Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 7/2019

01-07-2019 | NSCLC | Original Article

A prognostic parameter in advanced non-small cell lung cancer: the ratio of hemoglobin-to-red cell distribution width

Authors: Yakup Bozkaya, Bediz Kurt, Fatih Gürler

Published in: International Journal of Clinical Oncology | Issue 7/2019

Login to get access

Abstract

Background

This study aims to investigate the prognostic value of the ratio of hemoglobin–RDW (HRR) at diagnosis, in terms of overall survival (OS) and progression-free survival in patients with advanced non-small cell lung cancer (NSCLC).

Methods

Patients with metastatic NCCLC who attended two separate medical oncology clinics between April 2013 and December 2017 were retrospectively screened. HRR was calculated as Hgb (g/dL) divided by the RDW (%). Patients were assigned to either the low HRR group or high HRR group.

Results

A total of 153 patients were included in the study. The cuff-value for HRR was taken as 0.88. Among the low and high HRR groups, Glasgow prognostic scores (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and weight loss were statistically significantly different (p < 0.05). OS was found to be 5.6 months in the low HRR group and 13.9 months in the high HRR group (p < 0.001) while PFS was 5.1 months and 8.6 months in these two groups, respectively (p < 0.001). Univariate and multivariate analyses revealed that low HRR was an independent factor, predictive of both OS (p = 0.03, Hazard Ratio (HR) = 1.607, 95% CI = 1.041–2.480) and PFS (p < 0.001, HR = 2.635, 95% CI = 1.667–4.166) in advanced NSCLC.

