, albumin), which have been shown to be correlated with outcome of patients with a malignant neoplasm. [8][9][10][11][12] Our patients with a higher d-ROM value during the operation also had elevated CRP and NLR before the operation, and their prognosis was predicted to be poor based on the preoperative inflammatory markers. Several comorbidities, such as smoking and diabetes mellitus, have been reported to influence redox balance.…”

The impact of Red Cell Distribution Width and Neutrophil/Lymphocyte Ratio on Long-term Survival after Pulmonary Resection for Non-Small Cell Lung Cancer.

“…15,16 To date, few studies investigate the association of RDW with respect to mortality and long-term survival in patients with lung cancer. 7,14 Recently, Warwick et al evaluated patients undergoing pulmonary resections for non-small-cell lung cancer and concluded that RDW is a significant factor after risk adjustment, determining in-hospital morbidity, mortality and long-term survival. 7 Our study confirmed their results and found that patients who had undergone pulmonary resections for non-small cell lung cancer with high preoperative RDW levels had significantly lower overall and disease free survival rates than patients with normal RDW levels.…”

“…7,14 Recently, Warwick et al evaluated patients undergoing pulmonary resections for non-small-cell lung cancer and concluded that RDW is a significant factor after risk adjustment, determining in-hospital morbidity, mortality and long-term survival. 7 Our study confirmed their results and found that patients who had undergone pulmonary resections for non-small cell lung cancer with high preoperative RDW levels had significantly lower overall and disease free survival rates than patients with normal RDW levels. As shown in Table 2, Overall survival rates of patients with high and normal RDW levels were 42±7 and 84±12 months, respectively (p= 0.019).…”

“…[3][4][5] However, few studies have investigated RDW levels in lung cancer patients. 6,7 Neutrophil/Lymphocyte Ratio (NLR), an inexpensive and widely available blood test, can also be used for evaluating cell-mediated immune responses and reflects patients' inflammation status. 8 It has been found to be an important indicator of prognosis in various cancer types including colorectal, gastric, metastatic melanoma, renal cell carcinoma and pancreatic cancer.…”