Prognostic Significance of Hemoglobin/Prognostic Nutritional Index and Hemoglobin/Red Blood Cell Distribution in Rectal Cancer

Abstract

Background: We aimed to investigate the effect of hemoglobin/prognostic nutritional index and hemoglobin/red blood cell distribution, which are indicators of inflammation and nutrition, on prognosis and survival in patients with rectal cancer.

Methods: The retrospective study reviewed medical records of 138 patients with rectal cancer who were followed up between 2010 and 2021. The effects of hemoglobin/red blood cell distribution, hemoglobin/prognostic nutritional index, tumor stage, and lymph node status on survival and prognosis were evaluated using univariate and multivariate analyses. Overall survival and disease-free survival were calculated for both groups.

Results: Survival and prognosis were found to be significantly better in nonanemic patients with the hemoglobin/prognostic nutritional index higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/prognostic nutritional index. Similarly, survival and prognosis were found to be significantly better in nonanemic patients with a hemoglobin/red blood cell distribution higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/red blood cell distribution.

Conclusion: The results indicated that nutrition and inflammatory markers have independent prognostic significance in rectal cancer. These markers are simple, inexpensive, and useful biomarkers commonly used in clinical practice, and they were found to predict overall survival and disease-free survival independently.

Figure 1.

Kaplan–Meier analysis of the relationship between H/PNI and OS (high H/PNİ score (≥55.25) = 2.00-censored, low H/PNİ score (<55.25) = 1.00-censored). OS, overall survival; H/PNI, hemoglobin-to-prognostic nutritional index ratio.

Figure 2.

Kaplan–Meier analysis of the relationship between H/PNI and DFS (high H/PNİ score (≥55.25) = 2.00-censored, low H/PNİ score (<55.25) = 1.00-censored). DFS, disease-free survival; H/PNI, hemoglobin-to-prognostic nutritional index ratio.

Figure 3.

Kaplan–Meier analysis of the relationship between H/RDW and OS (high H/RDW score ≥0.89, low H/RDW score ≤0.89). OS, overall survival; H/RDW, hemoglobin-to-red blood cell distribution ratio.

Figure 4.

Kaplan–Meier analysis of the relationship between H/RDW and DFS (high H/RDW score ≥0.89, low H/RDW score ≤0.89). DFS, disease-free survival; H/RDW, hemoglobin-to-red blood cell distribution ratio.