Skip to main content

Advertisement

SpringerLink
Log in

Red Cell Distribution Width and Gallbladder Cancer: Is It Really Useful?

  • Original Research
  • Published:
Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

Abstract

Purpose

The data on the prognostic significance of red cell distribution width (RDW) in gallbladder cancers is sparse, especially in the potentially resectable cohort of patients. The aim was to assess the prognostic significance of RDW in gallbladder cancer patients undergoing surgery.

Methods

Retrospective analysis of prospectively maintained database of gallbladder cancer patients undergoing surgery at a tertiary cancer institute from 2010 till 2018. Baseline values were collected. Patients were grouped as per the median RDW value and compared. Survival analysis was done using the Kaplan Meier method.

Results

A total of 605 patients were included. The median follow up period was 23 months (range: 6–120 months). The median value of RDW was 14. Comparison between RDW > 14 and RDW < 14 groups showed no difference in outcomes. RDW did not predict overall survival or recurrences. However, in combined stages II and III, a statistically significant improvement in OS and DFS (p < 0.001) was noted in the RDW < 14 group.

Conclusion

RDW did not predict recurrence or survival in potentially resectable gallbladder cancer patients. However, in the subset of stages II and III in combination, lower RDW value was associated with better outcomes. More prospective studies are needed to conclusively establish the prognostic value of RDW.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Goetze TO. Gallbladder carcinoma: prognostic factors and therapeutic options. World J Gastroenterol. 2015;21(43):12211–7.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Patkar S, Ostwal V, Ramaswamy A, Engineer R, Chopra S, Shetty N, et al. Emerging role of multimodality treatment in gall bladder cancer: outcomes following 510 consecutive resections in a tertiary referral center. J Surg Oncol. 2017;117(3):372–9.

  3. Ellingsen TS, Lappegård J, Skjelbakken T, Brækkan SK, Hansen JB. Impact of red cell distribution width on future risk of cancer and all-cause mortality among cancer patients – the Tromsø Study. Hematologica. 2015;100(10):e387–9.

    Article  CAS  Google Scholar 

  4. Kos M, Hocazade C, Kos FT, Uncu D, Karakas E, Dogan M, et al. Evaluation of the effects of red blood cell distribution width on survival in lung cancer patients. Contemp Oncol (Pozn). 2016;20:153–7.

    Google Scholar 

  5. Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y, et al. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. Plos One. 2013;8.

  6. Yao MY, Liu Y, Jin HL, Liu XJ, Lv KZ, Wei HY, et al. Prognostic value of preoperative inflammatory markers in Chinese patients with breast cancer. Onco Targets Ther. 2014;7:1743–52.

    PubMed  PubMed Central  Google Scholar 

  7. Huang DP, Ma RM, Xiang YQ. Utility of red cell distribution width as a prognostic factor in young breast cancer patients. Medicine. 2016; 95(17):e3430.

  8. Hirahara N, Matsubara T, Kawahara D, Mizota Y, Ishibashi S, Tajima Y. Prognostic value of haematological parameters in patients undergoing esophagectomy for esophageal squamous cell carcinoma. Int J Clin Oncol. 2016;21:909–19.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sun P, Zhang F, Chen C, Bi X, Yang H, An X, et al. 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;7:42650–60.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhao T, Cui LJ, Li AJ. The significance of RDW in patients with hepatocellular carcinoma after radical resection. Cancer Biomark. 2016;16:507–12.

    Article  CAS  PubMed  Google Scholar 

  11. Smirne C, Grossi G, Pinato DJ, Burlone ME, Mauri FA, Januszewski A, et al. Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma. Dig Liver Dis. 2015;47:488–94.

    Article  PubMed  Google Scholar 

  12. Wang FM, Xu G, Zhang Y, Ma LL. Red cell distribution width is associated with presence, stage, and grade in patients with renal cell carcinoma. Dis Markers. 2014;2014:860419.

  13. Cheng YC, Huang CN, Wu WJ, Li CC, Ke HL, Li WM, et al. The prognostic significance of inflammation-associated blood cell markers in patients with upper tract urothelial carcinoma. Ann Surg Oncol. 2016;23:343–51.

