Abstract
Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.
Highlights
Cancers are characterized by rapid progress and have become a major cause of morbidity and mortality in most region worldwide [1], despite the development of effective drugs and supportive care, the majority of cancers are characterized by their incurability, low overall survival, and recurrence [2]
All studies were published between 2013 and 2016 in English peer-reviewed journals. These studies were from China, Japan, Italy, Korea, America, Turkey and Croatia, which evaluated various type of cancers, including four for esophageal cancer, three for lung cancer, two for hepatocellular carcinoma, two for breast cancer, one for multiple myeloma, one for diffuse large B-cell lymphoma, one for chronic myeloid leukemia, one for malignant mesothelioma, and one for upper tract urothelial Carcinoma
The combined results indicated that elevated Red blood cell distribution width (RDW) significantly predicted poor over survival (OS), poor cancer-specific survival (CSS), poor disease-free survival (DFS), poor event-free survival (EFS) and poor progress-free survival (PFS) of patients with cancer
Summary
Cancers are characterized by rapid progress and have become a major cause of morbidity and mortality in most region worldwide [1], despite the development of effective drugs and supportive care, the majority of cancers are characterized by their incurability, low overall survival, and recurrence [2]. A lot of biomarkers were carried out to help with prognosis of cancer [3,4,5]. RDW was considered as a inflammatory associated marker, and emerging studies suggested it was an potential factor for predicting overall mortality in a variety of human inflammation diseases [7, 8]. It is well known that Inflammation is a hallmark of cancer [9], accumulating studies have investigated the role of RDW in patients with various cancer, and RDW was proved to be an independent prognosis factor in lung cancer [10], prostate cancer [11], chronic lymphocytic leukemia [12] and so on. Different comments came into view with increasing researches referring to RDW and cancer [13, 14], and the reliability of RDW acting as a prognostic biomarker in various malignancies is www.impactjournals.com/oncotarget
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