Pretreatment Level of Red Cell Distribution Width as a Prognostic Indicator for Survival in a Large Cohort Study of Male Laryngeal Squamous Carcinoma.

Chi-Yao Hsueh,Liang Zhou,Lei Tao,Hui-Ching Lau,Hongli Gong,Ming Zhang,Shengjie Li

doi:10.3389/fonc.2019.00271

Abstract

Objective: High levels of red cell distribution width (RDW) may be associated with adverse outcomes in patients with cancer. The purpose of the present study was to investigate the prognostic impact of pretreatment RDW levels on overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) in a large cohort of male laryngeal squamous cell cancer (LSCC) patients.Methods: A total of 809 LSCC patients who were treated between 2007 and 2011 at the Eye & ENT Hospital of Fudan University were enrolled and evaluated retrospectively. OS, CSS, and DFS were analyzed using the Kaplan–Meier method. To evaluate the prognostic significance of RDW levels, univariate, and multivariate Cox analyses were applied.Results: Higher pretreatment RDW levels were significantly associated with high death events, red blood cell count, hemoglobin, radiotherapy, operation therapy, and advanced tumor stage (p < 0.05). From the univariate analysis, we observed that the higher (13.2–13.5%) and the highest (>13.5%) quartiles of RDW level were consistent factors for poor OS, CSS, and DFS in LSCC patients. In the multivariate analysis, after adjusting for confounding factors, the higher and highest quartiles of RDW levels were identified as independent prognostic factors in male LSCC patients.Conclusion: Higher pretreatment RDW levels were demonstrated to be associated with poor clinical outcome in male LSCC patients and might be novel markers for patient stratification in LSCC management.

Highlights

Laryngeal cancer is one of the most common cancers of the head and neck, of which the estimated crude incidence and mortality rates in China were 1.86/100,000 and 1.01/100,000, respectively [1]
A total of 809 male LSCC subjects were eligible in this study
To test whether high red cell distribution width (RDW) levels influence the clinical outcome of LSCC patients, we first subdivided the LSCC patients into four groups according to their RDW quartiles

Summary

Introduction

Laryngeal cancer is one of the most common cancers of the head and neck, of which the estimated crude incidence and mortality rates in China were 1.86/100,000 and 1.01/100,000, respectively [1]. This disease has a male predominance with a male-to-female ratio of 20 to 30:1 in China [2]. RDW as Predictors of Prognosis in LSCC (LSCC), accounting for 95% of cases involving the stratified squamous epithelial lining of the larynx [3, 4]. Several prognostic factors have been identified to predict prognosis in LSCC patients, such as tumor size, histological subtype or grade, vascular invasion, and lymph node metastases. The majority of these factors can only be assessed after surgery

Methods

Results

Conclusion