Red Cell Differential Width (RDW) As a Predictor of Survival Outcomes with Palliative and Adjuvant Chemotherapy for Metastatic Penile Cancer

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2020 Jul 25

PMID 32705478

Citations 4

Authors

Reena Patel

Louise English

Wing K Liu

Alison C Tree

Benjamin Ayres

Nick Watkin

Lisa M Pickering

Mehran Afshar

Affiliations

Soon will be listed here.

Abstract

Purpose: Red cell distribution width (RDW) measures red cells' size variability. Metastatic penile cancer displays poor chemotherapy response. As no validated prognostic predictor exists, we investigated whether RDW correlates independently with survival outcomes in metastatic penile cancer treated by chemotherapy.

Methods: Electronic chemotherapy files of patients with metastatic penile cancer (M1 or N3) from a large academic supra-regional centre were retrospectively analysed between 2005 and 2018. Patients were stratified into RDW > 13.9% and < 13.9%, as per published data on RDW in renal cell carcinoma. Survival time was calculated from the date of chemotherapy initiation until the date of death.

Results: 58 patients were analysed. The RDW-high group (n = 31) had a poorer survival than the RDW-low group (n = 27). Median overall survival (mOS) in all patients was 19.0 months (95% CI 13.1-24.9). mOS for RDW-high was 15.0 months (95% CI 10.1-19.9) and 37.0 months (95% CI 32.3-43.1) for RDW-low. Kaplan-Meier curves showed a clear disparity in survival (log rank p = 0.025). Cox proportional hazard ratio for death, corrected for T-stage, grade, age and deprivation score was 0.43 (p = 0.04). Sub-analysis of the M1 patients showed mOS in RDW-high of 17 m (95% CI 11.6-22.4) vs. NR; HR for death of 0.42. N3 patients' mOS in RDW-high cohort was 30 months (95% CI 4.5-55.9) vs. 13 months (95% CI 1.8-24.2) in RDW-low; HR for death was 0.30.

Conclusion: RDW correlates independently with survival outcomes in metastatic penile cancer and may act as a potential predictor of survival outcomes for patients with metastatic penile cancer receiving chemotherapy.

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References

Patel K, Ferrucci L, Ershler W, Longo D, Guralnik J . Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med. 2009; 169(5):515-23. PMC: 2765040. DOI: 10.1001/archinternmed.2009.11. View

Zyczkowski M, Rajwa P, Gabrys E, Jakubowska K, Jantos E, Paradysz A . The Relationship Between Red Cell Distribution Width and Cancer-Specific Survival in Patients With Renal Cell Carcinoma Treated With Partial and Radical Nephrectomy. Clin Genitourin Cancer. 2018; 16(3):e677-e683. DOI: 10.1016/j.clgc.2017.12.003. View

Hu L, Li M, Ding Y, Pu L, Liu J, Xie J . Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget. 2016; 8(9):16027-16035. PMC: 5362543. DOI: 10.18632/oncotarget.13784. View

Pond G, Milowsky M, Kolinsky M, Eigl B, Necchi A, Harshman L . Concurrent chemoradiotherapy for men with locally advanced penile squamous cell carcinoma. Clin Genitourin Cancer. 2014; 12(6):440-6. DOI: 10.1016/j.clgc.2014.03.009. View

Wang F, Xu G, Zhang Y, Ma L . Red cell distribution width is associated with presence, stage, and grade in patients with renal cell carcinoma. Dis Markers. 2015; 2014:860419. PMC: 4280806. DOI: 10.1155/2014/860419. View

Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y . Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One. 2013; 8(11):e80240. PMC: 3823700. DOI: 10.1371/journal.pone.0080240. View

Ellingsen T, Lappegard J, Skjelbakken T, Braekkan S, Hansen J . Impact of red cell distribution width on future risk of cancer and all-cause mortality among cancer patients - the Tromsø Study. Haematologica. 2015; 100(10):e387-9. PMC: 4591771. DOI: 10.3324/haematol.2015.129601. View

Hakenberg O, Comperat E, Minhas S, Necchi A, Protzel C, Watkin N . EAU guidelines on penile cancer: 2014 update. Eur Urol. 2014; 67(1):142-150. DOI: 10.1016/j.eururo.2014.10.017. View

Podhorecka M, Halicka D, Szymczyk A, Macheta A, Chocholska S, Hus M . Assessment of red blood cell distribution width as a prognostic marker in chronic lymphocytic leukemia. Oncotarget. 2016; 7(22):32846-53. PMC: 5078056. DOI: 10.18632/oncotarget.9055. View

10.

Li Z, Hong N, Robertson M, Wang C, Jiang G . Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer. Sci Rep. 2017; 7:43001. PMC: 5320446. DOI: 10.1038/srep43001. View

11.

Ohno Y, Nakashima J, Ohori M, Hatano T, Tachibana M . Pretreatment neutrophil-to-lymphocyte ratio as an independent predictor of recurrence in patients with nonmetastatic renal cell carcinoma. J Urol. 2010; 184(3):873-8. DOI: 10.1016/j.juro.2010.05.028. View

12.

Ichinose J, Murakawa T, Kawashima M, Nagayama K, Nitadori J, Anraku M . Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer. J Thorac Dis. 2017; 8(12):3658-3666. PMC: 5227271. DOI: 10.21037/jtd.2016.12.44. View

13.

Perisa V, Zibar L, Sincic-Petricevic J, Knezovic A, Perisa I, Barbic J . Red blood cell distribution width as a simple negative prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study. Croat Med J. 2015; 56(4):334-43. PMC: 4576747. DOI: 10.3325/cmj.2015.56.334. View

14.

de Gonzalo-Calvo D, de Luxan-Delgado B, Rodriguez-Gonzalez S, Garcia-Macia M, Suarez F, Solano J . Interleukin 6, soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population: a translational approach. Cytokine. 2012; 58(2):193-8. DOI: 10.1016/j.cyto.2012.01.005. View

15.

Mantovani A, Allavena P, Sica A, Balkwill F . Cancer-related inflammation. Nature. 2008; 454(7203):436-44. DOI: 10.1038/nature07205. View

16.

Dalpiaz O, Pichler M, Mannweiler S, Martin Hernandez J, Stojakovic T, Pummer K . Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. Br J Cancer. 2014; 110(10):2531-6. PMC: 4021523. DOI: 10.1038/bjc.2014.180. View

17.

Steffens S, Al Ghazal A, Steinestel J, Lehmann R, Wegener G, Schnoeller T . High CRP values predict poor survival in patients with penile cancer. BMC Cancer. 2013; 13:223. PMC: 3649950. DOI: 10.1186/1471-2407-13-223. View

18.

Salvagno G, Sanchis-Gomar F, Picanza A, Lippi G . Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2014; 52(2):86-105. DOI: 10.3109/10408363.2014.992064. View

19.

Baicus C, Caraiola S, Rimbas M, Patrascu R, Baicus A . Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss. J Investig Med. 2011; 59(6):951-5. DOI: 10.2310/JIM.0b013e31822467a3. View

20.

Konijn A . Iron metabolism in inflammation. Baillieres Clin Haematol. 1994; 7(4):829-49. DOI: 10.1016/s0950-3536(05)80127-1. View