Department of Urology, Medical University of Silesia, Zabrze, Poland.
Department of Urology, Medical University of Silesia, Zabrze, Poland.
Clin Genitourin Cancer. 2018 Jun;16(3):e677-e683. doi: 10.1016/j.clgc.2017.12.003. Epub 2017 Dec 27.
The aim of the study was to evaluate the influence of red cell distribution width (RDW) on cancer-specific survival (CSS) in patients who undergo nephrectomy for renal cell carcinoma (RCC).
A total number of 434 patients with pathologically proven RCC treated with radical or partial nephrectomy between 2003 and 2012 were identified in a single tertiary academic center. To evaluate the accuracy of RDW for CSS prediction, a receiver operating characteristic (ROC) curve was plotted. Patients were divided into 2 groups, with low and high RDW, according to the optimal cutoff value, which was determined according to the ROC curve. The association between groups and CSS was analyzed using the Kaplan-Meier method with log-rank testing. The Cox proportional hazards regression model was applied to perform univariate and multivariate analysis for CSS.
Median follow-up was 2146 days. There were no differences between subjects with high and low RDW in terms of sex, age, body mass index, histological type of tumor, frequency of partial nephrectomy, and TNM stage. Patients with high RDW had significantly lower hematocrit, hemoglobin level, and red blood cell count. Tumor necrosis and larger tumor size were significantly more prevalent in the group of patients with high RDW. CSS was significantly lower in patients with RDW ≥ 13.9% compared with patients with RDW < 13.9%. After adjustment for pathological and clinical covariates RDW remained an independent predictor for CSS in a multivariable model for CSS.
Our study revealed that the RDW might be an easily obtainable prognostic marker in RCC patients treated with nephrectomy.
本研究旨在评估红细胞分布宽度（RDW）对接受肾细胞癌（RCC）根治性或部分肾切除术患者的癌症特异性生存（CSS）的影响。
在一家单一的三级学术中心，共确定了 434 名经病理证实患有 RCC 并接受根治性或部分肾切除术治疗的患者。为了评估 RDW 预测 CSS 的准确性，绘制了接收器工作特征（ROC）曲线。根据 ROC 曲线确定的最佳截断值，将患者分为 RDW 低和高两组。使用 Kaplan-Meier 方法和对数秩检验分析组间与 CSS 的关联。应用 Cox 比例风险回归模型进行 CSS 的单变量和多变量分析。
中位随访时间为 2146 天。高和低 RDW 组之间在性别、年龄、体重指数、肿瘤组织学类型、部分肾切除术频率和 TNM 分期方面无差异。RDW 较高的患者的红细胞压积、血红蛋白水平和红细胞计数明显较低。肿瘤坏死和较大的肿瘤大小在 RDW 较高的患者中更为常见。与 RDW<13.9%的患者相比，RDW≥13.9%的患者 CSS 明显较低。在调整病理和临床协变量后，RDW 在 CSS 的多变量模型中仍然是 CSS 的独立预测因子。
我们的研究表明，RDW 可能是接受肾切除术治疗的 RCC 患者中一种易于获得的预后标志物。
