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. 2022 Oct 31:9:1137-1147.
doi: 10.2147/JHC.S380243. eCollection 2022.

Prognostic Value of Red Blood Cell Distribution Width (RDW) in the Recurrence of Hepatocellular Carcinoma Following Curative Resection

Mohammad Golriz  1   2 , Ali Ramouz  1 , Sadeq Ali-Hasan-Al-Saegh  1 , Saeed Shafiei  1 , Ehsan Aminizadeh  1 , Ahmed Hammad  1 , Markus Mieth  1 , Christian Rupp  2   3 , Christoph Springfeld  2   4 , Katrin Hoffmann  1   2 , Markus Büchler  1 , Arianeb Mehrabi  1   2
Affiliations

Prognostic Value of Red Blood Cell Distribution Width (RDW) in the Recurrence of Hepatocellular Carcinoma Following Curative Resection

Mohammad Golriz et al. J Hepatocell Carcinoma. .

Abstract

Purpose: Although surgery is associated with an acceptable cure rate, tumor recurrence is still a challenging issue in hepatocellular carcinoma (HCC) patients. Red blood cell distribution width (RDW) is considered an inflammatory marker for predicting overall mortality in a wide spectrum of malignancies. In the current study, the prognostic role of pre- and postoperative RDW in HCC recurrence after liver resection (LRx) is investigated.

Patients and methods: In 395 patients, RDW levels were evaluated preoperatively as well as six and twelve months after curative LRx. The RDW cutoff values were determined using receiver operating characteristic curves (ROCs) according to the recurrence-free survival (RFS). Survival analyses were performed using the Kaplan-Meier, and differences were compared using the Log rank test.

Results: The RFS was significantly higher among patients with low RDW at the 6th month and 12th month, postoperatively (P < 0.001 and P = 0.028). RDW levels of higher than 16.15% at the 6th (HR: 2.047, P <0.001) and higher than 15.85% at 12th (HR: 3.105, P < 0.002) months after liver resection were independent predictors of RFS.

Conclusion: Postoperative RDW values seem to be predictive of tumor recurrence in HCC patients. RDW levels at the 6th and 12th months postoperatively were independent predictors of recurrence after LRx.

Keywords: hepatectomy; hepatocellular carcinoma; liver resection; red blood cell distribution width.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) Receiver-operator characteristics curves for red blood cell distribution width (RDW) preoperatively. (B) Receiver-operator characteristics curves for RDW at 6 months postoperatively. (C) Receiver-operator characteristics curves for RDW at 12 months postoperatively.
Figure 2
Figure 2
Kaplan–Meier recurrence-free survival curves of hepatocellular carcinoma (HCC) patients after liver resection. Patients were divided into two groups: preoperative level of red blood cell distribution width (RDW) ≤14.25% and preoperative level of RDW >14.25%.
Figure 3
Figure 3
Kaplan–Meier recurrence-free survival curves of hepatocellular carcinoma (HCC) patients after liver resection. Patients were divided into two groups: red blood cell distribution width (RDW) at 6 months postoperatively ≤16.15% and RDW at 6 months postoperatively >16.15%.
Figure 4
Figure 4
Kaplan–Meier recurrence-free survival curves of hepatocellular carcinoma (HCC) patients after liver resection. Patients were divided into two groups: red blood cell distribution width (RDW) at 12 months postoperatively ≤15.85% and RDW at 12 months postoperatively >15.85%.
Figure 5
Figure 5
Forest plot of the multivariate cox-regression analysis.
See this image and copyright information in PMC

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