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Prognostic Significance of Pre- and Post-operative Red-Cell Distribution Width in Patients with Gastric Cancer

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

High red cell distribution width (RDW) is reportedly provoked by chronic inflammation and poor nutritional status; high pre-operative RDW is related to poor prognosis in some cancers. However, the prognostic significance of post-operative RDW in gastric cancer (GC) patients is unclear.

Methods

We enrolled 221 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma.

Results

Optimal cutoff values were determined by ROC analysis to be 14.85 (pre-operative) and 14.05 (post-operative). We accordingly divided patients into the high (pre-RDWHigh; ≥ 14.85) and low (pre-RDWLow; < 14.85) pre-operative RDW groups, and the high (post-RDWHigh; ≥ 14.05) and low (post-RDWLow; < 14.05) post-operative RDW subgroups. Five-year overall survival (OS) rates differed significantly in pre-RDWHigh group (52.4%) and pre-RDWLow group (78.0%; P < 0.0001). Five-year OS rates also differed significantly in post-RDWHigh (52.7%) and post-RDWLow subgroups (88.3%; P < 0.0001). Multivariate analysis showed post-operative RDW, but not pre-operative RDW, to be an independent prognostic indicator for OS.

Conclusions

Post-operative RDW may be a useful prognostic indicator in GC patients.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2):69–90.

    Article  Google Scholar 

  2. Nozoe T, Iguchi T, Adachi E, Matsukuma A, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancer. Surgery today 2011; 41(4):510–513.

    Article  CAS  Google Scholar 

  3. Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Yamamoto M, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer. Digestive surgery 2018.

  4. Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Postoperative Serum Albumin is a Potential Prognostic Factor for Older Patients with Gastric Cancer. Yonago acta medica 2018; 61(1):72–78.

    Article  CAS  Google Scholar 

  5. Miyatani K, Saito H, Kono Y, Murakami Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Combined analysis of the pre- and postoperative neutrophil-lymphocyte ratio predicts the outcomes of patients with gastric cancer. Surgery today 2018; 48(3):300–307.

    Article  Google Scholar 

  6. Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil-Lymphocyte Ratio in Gastric Cancer Patients. World journal of surgery 2018; 42(6):1819–1825.

    Article  Google Scholar 

  7. Murakami Y, Saito H, Kono Y, Shishido Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Combined analysis of the preoperative and postoperative prognostic nutritional index offers a precise predictor of the prognosis of patients with gastric cancer. Surgery today 2018; 48(4):395–403.

    Article  Google Scholar 

  8. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. American heart journal 2009; 158(4):659–666.

    Article  Google Scholar 

  9. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Archives of internal medicine 2009; 169(5):515–523.

    Article  Google Scholar 

  10. Douglas SW, Adamson JW. The anemia of chronic disorders: studies of marrow regulation and iron metabolism. Blood 1975; 45(1):55–65.

    Article  CAS  Google Scholar 

  11. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, Chaves PH, Ershler WB, Longo DL. Proinflammatory state and circulating erythropoietin in persons with and without anemia. The American journal of medicine 2005; 118(11):1288.

    Article  Google Scholar 

  12. Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y, Koyama M, Okada N, Nakashima N, Masuya D, Yoshimatsu H, Suzuki Y. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PloS one 2013; 8(11):e80240.

    Article  CAS  Google Scholar 

  13. Cheng S, Han F, Wang Y, Xu Y, Qu T, Ju Y, Lu Z. The red distribution width and the platelet distribution width as prognostic predictors in gastric cancer. BMC gastroenterology 2017; 17(1):163.

    Article  Google Scholar 

  14. Saito T, Kurokawa Y, Miyazaki Y, Makino T, Takahashi T, Yamasaki M, Nakajima K, Takiguchi S, Mori M, Doki Y. Which is a more reliable indicator of survival after gastric cancer surgery: Postoperative complication occurrence or C-reactive protein elevation? Journal of surgical oncology 2015; 112(8):894–899.