    Article  PubMed  Google Scholar 

  14. Li Y, Xing C, Wei M, Wu H, Hu X, Li S, et al. Combining red blood cell distribution width (RDW-CV) and CEA predict poor prognosis for survival outcomes in colorectal cancer. J Cancer. 2019;10(5):1162–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Abakay O, Tanrikulu AC, Palanci Y, Abakay A. The value of inflammatory parameters in the prognosis of malignant mesothelioma. J Int Med Res. 2014;42:554–65.

    Article  PubMed  Google Scholar 

  16. Iriyama N, Hatta Y, Kobayashi S, Uchino Y, Miura K, Kurita D, et al. Higher red blood cell distribution width is an adverse prognostic factor in chronic-phase chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Anticancer Res. 2015;35:5473–8.

    CAS  PubMed  Google Scholar 

  17. Liu F, Hu HJ, Ma WJ, Yang Q, Wang JK, Li FY. Prognostic significance of neutrophil–lymphocyte ratio and carbohydrate antigen 19–9 in patients with gallbladder carcinoma. Medicine (Baltimore). 2019;98(8):e14550

  18. Pang Q, Zhang LQ, Wang RT, Bi JB, Zhang JY, Qu K, et al. Platelet to lymphocyte ratio as a novel prognostic tool for gallbladder carcinoma. World J Gastroenterol. 2015;21(21):6675–83.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Xie Y, Zhang L, Zhan L. Can we assess the advancements of gallbladder cancer using red blood cell distribution width? Medicine (Baltimore). 2019;98(51):e18364.

  20. Gupta A, Gupta S, Gupta A, Gupta A, Goyal B, Agrawal S, et al. Red cell distribution width: a surrogate biomarker to predict tumor burden in carcinoma gallbladder. Niger J Surg. 2019;25(2):198–202.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chun YS, Pawlik TM, Vauthey JN. 8th Edition of the AJCC Cancer Staging Manual: Pancreas and Hepatobiliary Cancers. Ann Surg Oncol. 2018;25:845–7.

    Article  PubMed  Google Scholar 

  22. Engineer R, Patkar S, Lewis SC, Sharma AD, Shetty N, Ostwal V, et al. A phase III randomised clinical trial of perioperative therapy (neoadjuvant chemotherapy versus chemoradiotherapy) in locally advanced gallbladder cancers (POLCAGB): study protocol. BMJ Open. 2019;9:e028147

  23. Beyazit Y, Kekilli M, Ibis M, Kurt M, Sayilir A, Onal IK, et al. Can red cell distribution width help to discriminate benign from malignant biliary obstruction? A retrospective single center analysis Hepatogastroenterology. 2012;59(117):1469–73.

    PubMed  Google Scholar 

  24. John A, Kaman L, Behera A, Dahya D, Das R. Role of red cell distribution width and other blood cell indices in differentiating between benign and malignant diseases of gallbladder. HPB. 2018;20:S707–8.

    Article  Google Scholar 

  25. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50(1):40–7.

  26. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009;277(1–2):103–8.

    Article  PubMed  Google Scholar 

  27. Hu L, Li M, Ding Y, Pu L, Liu J, Xie J, et al. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget. 2017;8(9):16027–35.

    Article  PubMed  Google Scholar 

  28. Tang H, Lu W, Li B, Li C, Xu Y, Dong J. Prognostic significance of neutrophil-to-lymphocyte ratio in biliary tract cancers: a systematic review and meta-analysis. Oncotarget. 2017;8(22):36857–68.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank Dr. Mahesh for the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India

    Abhay K. Kattepur

  2. Division of HPB and Gastrointestinal Oncology Services, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India

    Shraddha Patkar & Mahesh Goel

  3. Division of HPB and Gastrointestinal Oncology Services, Department of Medical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India

    Anant Ramaswamy & Vikas Ostwal

Authors
  1. Abhay K. Kattepur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shraddha Patkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anant Ramaswamy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vikas Ostwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mahesh Goel
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All the authors have equally contributed to the manuscript in relation to conceptualization, drafting writing and editing.

Corresponding author

Correspondence to Shraddha Patkar.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kattepur, A.K., Patkar, S., Ramaswamy, A. et al. Red Cell Distribution Width and Gallbladder Cancer: Is It Really Useful?. J Gastrointest Canc 53, 995–1005 (2022). https://doi.org/10.1007/s12029-021-00742-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-021-00742-7

Keywords

Search

Navigation