Research Article
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Evaluation of clinicopathological and prognostic significance of RDW in gastric cancer

Year 2022, , 7 - 15, 24.03.2022
https://doi.org/10.47582/jompac.1054490

Abstract

Objective: We aimed to reveal possible relationships between pre-operative RDW values and clinicopathological features of gastric cancer (GC) and to evaluate its predictive impact on progression and prognosis of GC.
Material And Method: A total of 92 patients who underwent curative surgery were retrospectively included the study. GC patients were divided into two groups: high-RDW group (>14.5%, n=58) and low-RDW (<14.5%, n=34).
Results: The optimal pre-operative RDW cut-off value to predict mortality in GC patients was 14.5% (AUC=0.690, p=0.010). Increased tumor size and decreased albumin and hemoglobin values were found in the high-RDW group (p=0.036, 0.003 and <0.001, respectively). The 5-year overall survival (OS) rates were 17.6±5% in patients with high-RDW and 44.5±9% in the low-RDW group (p<0.001). Cox regression analysis showed perineural invasion, surgical margin positivity, N3 stage, leakage and high RDW were independent prognostic factors for mortality.
Conclusion: Our results indicate that RDW is associated with GC pathogenesis and tumor progression. Pre-operative RDW may be a non-invasive, easily accessible and reliable indicator to predict survival in patients with GC.

References

  • Petrillo A, Smyth EC. 27 years of stomach cancer: painting a global picture. Lancet Gastroenterol Hepatol 2020; 5: 5-6.
  • Thrift AP, El-Serag HB. Burden of gastric cancer. Clin Gastroenterol Hepatol 2020; 18: 534-42.
  • Bhandare MS, Chaudhari V, Shrikhande SV. Surgery for Gastric Cancer: State of the Art. Indian J Surg 2020: 1-11.
  • Ghidini M, Donida B, Totaro L, et al. Prognostic factors associated with survival in a large cohort of gastric cancer patients resected over a decade at a single Italian center: the Cremona experience. Clin Transl Oncol 2020; 22: 1004-12.
  • Chang W-J, Du Y, Zhao X, Ma L-Y, Cao G-W. Inflammation-related factors predicting prognosis of gastric cancer. World J Gastroenterol: WJG 2014; 20: 4586-96.
  • Zhou Y, Li X, Lu Z, Zhang L, Dai T. Prognostic significance of red blood cell distribution width in gastrointestinal cancers: A meta-analysis. Medicine 2020; 99: e19588.
  • Wang P-F, Song S-Y, Guo H, Wang T-J, Liu N, Yan C-X. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: a meta-analysis of 49 studies. J Cancer 2019; 10: 4305-17.
  • Edge SB, Byrd DR, Carducci MA, Compton CC, Fritz A, Greene F. AJCC cancer staging manual: Springer New York; 2010.
  • Lauren P. The two histological main types of gastric carcinoma: diffuse and so‐called intestinal‐type carcinoma: an attempt at a histo‐clinical classification. Acta Pathol Microbiol Scand 1965; 64: 31-49.
  • Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008; 454: 436-44.
  • Wan G-X, Chen P, Cai X-J, et al. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta 2016; 452: 199-203.
  • Cheng S, Han F, Wang Y, et al. The red distribution width and the platelet distribution width as prognostic predictors in gastric cancer. BMC Gastroenterol 2017; 17: 1-11.
  • Fu L, Li Q, Fan Q. Combination of preoperative red cell distribution width and neutrophil to lymphocyte ratio as a prognostic marker for gastric cancer patients. J Gastrointest Oncol 2021; 12: 1049-57.
  • Yüksel C, Erşen O, Culcu S, Bakırarar B, Unal AE, Demirci S. Prognostic role of red distribution width (RDW) value in gastric cancer. J Coll Physicians Surg Pak 2021; 31: 21-6.
  • Hu L, Li M, Ding Y, et al. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget 2017; 8: 16027-35.
  • Gao L, Zhang H, Zhang B, Zhang L, Wang C. Prognostic value of combination of preoperative platelet count and mean platelet volume in patients with resectable non-small cell lung cancer. Oncotarget 2017; 8: 15632-41.
  • Macciò A, Madeddu C, Gramignano G, et al. The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observational study. Haematologica 2015; 100: 124-32.
  • Gillies RJ, Robey I, Gatenby RA. Causes and consequences of increased glucose metabolism of cancers. J Nucl Med 2008; 49: 24S-42S.
  • Mcmillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 2009; 12: 223-6.
  • Sakin A, Aydemir O, Sahin S, et al. Red blood cell distribution width as a possible predictor of diagnosis and survival in gastric cancer. EJMI 2020; 4: 289-97.
  • Shota S, Saito H, Kono Y, et al. Prognostic significance of pre-and post-operative red-cell distribution width in patients with gastric cancer. J Gastrointest Surg 2020; 24: 1010-7.
  • Hirahara N, Tajima Y, Fujii Y, et al. Comprehensive analysis of red blood cell distribution width as a preoperative prognostic predictor in gastric cancer. Anticancer Res 2019; 39: 3121-30.
  • Yazici P, Demir U, Bozkurt E, Isil GR, Mihmanli M. The role of red cell distribution width in the prognosis of patients with gastric cancer. Cancer Biomark 2017; 18: 19-25.

