Association between preoperative red cell distribution width and prognosis in esophageal cancer: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Yan , LIN Lin , JI Yanli , ZHAO Chunlin , MEI Xiaoli , CHEN Yu ,  CHE Guowei

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

CHE Guowei, Email: cheguowei_hx@aliyun.com

Keywords：

Esophageal cancer; red blood cell distribution width; prognosis; meta-analysis

DOI：

10.7507/1007-4848.201903070

Video：

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Objective To explore the relation of preoperative red blood cell distribution width (RDW) with prognosis in esophageal cancer.Methods The PubMed, EMbase, Web of Science, Cochrane Library, VIP, Wanfang, CNKI and SinoMed databases were searched to identify potential studies assessing the correlation between preoperative RDW and prognosis of esophageal cancer patients from establishment of databases to February 2019. The endpoint events included the overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). The Stata 12.0 software was applied for the meta-analysis and the hazard ratio (HR) and 95% confidence interval (CI) were calculated.Results A total of 10 retrospective studies involving 4 260 esophageal cancer patients from China or Japan were included. The score of Newcastle-Ottawa scale (NOS) of the included studies was more than 6 points. The results demonstrated that elevated preoperative RDW was significantly associated with poor CSS (HR=1.50, 95% CI 1.14 to 1.99, P=0.004) and DFS (HR=1.45, 95% CI 1.14 to 1.85, P=0.002), while no significant association between preoperative RDW and OS in esophageal cancer was observed (HR=1.17, 95% CI 0.95 to 1.45, P=0.143). Subgroup analysis based on the pathology revealed that preoperative RDW had high prognostic value in esophageal squamous carcinoma (ESCC) (HR=1.37, 95% CI 1.05 to 1.77, P=0.018).Conclusion Preoperative RDW may be an independent prognostic factor for Chinese and Japanese esophageal cancer patients, especially for ESCC patients. However, more prospective studies with bigger sample sizes from other countries are still needed to verify our findings.

Citation： WANG Yan, LIN Lin, JI Yanli, ZHAO Chunlin, MEI Xiaoli, CHEN Yu, CHE Guowei. Association between preoperative red cell distribution width and prognosis in esophageal cancer: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1247-1251. doi: 10.7507/1007-4848.201903070 Copy

1.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
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3.	Coleman MP, Gatta G, Verdecchia A, et al. EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol, 2003, 14(5): 128-149.
4.	Colotta F, Allavena P, Sica A, et al. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis, 2009, 30(7): 1073-1081.
5.	Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet, 2001, 357: 539-545.
6.	Yeşil A, Senateş E, Bayoğlu IV, et al. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver, 2011, 5(4): 460-467.
7.	Gunebakmaz O, Kaya MG, Duran M, et al. Red blood cell distribution width in 'non-dippers' versus 'dippers'. Cardiology, 2012, 123(3): 154-159.
8.	Albayrak S, Zengin K, Tanik S, et al. Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev, 2014, 15(18): 7781-7784.
9.	Wells G, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric, 2014, 18(6): 727-734.
10.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring in-consistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
11.	Chen GP, Huang Y, Yang X, et al. A nomogram to predict prognostic value of red cell distribution width in patients with esophageal cancer. Mediators Inflamm, 2015, 2015: 854670.
12.	Hirahara N, Matsubara T, Kawahara D, et al. Prognostic value of hematological parameters in patients undergoing esophagectomy for esophageal squamous cell carcinoma. Int J Clin Oncol, 2016, 21(5): 909-919.
13.	吴振江, 吉庆春. 红细胞分布宽度对食管癌预后的影响. 华夏医学, 2016, 29(6): 10-12.
14.	Sun P, Zhang F, Chen C, et al. The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China. Oncotarget, 2016, 7(27): 42650-42660.
15.	Wan GX, Chen P, Cai XJ, et al. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta, 2016, 452: 199-203.
16.	Zhang F, Chen Z, Wang P, et al. Combination of platelet count and mean platelet volume (COP-MPV) predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients. Tumour Biol, 2016, 37(7): 9323-9331.
17.	Hu D, Lin X, Chen Y, et al. Preoperative blood-routine markers and prognosis of esophageal squamous cell carcinoma: The Fujian prospective investigation of cancer (FIESTA) study. Oncotarget, 2017, 8(14): 23841-23850.
18.	Han F, Liu Y, Cheng S, et al. Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer. Clin Chim Acta, 2019, 488: 150-158.
19.	Schreiber RD, Old LJ, Smyth MJ, et al. Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion. Science, 2011, 331(6024): 1565-70.
20.	Agarwal S. Red cell distribution width, inflammatory markers and cardiorespiratory fitness: results from the National Health and Nutrition Examination Survey. Indian Heart J, 2012, 64(4): 380-387.
21.	McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care, 2009, 12(3): 223-226.
22.	Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr, 2014, 38(2): 196-204.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
3. Coleman MP, Gatta G, Verdecchia A, et al. EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol, 2003, 14(5): 128-149.
4. Colotta F, Allavena P, Sica A, et al. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis, 2009, 30(7): 1073-1081.
5. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet, 2001, 357: 539-545.
6. Yeşil A, Senateş E, Bayoğlu IV, et al. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver, 2011, 5(4): 460-467.
7. Gunebakmaz O, Kaya MG, Duran M, et al. Red blood cell distribution width in 'non-dippers' versus 'dippers'. Cardiology, 2012, 123(3): 154-159.
8. Albayrak S, Zengin K, Tanik S, et al. Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev, 2014, 15(18): 7781-7784.
9. Wells G, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric, 2014, 18(6): 727-734.
10. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring in-consistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
11. Chen GP, Huang Y, Yang X, et al. A nomogram to predict prognostic value of red cell distribution width in patients with esophageal cancer. Mediators Inflamm, 2015, 2015: 854670.
12. Hirahara N, Matsubara T, Kawahara D, et al. Prognostic value of hematological parameters in patients undergoing esophagectomy for esophageal squamous cell carcinoma. Int J Clin Oncol, 2016, 21(5): 909-919.
13. 吴振江, 吉庆春. 红细胞分布宽度对食管癌预后的影响. 华夏医学, 2016, 29(6): 10-12.
14. Sun P, Zhang F, Chen C, et al. The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China. Oncotarget, 2016, 7(27): 42650-42660.
15. Wan GX, Chen P, Cai XJ, et al. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta, 2016, 452: 199-203.
16. Zhang F, Chen Z, Wang P, et al. Combination of platelet count and mean platelet volume (COP-MPV) predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients. Tumour Biol, 2016, 37(7): 9323-9331.
17. Hu D, Lin X, Chen Y, et al. Preoperative blood-routine markers and prognosis of esophageal squamous cell carcinoma: The Fujian prospective investigation of cancer (FIESTA) study. Oncotarget, 2017, 8(14): 23841-23850.
18. Han F, Liu Y, Cheng S, et al. Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer. Clin Chim Acta, 2019, 488: 150-158.
19. Schreiber RD, Old LJ, Smyth MJ, et al. Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion. Science, 2011, 331(6024): 1565-70.
20. Agarwal S. Red cell distribution width, inflammatory markers and cardiorespiratory fitness: results from the National Health and Nutrition Examination Survey. Indian Heart J, 2012, 64(4): 380-387.
21. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care, 2009, 12(3): 223-226.
22. Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr, 2014, 38(2): 196-204.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Association between preoperative red cell distribution width and prognosis in esophageal cancer: A systematic review and meta-analysis

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