Clinical significance of an increased red blood cell distribution width in patients with rectal cancer undergoing chemoradiotherapy followed by surgery

Surg Today. 2020 Jun;50(6):551-559. doi: 10.1007/s00595-019-01933-3. Epub 2019 Dec 20.

Abstract

Purpose: The clinical significance of the red blood cell distribution width (RDW) in patients with rectal cancer undergoing preoperative chemoradiotherapy (CRT) followed by surgery has not been fully evaluated.

Methods: In this retrospective study, we investigated the association between the RDW and the prognosis in 120 patients with locally advanced rectal cancer (LARC). We also performed a subgroup analysis limited to patients with pathological TNM stage I-II (ypN[-]) LARC.

Results: The RDW standard deviation was used to evaluate the RDW. We set 47.1% as the cut-off value of the RDW for the assessment of the prognosis. The RDW exhibited a significant negative relationship with the serum hemoglobin and albumin levels. An elevated RDW was an independent prognostic factor for the overall survival (OS) and disease-free survival (DFS) in patients with LARC. In addition, an elevated RDW predicted a poor OS and DFS in patients with pathological TNM stage I-II (ypN[-]) LARC.

Conclusions: The RDW is a promising predictor of a poor survival and recurrence in patients with LARC treated by CRT.

Keywords: Chemoradiotherapy; Inflammation; Prognosis; Rectal neoplasms; Red blood cell distribution width.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Chemoradiotherapy, Adjuvant*
  • Digestive System Surgical Procedures*
  • Erythrocyte Count*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Preoperative Period
  • Prognosis
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / diagnosis*
  • Rectal Neoplasms / therapy*
  • Retrospective Studies

Substances

  • Biomarkers, Tumor