Orabi Hazem, Howard Lauren, Amling Christopher L, Aronson William J, Cooperberg Matthew R, Kane Christopher J, Terris Martha K, Klaassen Zachary, Janes Jessica L, Freedland Stephen J, Polascik Thomas J
Division of Urology, Department of Surgery, Duke University, Durham, NC, USA.
Urology Department, Assiut University, Assiut, Egypt.
Eur Urol Open Sci. 2022 Feb 10;37:106-112. doi: 10.1016/j.euros.2022.01.003. eCollection 2022 Mar.
Recent reports with a small number of patients showed an association of red blood cell distribution width (RDW) with prostate cancer (PCa) progression.
To investigate whether preoperative RDW can serve as a prognostic marker in patients with PCa undergoing radical prostatectomy (RP) in a large, equal access, and diverse patient cohort.
Data were retrospectively collected on 4756 men treated with RP at eight Veteran Affairs medical centers within the Shared Equal Access Regional Cancer Hospital (SEARCH) database from 1999 through 2017.
Biochemical recurrence (BCR) was the primary outcome, while metastasis, all-cause mortality (ACM), and prostate cancer-specific mortality (PCSM) were secondary outcomes.
The mean (standard deviation) age was 62 yr (6.1), and 1589 (33%) men were black. The median (interquartile range) follow-up was 82 mo (46-127). Preoperative RDW either as a continuous variable or when stratified by quartiles was not associated with BCR. Likewise, preoperative RDW was not associated with metastases or PCSM. However, higher RDW was significantly associated with higher ACM, both as a continuous variable ( < 0.001) and when stratified by quartiles in univariable and multivariable models ( < 0.001). RDW was found to be correlated with D'Amico risk classification of PCa. Study limitations include its retrospective nature and lack of data regarding advanced PCa.
Preoperative RDW was not associated with PCa outcomes in men treated with RP but was associated with ACM. While RDW may be a biomarker of overall health, it is not a biomarker for PCa outcomes. These results emphasize the importance of diverse, larger sized studies in genitourinary cancer research.
Prostate cancer includes a wide spectrum of diseases with different genetic, pathological, and oncological behaviors. Red blood cell distribution width is helpful in predicting the overall survival for a localized prostate cancer patient, and hence, it can help inform personalized treatment decisions and operative care.
近期针对少数患者的报告显示红细胞分布宽度（RDW）与前列腺癌（PCa）进展相关。
在一个大型、平等准入且多样化的患者队列中，研究术前RDW是否可作为接受根治性前列腺切除术（RP）的PCa患者的预后标志物。
设计、设置与参与者：回顾性收集了1999年至2017年期间在共享平等准入区域癌症医院（SEARCH）数据库中的8家退伍军人事务医疗中心接受RP治疗的4756名男性的数据。
生化复发（BCR）是主要结局，而转移、全因死亡率（ACM）和前列腺癌特异性死亡率（PCSM）是次要结局。
平均（标准差）年龄为62岁（6.1），1589名（33%）男性为黑人。中位（四分位间距）随访时间为82个月（46 - 127）。术前RDW作为连续变量或按四分位数分层时均与BCR无关。同样，术前RDW与转移或PCSM无关。然而，较高的RDW与较高的ACM显著相关，无论是作为连续变量（<0.001），还是在单变量和多变量模型中按四分位数分层时（<0.001）。发现RDW与PCa的达米科风险分类相关。研究局限性包括其回顾性性质以及缺乏关于晚期PCa的数据。
术前RDW与接受RP治疗的男性的PCa结局无关，但与ACM相关。虽然RDW可能是总体健康的生物标志物，但它不是PCa结局指标。这些结果强调了在泌尿生殖系统癌症研究中进行多样化、更大规模研究的重要性。
前列腺癌包括一系列具有不同遗传、病理和肿瘤学行为的疾病。红细胞分布宽度有助于预测局限性前列腺癌患者的总体生存，因此，它有助于为个性化治疗决策和手术护理提供参考。
