Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer
Abstract Background Increased preoperative red cell distribution width (RDW) is associated with poor prognosis in several cancers, but the relationships between preoperative RDW and changes in RDW (ΔRDW) and colorectal cancer (CRC) prognosis remain unclear. Our study aimed to demonstrate the prognos...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6036 |
| _version_ | 1797775578651164672 |
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| author | Xian Lu Xiaofan Huang Meng Xue Zhenyu Zhong Ran Wang Wen Zhang Lili Wang Yuhan Qiao Fei Ling Qian Zhang Yueying Zhang |
| author_facet | Xian Lu Xiaofan Huang Meng Xue Zhenyu Zhong Ran Wang Wen Zhang Lili Wang Yuhan Qiao Fei Ling Qian Zhang Yueying Zhang |
| author_sort | Xian Lu |
| collection | DOAJ |
| description | Abstract Background Increased preoperative red cell distribution width (RDW) is associated with poor prognosis in several cancers, but the relationships between preoperative RDW and changes in RDW (ΔRDW) and colorectal cancer (CRC) prognosis remain unclear. Our study aimed to demonstrate the prognostic significance of increased preoperative RDW and ΔRDW for CRC. Methods In this retrospective analysis, we enrolled 833 patients who underwent CRC surgery between 2015 and 2019 at the Affiliated Hospital of Xuzhou Medical University, China. ΔRDW in our study was defined as RDW at 1 month after discharge minus preoperative RDW. According to receiver operating characteristic (ROC) curve analysis, we used cut‐off values of 13.5% for RDW, 0.9% for ΔRDW. The cumulative survival rate was determined using the Kaplan–Meier method, and significant differences were evaluated by the log‐rank test. Multivariable Cox regression model was applied to clarify the independent risk factors for overall survival (OS), which were used to construct a nomogram prediction model. The competing risk method was also applied, and we analyzed only patients with early‐stage disease (stage 0‐II) for sensitivity analysis. Results Multivariable Cox regression analysis demonstrated that age, RDW, ΔRDW, postoperative adjuvant chemotherapy, CEA, CA19‐9, ASA, TNM stage, and pathological type were independent factors for OS in CRC patients (all p < 0.05). These prognostic factors were used to establish and verify the OS nomogram. Poorer OS was linked to higher RDW (HR = 1.52; 95% CI, 1.11–2.08; p < 0.01) and ΔRDW (HR = 1.65; 95% CI, 1.19–2.28; p < 0.01) in all‐stage patients, and was only linked to higher RDW in early‐stage patients. In competing risk model, H‐RDW and H‐ΔRDW were confirmed to be independent risk factors for CSS in CRC patients. Conclusions High preoperative RDW and ΔRDW are both risk factors for OS and CSS in CRC. |
| first_indexed | 2024-03-12T22:37:41Z |
| format | Article |
| id | doaj.art-b88203bae98a4ad19e2b21a25b0c5d8a |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-12T22:37:41Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-b88203bae98a4ad19e2b21a25b0c5d8a2023-07-21T11:20:58ZengWileyCancer Medicine2045-76342023-06-011212133611337310.1002/cam4.6036Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancerXian Lu0Xiaofan Huang1Meng Xue2Zhenyu Zhong3Ran Wang4Wen Zhang5Lili Wang6Yuhan Qiao7Fei Ling8Qian Zhang9Yueying Zhang10Jiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaJiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou Jiangsu ChinaAbstract Background Increased preoperative red cell distribution width (RDW) is associated with poor prognosis in several cancers, but the relationships between preoperative RDW and changes in RDW (ΔRDW) and colorectal cancer (CRC) prognosis remain unclear. Our study aimed to demonstrate the prognostic significance of increased preoperative RDW and ΔRDW for CRC. Methods In this retrospective analysis, we enrolled 833 patients who underwent CRC surgery between 2015 and 2019 at the Affiliated Hospital of Xuzhou Medical University, China. ΔRDW in our study was defined as RDW at 1 month after discharge minus preoperative RDW. According to receiver operating characteristic (ROC) curve analysis, we used cut‐off values of 13.5% for RDW, 0.9% for ΔRDW. The cumulative survival rate was determined using the Kaplan–Meier method, and significant differences were evaluated by the log‐rank test. Multivariable Cox regression model was applied to clarify the independent risk factors for overall survival (OS), which were used to construct a nomogram prediction model. The competing risk method was also applied, and we analyzed only patients with early‐stage disease (stage 0‐II) for sensitivity analysis. Results Multivariable Cox regression analysis demonstrated that age, RDW, ΔRDW, postoperative adjuvant chemotherapy, CEA, CA19‐9, ASA, TNM stage, and pathological type were independent factors for OS in CRC patients (all p < 0.05). These prognostic factors were used to establish and verify the OS nomogram. Poorer OS was linked to higher RDW (HR = 1.52; 95% CI, 1.11–2.08; p < 0.01) and ΔRDW (HR = 1.65; 95% CI, 1.19–2.28; p < 0.01) in all‐stage patients, and was only linked to higher RDW in early‐stage patients. In competing risk model, H‐RDW and H‐ΔRDW were confirmed to be independent risk factors for CSS in CRC patients. Conclusions High preoperative RDW and ΔRDW are both risk factors for OS and CSS in CRC.https://doi.org/10.1002/cam4.6036all‐cause mortalitychanges in RDWcolorectal cancerprognosisRDW |
| spellingShingle | Xian Lu Xiaofan Huang Meng Xue Zhenyu Zhong Ran Wang Wen Zhang Lili Wang Yuhan Qiao Fei Ling Qian Zhang Yueying Zhang Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer Cancer Medicine all‐cause mortality changes in RDW colorectal cancer prognosis RDW |
| title | Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer |
| title_full | Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer |
| title_fullStr | Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer |
| title_full_unstemmed | Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer |
| title_short | Prognostic significance of increased preoperative red cell distribution width (RDW) and changes in RDW for colorectal cancer |
| title_sort | prognostic significance of increased preoperative red cell distribution width rdw and changes in rdw for colorectal cancer |
| topic | all‐cause mortality changes in RDW colorectal cancer prognosis RDW |
| url | https://doi.org/10.1002/cam4.6036 |
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