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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 11/2018

01-11-2018 | Head & Neck

Evaluation of the prognostic utility of the hemoglobin-to-red cell distribution width ratio in head and neck cancer

Authors: Tristan Tham, Caitlin Olson, Michael Wotman, Sireesha Teegala, Julian Khaymovich, Josephine Coury, Peter Costantino

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2018

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Abstract

Purpose

Hemoglobin is a known prognostic marker in many cancers, including head and neck cancer (HNC). There is some evidence that the red cell distribution width, which is an index of variation in size of red blood cells (RBCs), might be associated with prognosis as well. Recently, a novel prognostic biomarker has been reported—the ratio of the hemoglobin-to-red cell distribution width (Hb/RDW). Our objective was to evaluate the prognostic utility of the pretreatment Hb/RDW in HNC, controlled with known prognostic indices.

Methods

Retrospective cohort study in a tertiary academic hospital setting. Patients diagnosed with HNC treated with curative-intent surgery were eligible. Metastatic disease was excluded. The variables collected were age, sex, BMI, alcohol/tobacco exposure, performance scores, ACE-27, tumor characteristics, adjuvant treatment, and lab values. The primary endpoints were event-free survival (EFS) and overall survival (OS). OS was defined as time from start of treatment to death from any cause, and EFS was defined as time from start of treatment to any progression, recurrence, or death from any cause. Univariate and multivariate survival analysis was performed on the primary endpoints.

Results

A total of 205 patients were enrolled from 2010 to 2016. In multivariate analysis, the factors independently associated with EFS were BMI (p = 0.0364), advanced T stage (p = 0.001), and low Hb/RDW ratio (p = 0.017). The factors independently associated with OS were ECOG score (p = 0.042), advanced T stage (p < 0.0001), positive nodes (p = 0.0195), and Hemoglobin (0.0134).

Conclusion

A low Hb/RDW ratio was associated with poorer EFS (HR = 2.02, 95% CI 1.13–3.61, p = 0.017), but was not associated with OS. This is the first study reporting the prognostic utility of Hb:RDW in head and neck cancer.
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Metadata
Title
Evaluation of the prognostic utility of the hemoglobin-to-red cell distribution width ratio in head and neck cancer
Authors
Tristan Tham
Caitlin Olson
Michael Wotman
Sireesha Teegala
Julian Khaymovich
Josephine Coury
Peter Costantino
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 11/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5144-8

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