RDW'nin mide kanserinde klinikopatolojik ve prognostik öneminin değerlendirilmesi

Year 2022, , 7 - 15, 24.03.2022
https://doi.org/10.47582/jompac.1054490

Abstract

Amaç: Preoperatif RDW değerleri ile mide kanseri (MK)’nin klinikopatolojik özellikleri arasındaki olası ilişkileri ortaya koymayı ve MK’nin progresyonu ve prognozu üzerindeki prediktif etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Küratif cerrahi uygulanan toplam 92 hasta retrospektif olarak çalışmaya dahil edildi. MK hastaları iki gruba ayrıldı: yüksek RDW grubu (>%14,5, n=58) ve düşük RDW (<%14,5, n=34).
Bulgular: MK hastalarında mortaliteyi öngörmek için optimal preoperatif RDW eşik değeri %14,5 idi (AUC=0,690, p=0,010). Yüksek RDW grubunda tümör boyutunda artış, albümin ve hemoglobin değerlerinde azalma saptandı (sırasıyla p=0,036, 0,003 ve <0,001). Yüksek RDW’li hastalarda 5 yıllık genel sağkalım (OS) oranları %17,6±%5 ve düşük RDW grubunda %44,5±%9 idi (p<0,001). Cox regresyon analizi perinöral invazyon, cerrahi sınır pozitifliği, N3 evresi, sızıntı ve yüksek RDW değerinin mortalite için bağımsız prognostik faktörler olduğunu gösterdi.
Sonuç: Sonuçlarımız, RDW’nin MK patogenezinde ve tümör progresyonunda rol oynadığını göstermektedir. Preoperatif RDW, MK’li hastalarda sağkalımı öngörmek için invazif olmayan, kolay erişilebilir ve güvenilir bir gösterge olabilir.

