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. 2023 Dec 5;59(12):2124.
doi: 10.3390/medicina59122124.

Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions

Donatella Coradduzza  1 , Serenella Medici  2 , Carla Chessa  3 , Angelo Zinellu  1 , Massimo Madonia  3 , Andrea Angius  4 , Ciriaco Carru  1   5 , Maria Rosaria De Miglio  3
Affiliations

Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions

Donatella Coradduzza et al. Medicina (Kaunas). .

Abstract

Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the Hb/RDW ratio in cancer and the implications for clinical practice. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science databases was performed by an independent author between 18 March and 30 March 2023 to collect relevant literature that assessed the prognostic value of the Hb/RDW ratio in cancer. Overall survival (OS), progression-free survival (PFS), and the association of these with the Hb/RDW ratio were considered to be the main endpoints. Results: Thirteen retrospective studies, including 3818 cancer patients, were identified and involved in this review. It was observed that, when patients with a high vs. low Hb/RDW ratio were compared, those with a lower Hb/RDW ratio had significantly poorer outcomes (p < 0.05). In lung cancer patients, a one-unit increase in the Hb/RDW ratio reduces mortality by 1.6 times, whilst in esophageal squamous-cell carcinoma patients, a lower Hb/RDW ratio results in a 1.416-times greater risk of mortality. Conclusions: A low Hb/RDW ratio was associated with poor OS and disease progression in patients with cancer. This blood parameter should be considered a standard biomarker in clinical practice for predicting OS and PFS in cancer patients. Future searches will be necessary to determine and standardize the Hb/RDW cut-off value and to assess whether the Hb/RDW ratio is optimal as an independent prognostic factor or if it requires incorporation into risk assessment models for predicting outcomes in cancer patients.

Keywords: Hb/RDW ratio; cancer; hemoglobin to red cell distribution width; risk assessment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Critical role of hemoglobin (Hb)/Red Cell Distribution Width (RDW) ratios in utilizing blood cell data for diagnostic and prognostic purposes. Hb levels and RDW are fundamental parameters analyzed from blood samples, and their ratio (Hb/RDW) serves as a valuable metric in clinical assessment.
Figure 2
Figure 2
PRISMA flow diagram representing the literature search and study selection process.
See this image and copyright information in PMC

References

    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global cancer statistics 2020: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2021. CA Cancer J. Clin. 2021;71:7–33. doi: 10.3322/caac.21654. - DOI - PubMed
    1. Schottenfeld D., Beebe-Dimmer J.L., Buffler P.A., Omenn G.S. Current perspective on the global and united states cancer burden attributable to lifestyle and environmental risk factors. Annu. Rev. Public Health. 2013;34:97–117. doi: 10.1146/annurev-publhealth-031912-114350. - DOI - PubMed
    1. Dunn B.K., Woloshin S., Xie H., Kramer B.S. Cancer overdiagnosis: A challenge in the era of screening. J. Natl. Cancer Cent. 2022;2:235–242. doi: 10.1016/j.jncc.2022.08.005. - DOI - PMC - PubMed

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