The Relationship Between Red Cell Distribution Width and Cancer-Specific Survival in Patients With Renal Cell Carcinoma Treated With Partial and Radical Nephrectomy

Abstract

Introduction: The aim of the study was to evaluate the influence of red cell distribution width (RDW) on cancer-specific survival (CSS) in patients who undergo nephrectomy for renal cell carcinoma (RCC).

Patients and methods: A total number of 434 patients with pathologically proven RCC treated with radical or partial nephrectomy between 2003 and 2012 were identified in a single tertiary academic center. To evaluate the accuracy of RDW for CSS prediction, a receiver operating characteristic (ROC) curve was plotted. Patients were divided into 2 groups, with low and high RDW, according to the optimal cutoff value, which was determined according to the ROC curve. The association between groups and CSS was analyzed using the Kaplan-Meier method with log-rank testing. The Cox proportional hazards regression model was applied to perform univariate and multivariate analysis for CSS.

Results: Median follow-up was 2146 days. There were no differences between subjects with high and low RDW in terms of sex, age, body mass index, histological type of tumor, frequency of partial nephrectomy, and TNM stage. Patients with high RDW had significantly lower hematocrit, hemoglobin level, and red blood cell count. Tumor necrosis and larger tumor size were significantly more prevalent in the group of patients with high RDW. CSS was significantly lower in patients with RDW ≥ 13.9% compared with patients with RDW < 13.9%. After adjustment for pathological and clinical covariates RDW remained an independent predictor for CSS in a multivariable model for CSS.

Conclusion: Our study revealed that the RDW might be an easily obtainable prognostic marker in RCC patients treated with nephrectomy.

Keywords: Biomarkers; Kidney cancer; RCC; RDW; Renal cell cancer.