The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China

Abstract

// Peng Sun 1, 2, * , Fei Zhang 1, 2, * , Cui Chen 3, * , Xiwen Bi 1, 2 , Hang Yang 1, 2 , Xin An 1, 2 , Fenghua Wang 1, 2 , Wenqi Jiang 1, 2 1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China 2 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China 3 Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province 510080, P. R. China * These authors have contributed equally to this work Correspondence to: Fenghua Wang, email: wangfh@sysucc.org.cn Wenqi Jiang, email: jiangwq@sysucc.org.cn Keywords: esophageal squamous cell carcinoma (ESCC), hemoglobin, red cell distribution width (RDW), prognosis, survival Received: February 14, 2016      Accepted: April 16, 2016      Published: May 20, 2016 ABSTRACT Background: We propose a novel prognostic parameter for esophageal squamous cell carcinoma (ESCC)—hemoglobin/red cell distribution width (HB/RDW) ratio. Its clinical prognostic value and relationship with other clinicopathological characteristics were investigated in ESCC patients. Results: The optimal cut-off value was 0.989 for the HB/RDW ratio. The HB/RDW ratio ( P = 0.035), tumor depth ( P = 0.020) and lymph node status ( P <0.001) were identified to be an independent prognostic factors of OS by multivariate analysis, which was validated by bootstrap resampling. Patients with a low HB/RDW ratio had a 1.416 times greater risk of dying during follow-up compared with those with a high HB/RDW (95% CI = 1.024–1.958, P = 0.035). Materials and Methods: We retrospectively analyzed 362 patients who underwent curative treatment at a single institution between January 2007 and December 2008. The chi-square test was used to evaluate relationships between the HB/RDW ratio and other clinicopathological variables; the Kaplan–Meier method was used to analyze the 5-year overall survival (OS); and the Cox proportional hazards models were used for univariate and multivariate analyses of variables related to OS. Conclusion: A significant association was found between the HB/RDW ratio and clinical characteristics and survival outcomes in ESCC patients. Based on these findings, we believe that the HB/RDW ratio is a novel and promising prognostic parameter for ESCC patients.