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Diagnosis and Treatment of Primary and Secondary Lung Cancers
Article

Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

1
Department of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
2
Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20141 Milan, Italy
3
Department of Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
4
Department of Radiology, Ente Ospedaliero Cantonale (EOC) Istituto di Imaging della Svizzera Italiana (IIMSI), 6903 Lugano, Switzerland
5
Facoltà di Scienze Biomediche, Università della Svizzera italiana, via Buffi 13, 6900 Lugano, Switzerland
*
Author to whom correspondence should be addressed.
Academic Editor: Åslaug Helland
Cancers 2021, 13(4), 710; https://doi.org/10.3390/cancers13040710
Received: 15 January 2021 / Revised: 2 February 2021 / Accepted: 8 February 2021 / Published: 9 February 2021
(This article belongs to the Special Issue Diagnosis and Treatment of Primary and Secondary Lung Cancers)
Low hemoglobin (Hb) values—indicating a condition of anemia—are related to impaired nutrition and immune system status, suggesting reduced tolerance to therapies in oncologic patients. In fact, it has been shown that pre-treatment anemia predicts poor outcomes in many neoplastic diseases. Similarly, red cell distribution width—which is a measure of the size of variation of circulating erythrocytes—has been shown to be closely related to poor prognosis both in cardiovascular and in oncologic diseases. The use of the Hb-to-red cell distribution width (RDW) ratio (HRR)—which merges data coming from the two blood parameters—is a prognostic marker in esophageal squamous cell carcinoma, small cell lung cancer, and several other types of solid tumors, emerging as an independent prognostic factor for overall survival and disease-free survival. The aim of the present study was to investigate the prognostic role of pre-operative HRR in resected-pulmonary adenocarcinoma patients undergoing a multidisciplinary treatment.
Background: The ratio of hemoglobin to red cell distribution width (HRR) has been described as an effective prognostic factor in several types of cancer. The aim of this study was to investigate the prognostic role of preoperative HRR in resected-lung-adenocarcinoma patients. Methods: We enrolled 342 consecutive patients. Age, sex, surgical resection, adjuvant treatments, pathological stage, preoperative hemoglobin, red cell distribution width, and their ratio were recorded for each patient. Results: Mean age was 66 years (SD: 9.0). There were 163 females (47.1%); 169 patients (49.4%) had tumors at stage I, 71 (20.8%) at stage II, and 102 (29.8%) at stage III. In total, 318 patients (93.0%) underwent lobectomy, and 24 (7.0%) pneumonectomy. Disease-free survival multivariable analysis disclosed an increased hazard ratio (HR) of relapse for preoperative HRR lower than 1.01 (HR = 2.20, 95%CI: (1.30–3.72), p = 0.004), as well as for N1 single-node (HR = 2.55, 95%CI: (1.33–4.90), p = 0.005) and multiple-level lymph node involvement compared to N0 for both N1 (HR = 9.16, 95%CI:(3.65–23.0), p < 0.001) and N2 (HR = 10.5, 95%CI:(3.44–32.2, p < 0.001). Conclusion: Pre-operative HRR is an effective prognostic factor of disease-free survival in resected-lung-adenocarcinoma patients, together with the level of pathologic node involvement. View Full-Text
Keywords: hemoglobin/red blood cell distribution width ratio (HRR); lung adenocarcinoma; disease-free survival hemoglobin/red blood cell distribution width ratio (HRR); lung adenocarcinoma; disease-free survival
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MDPI and ACS Style

Petrella, F.; Casiraghi, M.; Radice, D.; Cara, A.; Maffeis, G.; Prisciandaro, E.; Rizzo, S.; Spaggiari, L. Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma. Cancers 2021, 13, 710. https://doi.org/10.3390/cancers13040710

AMA Style

Petrella F, Casiraghi M, Radice D, Cara A, Maffeis G, Prisciandaro E, Rizzo S, Spaggiari L. Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma. Cancers. 2021; 13(4):710. https://doi.org/10.3390/cancers13040710

Chicago/Turabian Style

Petrella, Francesco, Monica Casiraghi, Davide Radice, Andrea Cara, Gabriele Maffeis, Elena Prisciandaro, Stefania Rizzo, and Lorenzo Spaggiari. 2021. "Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma" Cancers 13, no. 4: 710. https://doi.org/10.3390/cancers13040710

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