Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2021 Feb 12

PMID 33572378

Citations 13

Authors

Francesco Petrella

Monica Casiraghi

Davide Radice

Andrea Cara

Gabriele Maffeis

Elena Prisciandaro

Stefania Rizzo

Lorenzo Spaggiari

Affiliations

Soon will be listed here.

Abstract

Background: The ratio of hemoglobin to red cell distribution width (HRR) has been described as an effective prognostic factor in several types of cancer. The aim of this study was to investigate the prognostic role of preoperative HRR in resected-lung-adenocarcinoma patients.

Methods: We enrolled 342 consecutive patients. Age, sex, surgical resection, adjuvant treatments, pathological stage, preoperative hemoglobin, red cell distribution width, and their ratio were recorded for each patient.

Results: Mean age was 66 years (SD: 9.0). There were 163 females (47.1%); 169 patients (49.4%) had tumors at stage I, 71 (20.8%) at stage II, and 102 (29.8%) at stage III. In total, 318 patients (93.0%) underwent lobectomy, and 24 (7.0%) pneumonectomy. Disease-free survival multivariable analysis disclosed an increased hazard ratio (HR) of relapse for preoperative HRR lower than 1.01 (HR = 2.20, 95%CI: (1.30-3.72), = 0.004), as well as for N1 single-node (HR = 2.55, 95%CI: (1.33-4.90), = 0.005) and multiple-level lymph node involvement compared to N0 for both N1 (HR = 9.16, 95%CI:(3.65-23.0), < 0.001) and N2 (HR = 10.5, 95%CI:(3.44-32.2, < 0.001).

Conclusion: Pre-operative HRR is an effective prognostic factor of disease-free survival in resected-lung-adenocarcinoma patients, together with the level of pathologic node involvement.

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References

Wang L, Wang C, Wu S, Li Y, Guo W, Liu M . Red blood cell distribution width is associated with mortality after acute ischemic stroke: a cohort study and systematic review. Ann Transl Med. 2020; 8(4):81. PMC: 7049007. DOI: 10.21037/atm.2019.12.142. View

Ivanovic J, Al-Hussaini A, Al-Shehab D, Threader J, Villeneuve P, Ramsay T . Evaluating the reliability and reproducibility of the Ottawa Thoracic Morbidity and Mortality classification system. Ann Thorac Surg. 2011; 91(2):387-93. DOI: 10.1016/j.athoracsur.2010.10.035. View

Petrella F, Radice D, Guarize J, Piperno G, Rampinelli C, de Marinis F . The Impact of Multidisciplinary Team Meetings on Patient Management in Oncologic Thoracic Surgery: A Single-Center Experience. Cancers (Basel). 2021; 13(2). PMC: 7827504. DOI: 10.3390/cancers13020228. View

Riedl J, Posch F, Konigsbrugge O, Lotsch F, Reitter E, Eigenbauer E . Red cell distribution width and other red blood cell parameters in patients with cancer: association with risk of venous thromboembolism and mortality. PLoS One. 2014; 9(10):e111440. PMC: 4210186. DOI: 10.1371/journal.pone.0111440. View

Li W, Li X, Wang M, Ge X, Li F, Huang B . Association between red cell distribution width and the risk of heart events in patients with coronary artery disease. Exp Ther Med. 2015; 9(4):1508-1514. PMC: 4353804. DOI: 10.3892/etm.2015.2244. 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

Arigami T, Okumura H, Matsumoto M, Uchikado Y, Uenosono Y, Kita Y . Analysis of the Fibrinogen and Neutrophil-Lymphocyte Ratio in Esophageal Squamous Cell Carcinoma: A Promising Blood Marker of Tumor Progression and Prognosis. Medicine (Baltimore). 2015; 94(42):e1702. PMC: 4620830. DOI: 10.1097/MD.0000000000001702. View

Wu F, Yang S, Tang X, Liu W, Chen H, Gao H . Prognostic value of baseline hemoglobin-to-red blood cell distribution width ratio in small cell lung cancer: A retrospective analysis. Thorac Cancer. 2020; 11(4):888-897. PMC: 7113058. DOI: 10.1111/1759-7714.13330. View

Petrella F, Diotti C, Rimessi A, Spaggiari L . Pulmonary metastasectomy: an overview. J Thorac Dis. 2017; 9(Suppl 12):S1291-S1298. PMC: 5653506. DOI: 10.21037/jtd.2017.03.175. View

10.

Hishida T, Yoshida J, Ohe Y, Aokage K, Ishii G, Nagai K . Surgical outcomes after initial surgery for clinical single-station N2 non-small-cell lung cancer. Jpn J Clin Oncol. 2013; 44(1):85-92. DOI: 10.1093/jjco/hyt164. View

11.

Fanti S, Farsad M, Battista G, Monetti F, Montini G, Chiti A . Somatostatin receptor scintigraphy for bronchial carcinoid follow-up. Clin Nucl Med. 2003; 28(7):548-52. DOI: 10.1097/00003072-200307000-00003. View

12.

Cordella C, Luebbers H, Rivelli V, Gratz K, Kruse A . An evaluation of the preoperative hemoglobin level as a prognostic factor for oral squamous cell carcinoma. Head Neck Oncol. 2011; 3:35. PMC: 3199902. DOI: 10.1186/1758-3284-3-35. View

13.

Kowalewski J, Szczesny T . Is single-station N2 disease on PET-CT an indication for primary surgery in lung cancer patients?. J Thorac Dis. 2018; 9(12):4828-4831. PMC: 5756984. DOI: 10.21037/jtd.2017.10.154. View

14.

Casiraghi M, Maisonneuve P, Piperno G, Bellini R, Brambilla D, Petrella F . Salvage Surgery After Definitive Chemoradiotherapy for Non-small Cell Lung Cancer. Semin Thorac Cardiovasc Surg. 2017; 29(2):233-241. DOI: 10.1053/j.semtcvs.2017.02.001. View

15.

Warwick R, Mediratta N, Shackcloth M, Shaw M, McShane J, Poullis M . Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2013; 45(1):108-13. DOI: 10.1093/ejcts/ezt275. View

16.

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

17.

Sun P, Zhang F, Chen C, Bi X, Yang H, An X . 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; 7(27):42650-42660. PMC: 5173164. DOI: 10.18632/oncotarget.9516. View

18.

Spaggiari L, Sedda G, Maisonneuve P, Tessitore A, Casiraghi M, Petrella F . A Brief Report on Survival After Robotic Lobectomy for Early-Stage Lung Cancer. J Thorac Oncol. 2019; 14(12):2176-2180. DOI: 10.1016/j.jtho.2019.07.032. View

19.

Petrella F, Leo F, Veronesi G, Solli P, Borri A, Galetta D . "Salvage" surgery for primary mediastinal malignancies: is it worthwhile?. J Thorac Oncol. 2008; 3(1):53-8. DOI: 10.1097/JTO.0b013e31815e6d54. View

20.

Agarwal S . Red cell distribution width, inflammatory markers and cardiorespiratory fitness: results from the National Health and Nutrition Examination Survey. Indian Heart J. 2012; 64(4):380-7. PMC: 3860736. DOI: 10.1016/j.ihj.2012.06.006. View