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Article

Prognostic Value of Red Blood Cell Distribution Width in Resected pN1 Lung Adenocarcinoma

1
Department of Thoracic Surgery, IRCCS European Institute of Oncology, 20141 Milan, Italy
2
Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20141 Milan, Italy
3
Department of Biostatistcs, IRCCS European Institute of Oncology, 20141 Milan, Italy
4
Department of Radiology, Ente Ospedaliero Cantonale (EOC) Istituto di Imaging della Svizzera Italiana (IIMSI), 6903 Lugano, Switzerland
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(12), 3677; https://doi.org/10.3390/cancers12123677
Received: 2 October 2020 / Revised: 12 November 2020 / Accepted: 7 December 2020 / Published: 8 December 2020
Red blood cell distribution width is a measure of the variation of erythrocyte volume. Impaired erythropoiesis can lead to a wide variation in erythrocyte dimension—defined as anisocytosis—indicating that pathological modifications are taking place. Recently, red blood cell distribution width has been advocated as an effective prognostic factor in cardiovascular diseases, acute kidney injury, autoimmune disease, and oncologic settings. In many advanced and several early-stage oncologic conditions, it has shown excellent prognostic efficacy; we therefore investigated what prognostic role red blood cell distribution width may have in resected lung cancer, focusing on pN1 adenocarcinoma patients in whom adjuvant treatments—although well-established—are still proposed case by case. Our findings suggest that red blood cell distribution width is strictly related to disease-free survival; it could therefore be considered as a further tool for planning postoperative adjuvant treatments and setting up an adequate follow-up program.
Background: Red blood cell distribution width is a measure of the variation of erythrocyte volume and has recently been advocated as a prognostic tool in neoplastic and non-neoplastic diseases. We studied the prognostic role of preoperative red blood cell distribution width (RDW) in resected pN1 lung adenocarcinoma patients. Methods: Sixty-seven consecutive pN1 lung adenocarcinoma patients operated in the last two years were retrospectively evaluated in the present study. Age, sex, smoking status, type of surgical resection, neoadjuvant and adjuvant treatments, pathological stage, T and N status, tumor size, preoperative hemoglobin (Hb) and RDW, preoperative neutrophils, lymphocytes, and their ratio were collected for each patient. Outpatient follow-up was performed and date of relapse was recorded. Results: There were 24 females (35.8%). Twenty-eight patients (41.8%) belonged to stage 3A and thirty-nine patients (58.2%) to stage 2B. Mean preoperative RDW % was 14.1 (IQR: 12.9–14.8). Univariate analysis disclosed preoperative RDW as strictly related to disease-free survival (p = 0.02), which was confirmed in the exploratory multivariable analysis (p = 0.003). Conclusions: Pre-operative RDW is an effective prognostic factor of disease-free survival in resected pN1 lung adenocarcinoma; it could therefore be considered as a further tool for planning postoperative adjuvant treatments and setting up an adequate follow-up program. View Full-Text
Keywords: red blood cell distribution width (RDW); lung adenocarcinoma; disease-free interval red blood cell distribution width (RDW); lung adenocarcinoma; disease-free interval
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MDPI and ACS Style

Petrella, F.; Casiraghi, M.; Radice, D.; Prisciandaro, E.; Rizzo, S.; Spaggiari, L. Prognostic Value of Red Blood Cell Distribution Width in Resected pN1 Lung Adenocarcinoma. Cancers 2020, 12, 3677. https://doi.org/10.3390/cancers12123677

AMA Style

Petrella F, Casiraghi M, Radice D, Prisciandaro E, Rizzo S, Spaggiari L. Prognostic Value of Red Blood Cell Distribution Width in Resected pN1 Lung Adenocarcinoma. Cancers. 2020; 12(12):3677. https://doi.org/10.3390/cancers12123677

Chicago/Turabian Style

Petrella, Francesco, Monica Casiraghi, Davide Radice, Elena Prisciandaro, Stefania Rizzo, and Lorenzo Spaggiari. 2020. "Prognostic Value of Red Blood Cell Distribution Width in Resected pN1 Lung Adenocarcinoma" Cancers 12, no. 12: 3677. https://doi.org/10.3390/cancers12123677

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