The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China.

Peng Sun,Wenqi Jiang,Xiwen Bi,Xin An,Fenghua Wang,Hang Yang,Fei Zhang,Cui Chen

doi:10.18632/oncotarget.9516

Abstract

BackgroundWe propose a novel prognostic parameter for esophageal squamous cell carcinoma (ESCC)—hemoglobin/red cell distribution width (HB/RDW) ratio. Its clinical prognostic value and relationship with other clinicopathological characteristics were investigated in ESCC patients.ResultsThe optimal cut-off value was 0.989 for the HB/RDW ratio. The HB/RDW ratio (P= 0.035), tumor depth (P = 0.020) and lymph node status (P<0.001) were identified to be an independent prognostic factors of OS by multivariate analysis, which was validated by bootstrap resampling. Patients with a low HB/RDW ratio had a 1.416 times greater risk of dying during follow-up compared with those with a high HB/RDW (95% CI = 1.024–1.958, P = 0.035).Materials and MethodsWe retrospectively analyzed 362 patients who underwent curative treatment at a single institution between January 2007 and December 2008. The chi-square test was used to evaluate relationships between the HB/RDW ratio and other clinicopathological variables; the Kaplan–Meier method was used to analyze the 5-year overall survival (OS); and the Cox proportional hazards models were used for univariate and multivariate analyses of variables related to OS.ConclusionA significant association was found between the HB/RDW ratio and clinical characteristics and survival outcomes in ESCC patients. Based on these findings, we believe that the HB/RDW ratio is a novel and promising prognostic parameter for ESCC patients.

Highlights

Esophageal cancer is one of the most common digestive malignancies worldwide [1, 2], leading to more than 20000 deaths every year in China [3, 4]
A significant association was found between the HB/red cell distribution width (RDW) ratio and clinical characteristics and survival outcomes in esophageal squamous cell carcinoma (ESCC) patients
We believe that the HB/RDW ratio is a novel and promising prognostic parameter for ESCC patients

Summary

Introduction

Esophageal cancer is one of the most common digestive malignancies worldwide [1, 2], leading to more than 20000 deaths every year in China [3, 4]. Esophageal squamous cell carcinoma (ESCC) is the predominant histological subtype of esophageal cancer in Asia [2, 3]. The clinical outcome of ESCC is poor, with the 5-year overall survival rate being less than 50% [5, 6]. The prognosis of ESCC is commonly based on the tumor stage determined according to the TNM staging system [5, 6]. Several prognostic factors associated with ESCC have been identified [7,8,9]. We propose a novel prognostic parameter for esophageal squamous cell carcinoma (ESCC)—hemoglobin/red cell distribution width (HB/RDW) ratio. Its clinical prognostic value and relationship with other clinicopathological characteristics were investigated in ESCC patients

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