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. 2023 Jun 3;15(6):e39907.
doi: 10.7759/cureus.39907. eCollection 2023 Jun.

A New Prognostic Parameter Associated With Recurrence in Patients With Nasopharyngeal Cancer Treated With Chemoradiotherapy: The Ratio of the Hemoglobin-to-Red Cell Distribution Width

Yakup Bozkaya  1 , Muhammet Dilber  2 , Ahmet M Bilgili  3 , Caner Aktaş  4
Affiliations

A New Prognostic Parameter Associated With Recurrence in Patients With Nasopharyngeal Cancer Treated With Chemoradiotherapy: The Ratio of the Hemoglobin-to-Red Cell Distribution Width

Yakup Bozkaya et al. Cureus. .

Abstract

Introduction: This study aims to investigate the prognostic significance of the pre-treatment hemoglobin-red blood cell distribution width (RDW) ratio (HRR) in terms of overall survival (OS) and disease-free survival (DFS) in patients with locally advanced nasopharyngeal cancer (LANC) treated with chemoradiotherapy.

Methods: Patients with LANC who attended the oncology clinic between October 2010 and June 2020 were retrospectively screened. HRR was calculated as hemoglobin (g/dL) divided by the RDW (%). Patients were assigned to either the low HRR group or the high HRR group.

Results: A total of 102 patients were included in the study. The cut-off value for HRR was taken as 0.97. Between the low and high HRR groups, mean age, Eastern Cooperative Oncology Group (ECOG) performance score, gamma-glutamyl transferase (GGT), albumin and lactate dehydrogenase (LDH) levels, weight loss at diagnosis, and recurrence and metastasis rate were significantly different. In the low HRR group, OS and DFS were 44.4 (95% CI: 4.9-83.8) and 15.7 months (95% CI: 0.1-36.2), respectively, but could not be reached in the high HRR group (p<0.001). In the multivariate analysis, low HRR was shown to be an independent factor in terms of both OS (p=0.004, hazard ratio (HR)=3.07, 95% CI: 1.444-6.529) and DFS (p<0.001, HR=3.94, 95% CI: 1.883-8.244).

Conclusion: This is the first study showing that HRR is an independent prognostic marker for OS and DFS in patients with LANC treated with chemoradiotherapy. Thus, HRR can be used as an easily applicable, inexpensive marker in clinical practice in this patient group.

Keywords: chemo-radiotherapy; hemoglobin; locally advanced nasopharyngeal cancer; prognostic factor; red cell distribution width.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Kaplan-Meier curve for overall survival of the low HRR and high HRR groups.
HRR: hemoglobin/red cell distribution width ratio.
Figure 2
Figure 2. Kaplan-Meier curve for disease-free survival of the low HRR and high HRR groups.
HRR: hemoglobin/red cell distribution width ratio.
See this image and copyright information in PMC

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