References

  • Petrillo A, Smyth EC. 27 years of stomach cancer: painting a global picture. Lancet Gastroenterol Hepatol 2020; 5: 5-6.
  • Thrift AP, El-Serag HB. Burden of gastric cancer. Clin Gastroenterol Hepatol 2020; 18: 534-42.
  • Bhandare MS, Chaudhari V, Shrikhande SV. Surgery for Gastric Cancer: State of the Art. Indian J Surg 2020: 1-11.
  • Ghidini M, Donida B, Totaro L, et al. Prognostic factors associated with survival in a large cohort of gastric cancer patients resected over a decade at a single Italian center: the Cremona experience. Clin Transl Oncol 2020; 22: 1004-12.
  • Chang W-J, Du Y, Zhao X, Ma L-Y, Cao G-W. Inflammation-related factors predicting prognosis of gastric cancer. World J Gastroenterol: WJG 2014; 20: 4586-96.
  • Zhou Y, Li X, Lu Z, Zhang L, Dai T. Prognostic significance of red blood cell distribution width in gastrointestinal cancers: A meta-analysis. Medicine 2020; 99: e19588.
  • Wang P-F, Song S-Y, Guo H, Wang T-J, Liu N, Yan C-X. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: a meta-analysis of 49 studies. J Cancer 2019; 10: 4305-17.
  • Edge SB, Byrd DR, Carducci MA, Compton CC, Fritz A, Greene F. AJCC cancer staging manual: Springer New York; 2010.
  • Lauren P. The two histological main types of gastric carcinoma: diffuse and so‐called intestinal‐type carcinoma: an attempt at a histo‐clinical classification. Acta Pathol Microbiol Scand 1965; 64: 31-49.
  • Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008; 454: 436-44.
  • Wan G-X, Chen P, Cai X-J, et al. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta 2016; 452: 199-203.
  • Cheng S, Han F, Wang Y, et al. The red distribution width and the platelet distribution width as prognostic predictors in gastric cancer. BMC Gastroenterol 2017; 17: 1-11.
  • Fu L, Li Q, Fan Q. Combination of preoperative red cell distribution width and neutrophil to lymphocyte ratio as a prognostic marker for gastric cancer patients. J Gastrointest Oncol 2021; 12: 1049-57.
  • Yüksel C, Erşen O, Culcu S, Bakırarar B, Unal AE, Demirci S. Prognostic role of red distribution width (RDW) value in gastric cancer. J Coll Physicians Surg Pak 2021; 31: 21-6.
  • Hu L, Li M, Ding Y, et al. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget 2017; 8: 16027-35.
  • Gao L, Zhang H, Zhang B, Zhang L, Wang C. Prognostic value of combination of preoperative platelet count and mean platelet volume in patients with resectable non-small cell lung cancer. Oncotarget 2017; 8: 15632-41.
  • Macciò A, Madeddu C, Gramignano G, et al. The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observational study. Haematologica 2015; 100: 124-32.
  • Gillies RJ, Robey I, Gatenby RA. Causes and consequences of increased glucose metabolism of cancers. J Nucl Med 2008; 49: 24S-42S.
  • Mcmillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 2009; 12: 223-6.
  • Sakin A, Aydemir O, Sahin S, et al. Red blood cell distribution width as a possible predictor of diagnosis and survival in gastric cancer. EJMI 2020; 4: 289-97.
  • Shota S, Saito H, Kono Y, et al. Prognostic significance of pre-and post-operative red-cell distribution width in patients with gastric cancer. J Gastrointest Surg 2020; 24: 1010-7.
  • Hirahara N, Tajima Y, Fujii Y, et al. Comprehensive analysis of red blood cell distribution width as a preoperative prognostic predictor in gastric cancer. Anticancer Res 2019; 39: 3121-30.
  • Yazici P, Demir U, Bozkurt E, Isil GR, Mihmanli M. The role of red cell distribution width in the prognosis of patients with gastric cancer. Cancer Biomark 2017; 18: 19-25.
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Dursun Burak Özdemir 0000-0002-3672-5738

Ahmet Karayiğit

Hayrettin Dizen

Bülent Ünal

Publication Date March 24, 2022
Published in Issue Year 2022

Cite

AMA Özdemir DB, Karayiğit A, Dizen H, Ünal B. Evaluation of clinicopathological and prognostic significance of RDW in gastric cancer. J Med Palliat Care / JOMPAC / Jompac. March 2022;3(1):7-15. doi:10.47582/jompac.1054490

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