Abstract
BackgroundAlthough the red blood cell distribution width (RDW) has been reported as a reliable predictor of prognosis in several types of cancer, the prognostic value of RDW in hilar cholangiocarcinoma (HC) has not been studied.MethodsA retrospective analysis of 292 consecutively recruited HC patients undergoing radical resection was conducted. The optimal cutoff value of RDW was determined by the receiver operating characteristic curve (ROC). Survival analysis by the Kaplan-Meier method, the difference between the clinico-pathologic variables and survival were evaluated by log-rank analysis. Multivariate analysis identified independent prognostic risk factors of overall survival (OS).ResultsROC analysis suggested that the optimal cutoff value for the RDW was 14.95. Linear correlation analysis revealed that RDW is associated with white blood cell count (P = 0.007), neutrophil-to-lymphocyte ratio (P = 0.02), and hemoglobin (P < 0.001), albumin (P < 0.001). In a multivariate analysis, the RDW was an independent prognostic factor for OS (HR = 1.755, 95% CI 1.311-2.349, P < 0.001).ConclusionsElevated RDW may be regarded as an indicator of systemic inflammatory response which might facilitate HC growth and metastasis. Current evidence suggests that RDW may have clinical significance in predicting OS after surgery in HC patients.
Highlights
Hilar cholangiocarcinoma (HC) is a neoplasm arising from the biliary epithelium at the common hepatic duct bifurcation, and may extend to intrahepatic biliary tree and liver [1, 2]
Linear correlation analysis revealed that red blood cell distribution width (RDW) is associated with white blood cell count (P = 0.007), neutrophil-to-lymphocyte ratio (P = 0.02), and hemoglobin (P < 0.001), albumin (P < 0.001)
Elevated RDW may be regarded as an indicator of systemic inflammatory response which might facilitate hilar cholangiocarcinoma (HC) growth and metastasis
Summary
Hilar cholangiocarcinoma (HC) is a neoplasm arising from the biliary epithelium at the common hepatic duct bifurcation, and may extend to intrahepatic biliary tree and liver [1, 2]. Red blood cell distribution width (RDW) is a routine laboratory parameter examined with the complete blood count test that indicates the heterogeneity in the size of circulating erythrocytes. RDW is a widely used laboratory parameter for inflammatory diseases [8]. Recent studies showed that RDW is correlated with prognosis in several malignances, such as lung cancer [9], prostate cancer [10] esophageal cancer [11] and hepatocellular carcinoma [12]. To our knowledge, no studies regarding the prognostic value of RDW in HC are available. The red blood cell distribution width (RDW) has been reported as a reliable predictor of prognosis in several types of cancer, the prognostic value of RDW in hilar cholangiocarcinoma (HC) has not been studied
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