术前红细胞分布宽度作为转移性肾细胞癌的独立预后因素
Preoperative red blood cell distribution width as an independent prognostic factor in metastatic renal cell carcinoma.
作者信息
Wei Zongjie, Zhang Fan, Ma Xin, He Weiyang, Gou Xin, Zhang Xu, Xie Yongpeng
机构信息
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China.
出版信息
Transl Oncol. 2022 Sep;23:101486. doi: 10.1016/j.tranon.2022.101486. Epub 2022 Jul 12.
OBJECTIVE
This study aimed to explore the prognostic value of preoperative red blood cell distribution width (RDW) in patients with metastatic renal cell carcinoma (mRCC).
METHODS
Clinicopathological data of 230 patients with mRCC treated at the First Affiliated Hospital of Chongqing Medical University and the Chinese PLA General Hospital from January 2008 to December 2018 were retrospectively analyzed. Patients were stratified according to the optimal cut-off value of RDW calculated using X-tile software. The prognostic value of RDW was analyzed using the Kaplan-Meier curve with log-rank test and univariate and multivariate Cox proportional hazards models.
RESULTS
A total of 230 patients were included. The optimal cut-off value of RDW obtained using X-tile software was 13.1%. The median Progression-free survival (PFS) and Overall survival (OS) of all populations were 12.06 months (IQR: 4.73-36.9) and 32.20 months (IQR: 13.73-69.46), respectively. Kaplan-Meier curves showed that patients with high RDW had worse PFS and OS than those with low RDW (median PFS of 9.7 months vs. 17.9 months, P = 0.002, and median OS of 27.8 months vs. 45.1 months, P = 0.012, respectively). Multivariate analysis showed that RDW was an independent risk factor for PFS (HR: 1.505; 95% CI: 1.111-2.037; P = 0.008) and OS (HR: 1.626; 95% CI: 1.164-2.272; P = 0.004) in mRCC after cytoreductive nephrectomy.
CONCLUSION
Preoperative RDW was independently associated with PFS and OS in patients with mRCC and may be a potential predictor of survival outcomes in mRCC.
目的
本研究旨在探讨术前红细胞分布宽度（RDW）对转移性肾细胞癌（mRCC）患者的预后价值。
方法
回顾性分析2008年1月至2018年12月在重庆医科大学附属第一医院和中国人民解放军总医院接受治疗的230例mRCC患者的临床病理资料。根据使用X-tile软件计算出的RDW最佳临界值对患者进行分层。采用Kaplan-Meier曲线结合对数秩检验以及单因素和多因素Cox比例风险模型分析RDW的预后价值。
结果
共纳入230例患者。使用X-tile软件得出的RDW最佳临界值为13.1%。所有患者的中位无进展生存期（PFS）和总生存期（OS）分别为12.06个月（四分位间距：4.73 - 36.9）和32.20个月（四分位间距：13.73 - 69.46）。Kaplan-Meier曲线显示，高RDW患者的PFS和OS均低于低RDW患者（中位PFS分别为9.7个月和17.9个月，P = 0.002；中位OS分别为27.8个月和45.1个月，P = 0.012）。多因素分析显示，在减瘤性肾切除术后的mRCC患者中，RDW是PFS（风险比：1.505；95%置信区间：1.111 - 2.037；P = 0.008）和OS（风险比：1.626；95%置信区间：1.164 - 2.272；P = 0.004）的独立危险因素。
结论
术前RDW与mRCC患者的PFS和OS独立相关，可能是mRCC生存结局的潜在预测指标。
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