    Article  CAS  Google Scholar 

  15. The Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2011; 14(2):101–112.

    Article  Google Scholar 

  16. Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi 1984; 85(9):1001–1005.

    CAS  PubMed  Google Scholar 

  17. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell 2010; 140(6):883–899.

    Article  CAS  Google Scholar 

  18. Ikeda M, Furukawa H, Imamura H, Shimizu J, Ishida H, Masutani S, Tatsuta M, Satomi T. Poor prognosis associated with thrombocytosis in patients with gastric cancer. Annals of surgical oncology 2002; 9(3):287–291.

    Article  Google Scholar 

  19. Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Prognostic Significance of Platelet-Based Inflammatory Indicators in Patients with Gastric Cancer. World journal of surgery 2018; 42(8):2542–2550.

    Article  Google Scholar 

  20. Han WX, Chen ZM, Wei ZJ, Xu AM. Preoperative pre-albumin predicts prognosis of patients after gastrectomy for adenocarcinoma of esophagogastric junction. World journal of surgical oncology 2016; 14(1):279.

    Article  Google Scholar 

  21. Nozoe T, Ninomiya M, Maeda T, Matsukuma A, Nakashima H, Ezaki T. Prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma. Surgery today 2010; 40(5):440–443.

    Article  Google Scholar 

  22. Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M. Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Annals of surgical oncology 2013; 20(5):1575–1583.

    Article  Google Scholar 

  23. Wei TT, Wang LL, Yin JR, Liu YT, Qin BD, Li JY, Yin X, Zhou L, Zhong RQ. Relationship between red blood cell distribution width, bilirubin, and clinical characteristics of patients with gastric cancer. International journal of laboratory hematology 2017; 39(5):497–501.

    Article  Google Scholar 

  24. Yazici P, Demir U, Bozkurt E, Isil GR, Mihmanli M. The role of red cell distribution width in the prognosis of patients with gastric cancer. Cancer biomarkers : section A of Disease markers 2017; 18(1):19–25.

    Article  CAS  Google Scholar 

  25. Yoshida K, Kodera Y, Kochi M, Ichikawa W, Kakeji Y, Sano T, Nagao N, Takahashi M, Takagane A, Watanabe T, Kaji M, Okitsu H, Nomura T, Matsui T, Yoshikawa T, Matsuyama J, Yamada M, Ito S, Takeuchi M, Fujii M. Addition of Docetaxel to Oral Fluoropyrimidine Improves Efficacy in Patients With Stage III Gastric Cancer: Interim Analysis of JACCRO GC-07, a Randomized Controlled Trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2019; 37(15):1296–1304.

    Article  CAS  Google Scholar 

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Acknowledgments

We thank Marla Brunker from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Author notes

  1. Shimizu Shota and Hiroaki Saito contributed equally to this work.

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan

    Shimizu Shota, Hiroaki Saito, Yusuke Kono, Yuki Murakami, Yuji Shishido, Kozo Miyatani, Tomoyuki Matsunaga, Yoji Fukumoto & Yoshiyuki Fujiwara

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  1. Shimizu Shota
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  2. Hiroaki Saito
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  3. Yusuke Kono
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  6. Kozo Miyatani
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  7. Tomoyuki Matsunaga
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  8. Yoji Fukumoto
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  9. Yoshiyuki Fujiwara
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Contributions

Study conception and design: S; acquisition of data: M, S, K, M, S, M, and F; analysis and interpretation of data: S and S; drafting of manuscript: S, S, K, M, S, M, and F; critical revision: S and F; final approval of the article: all authors.

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Correspondence to Hiroaki Saito.

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All authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or with comparable ethical standards.

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Shota, S., Saito, H., Kono, Y. et al. Prognostic Significance of Pre- and Post-operative Red-Cell Distribution Width in Patients with Gastric Cancer. J Gastrointest Surg 24, 1010–1017 (2020). https://doi.org/10.1007/s11605-019-04392-w

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  • DOI: https://doi.org/10.1007/s11605-019-04392-w

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