Red Blood Cell Distribution Width as a Possible Predictor of Diagnosis and Survival in Gastric Cancer


Sakin A., Aydemir O., Şahin S., Alay M., Aytekin A., Aldemir M. N., ...More

Eurasian Journal of Medical Investigation, vol.4, no.3, pp.289-297, 2020 (Peer-Reviewed Journal)

Abstract

Objectives: To compare the preoperative Red Cell Distribution Width (RDW) value in curatively-operated gastric cancer (GC) patients without receiving neoadjuvant chemotherapy (NACT) vs. control group, with the aim of investigating its preoperative prognostic effect. Methods: Receiver Operator Characteristics (ROC) curve of RDW value was plotted for DFS. The area under curve (AUC) of the RDW was 0.714 with 73.5% sensitivity and >5.5 with 71.1% specificity. Patients were divided into 2 groups as RDW ?15.5 and RDW >15.5. Results: The study included 330 GC patients (37.7% female and 62.3% male) and 330 healthy controls (63.9% male and 36.1% female). ROC curves were used to confirm the predictive role of preoperative RDW value in predicting the presence of GC. For GC, the AUC of RDW was 0.665 with 61.3% sensitivity and 14.1 with 64% specificity. There was a positive correlation between disease stage and RDW in GC patients (Rho=0.338, p<0.001). Five-year DFS was 81.1% in the low-RDW group and 61.9% in the high-RDW group (p=0.001). Similarly, Corresponding 5-year overall survival (OS) rates were 74.4% and 57.7 (p=0.001). In multivariate analysis, male gender, stage III disease, high CEA, and RDW ?15.5 were the factors associated with worse DFS, whereas adjuvant therapy (p=0.036) prolonged DFS significantly. Conclusion: In our study, preoperative RDW was found to be both predictive and prognostic for GC.