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

Oncotarget. 2016 Jul 5;7(27):42650-42660. doi: 10.18632/oncotarget.9516.

Abstract

Background: 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.

Results: The 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 methods: We 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.

Conclusion: A 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.

Keywords: esophageal squamous cell carcinoma (ESCC); hemoglobin; prognosis; red cell distribution width (RDW); survival.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / mortality
  • China
  • Disease-Free Survival
  • Erythrocytes / cytology*
  • Esophageal Neoplasms / blood*
  • Esophageal Neoplasms / mortality
  • Esophageal Squamous Cell Carcinoma
  • Esophagectomy
  • Female
  • Follow-Up Studies
  • Hemoglobins / analysis*
  • Humans
  • Inflammation
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Hemoglobins