The role of red cell distribution width in the locoregional recurrence of laryngeal cancer

Abstract

Introduction: Although the red cell distribution width has been reported as a reliable predictor of prognosis in several types of cancer, to our knowledge few reports have focused on the prognostic value of red cell distribution width in laryngeal carcinoma. Objective: We aimed to explore whether the pretreatment red cell distribution width predicted recurrence in laryngeal cancer patients is a simple, reproducible, and inexpensive prognostic biomarker. Methods: All laryngeal cancer patients who underwent curative surgery (n = 132) over a 7 year study period were evaluated. Data on demographics, primary tumor site, T-stage, N-stage, histological features (differentiation; the presence of perineural/perivascular invasion), treatment group (total laryngectomy or partial laryngectomy) or adjuvant therapy (chemotherapy/radiotherapy); laboratory parameters (complete blood count, including the pre-operative red cell distribution width), and disease-free survival rates were retrospectively reviewed. All cases were divided into three groups by the red cell distribution width tertile [14.4% (75th percentile) (n = 29)]. Results: High-red cell distribution width group included more patients of advanced age, and more of those with recurrent and metastatic tumors (p = 0.005, 0.048, and 0.043, respectively). Individuals with red cell distribution width >14.4% (75th percentile) had lower disease free survival rates than did those with red cell distribution width 14.4% at diagnosis were at a higher risk of locoregional recurrence (hazard ratio = 5.818, 95% confidence interval (95% CI) 1.25–26.97; p = 0.024) than patients with a normal red cell distribution width ( 14,4% (percentil 75) (n = 29)]. Resultados: O grupo com amplitude de distribuição de eritrócitos elevado incluiu um número maior de pacientes com idade avançada e mais pacientes com tumores recorrentes e metastáticos (p = 0,005, 0,048 e 0,043, respectivamente). Os indivíduos com a amplitude de distribuição de eritrócitos >14,4% (percentil 75) apresentaram taxas de sobrevida livre de doença menores do que aqueles com a amplitude de distribuição de eritrócitos 14,4% no diagnóstico apresentaram maior risco de recorrência locorregional [Hazard Ratio = 5,818, intervalo de confiança de 95% (IC 95%) 1,25–26,97; p = 0,024] do que pacientes com a amplitude de distribuição de eritrócitos normal (< 13%). Conclusão: Verificamos que a amplitude de distribuição de eritrócitos pré-tratamento foi um fator prognóstico independente de sobrevida livre de doença em pacientes com câncer de laringe e pode servir como um novo parâmetro, preciso e reprodutível, para identificar pacientes com câncer de laringe em estágio inicial com piores prognósticos. Keywords: Red cell distribution width, Larynx cancer, Disease free survival, Palavras-chave: Amplitude de distribuição de eritrócitos, Câncer de laringe, Sobrevida livre de doença