Conclusion

This is the first study to show that low HRR is associated with poor OS and PFS in patients with advanced NSCLC. Thus, hemoglobin and RDW which can be easily measured in routine practice may be used as a prognostic tool in these patients.
Literature
1.
Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRef
2.
3.
Hoang T, Xu R, Schiller JH et al (2005) Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. J Clin Oncol 23:175–183CrossRefPubMed
4.
Yin Y, Wang J, Wan X et al (2015) Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: a meta-analysis. Clinics (Sao Paulo) 70(7):524–530CrossRef
5.
Toda M, Tsukioka T, Izumi N et al (2018) Platelet-to-lymphocyte ratio predicts the prognosis of patients with non-small cell lung cancer treated with surgery and postoperative adjuvant chemotherapy. Thorac Cancer 9(1):112–119CrossRefPubMed
6.
Watanabe K, Yasumoto A, Amano Y et al (2018) Mean platelet volume and lymphocyte-to-monocyte ratio are associated with shorter progression-free survival in EGFR-mutant lung adenocarcinoma treated by EGFR tyrosine kinase inhibitor. PLoS One 13(9):e0203625CrossRefPubMedPubMedCentral
7.
Holgersson G, Sandelin M, Hoye E E et al (2012) Swedish lung cancer radiation study group: the prognostic value of anaemia, thrombocytosis and leukocytosis at time of diagnosis in patients with non-small cell lung cancer. Med Oncol 29(5):3176–3182CrossRefPubMed
8.
Ray-Coquard I, Morère JF, Scotté F et al (2012) Management of anemia in advanced breast and lung cancer patients in daily practice: results of a French survey. Adv Ther 29(2):124–133CrossRefPubMed
9.
Vannella L, Lahner E, Osborn J et al (2013) Systematic review: gastric cancer incidence in pernicious anaemia. Aliment Pharmacol Ther 37(4):375–382CrossRefPubMed
10.
Altman AD, Liu XQ, Nelson G et al (2013) The effects of anemia and blood transfusion on patients with stage III-IV ovarian cancer. Int J Gynecol Cancer 23(9):1569–1576CrossRefPubMed
11.
Fyles AW, Milosevic M, Pintilie M et al (2000) Anemia, hypoxia and transfusion in patients with cervix cancer: a review. Radiother Oncol 57:13–19CrossRefPubMed
12.
Aoe K, Hiraki A, Maeda T et al (2005) Serum hemoglobin level determined at the first presentation is a poor prognostic indicator in patients with lung cancer. Intern Med 44(8):800–804CrossRefPubMed
13.
Gauthier I, Ding K, Winton T et al (2007) Impact of hemoglobin levels on outcomes of adjuvant chemotherapy in resected non-small cell lung cancer: the JBR. 10 trial experince. Lung Cancer 55(3):357–363CrossRefPubMed
14.
Zhang YH, Lu Y, Lu H et al (2018) Pretreatment hemoglobin level ıs an ındependent prognostic factor in patients with lung Adenocarcinoma. Can Respir J 15:6328127
15.
Tonelli M, Sacks F, Arnold M et al (2008) Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 117(2):163–168CrossRefPubMed
16.
Çetinkaya E, Şenol K, Saylam B et al (2014) Red cell distribution width to platelet ratio: new and promising prognostic marker in acute pancreatitis. World J Gastroenterol 20:14450–14454CrossRefPubMedPubMedCentral
17.
Xu WS, Qiu XM, Qs O et al (2015) Red blood cell distribution width levels correlate with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 94:e612CrossRef
18.
Warwick R, Mediratta N, Shackcloth M et al (2014) Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer. Eur J Cardiothorac Surg 45(1):108–113CrossRefPubMed
19.
Seretis C, Seretis F, Lagoudianakis E et al (2013) Is red cell distribution width a novel biomarker of breast cancer activity? Data from a pilot study. J Clin Med Res 5(2):121PubMedPubMedCentral
20.
Wang F-M, Xu G, Zhang Y et al (2014) Red cell distribution width is associated with presence, stage, and grade in patients with renal cell carcinoma. Dis Markers 2014:860419PubMedPubMedCentral
21.
Sun P, Zhang F, Chen C et al (2016) The ratio of hemoglobin tor ed cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China. Oncotarget 7(27):52650–42660
22.
Tham T, Olson C, Wotman M et al (2018) Evaluation of the prognostic utility of the hemoglobin-to- red cell distribution width ratio in head and neck cancer. Eur Arch Otorhinolaryngol 275(11):2869–2878CrossRefPubMed
23.
24.
Felker GM, Allen LA, Pocock SJ et al (2007) Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM program and the duke databank. J Am Coll Cardiol 50(1):40–47CrossRefPubMed
25.
Kim J, Kim YD, Song TJ et al (2012) Red blood cell distribution width is associated with poor clinical outcome in acute cerebral infarction. Thromb Haemost 108(2):349–356CrossRefPubMed
26.
Seyhan EC, Özgül MA, Tutar N et al (2013) Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD 10(4):416–424CrossRefPubMed
27.
28.
Kemal Y, Demirag G, Baş B et al (2015) The value of red blood cell distribution width in endometrial cancer. Clin Chem Lab Med 53:823–827CrossRefPubMed
29.
Koma Y, Onishi A, Matsuoka H et al (2013) Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One 2013 Nov 11(11):e80240 8(CrossRef
30.
Smirne C, Grossi G, Pinato DJ et al (2015) Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma. Dig Liver Dis 47:488–494CrossRefPubMed
31.
Qin Y, Wang P, Huang Z et al (2017) The value of red cell distribution width in patients with ovarian cancer. Medicine (Baltimore) 96(17):e6752CrossRef
32.
Ichinose J, Murakawa T, Kawashima M et al (2016) Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer. J Thorac Dis 8(12):3658–3666CrossRefPubMedPubMedCentral
33.
Douglas SW, Adamson JW (1975) The anemia of chronic disorders: studies of marrow regulation and iron metabolism. Blood 45:55–65PubMed
34.
Ferrucci L, Guralnik JM, Woodman RC et al (2005) Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med 118:1288CrossRefPubMed
35.
Mantovani A, Allavena P, Sica A et al (2008) Cancer-related inflammation. Nature 454:436–444CrossRef
36.
Tesarova P, Kvasnicka J (1995) Treatment of anemia in patients with tumors. Cas Lek Cesk 134:647–650PubMed
37.
Caro JJ, Salas M, Ward A et al (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 91:2214–2221CrossRef
38.
Obermair A, Handisurya A, Kaider A et al (1998) The relationship of pretreatment serum hemoglobin level to the survival of epithelial ovarian carcinoma patients: a prospective review. Cancer 83:726–731CrossRefPubMed
39.
Wilairat W, Benjapibal M (2012) Presence of anemia and poor prognostic factors in patients with endometrial carcinoma. Asian Pac J Cancer Prev 13:3187–3190CrossRefPubMed
40.
Banzet S, Sanchez H, Chapot R et al (2012) Interleukin-6 contributes to hepcidin mRNA increase in response to exercise. Cytokine 58(2):158–161CrossRefPubMed
41.
Wu Y, Antony S, Meitzler JL et al (2014) Molecular mechanisms underlying chronic inflammation associated cancers. Cancer Lett 345(2):164–173CrossRefPubMed
42.
Li S, Meng W, Guan Z et al (2016) The hypoxia related signaling pathways of vasculogenic mimicry in tumor treatment. Biomed Pharmacother 80:127–135CrossRefPubMed
43.
Ay S, Eryilmaz MA, Aksoy N et al (2015) Is early detection of colon cancer possible with red blood cell distribution width. Asian Pac J Cancer Prev 753–756
44.
Albayrak S, Zengin K, Tanik S et al (2014) Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev 15:7781–7784CrossRefPubMed
45.
Diem S, Schmid S, Krapf M et al (2017) Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer 111:176–181CrossRefPubMed
46.
Bacha S, Sghaier A, Habibech S et al (2017) Combined C-reactive protein and Neutrophil to lymphocyte ratio use predict survival in non-small-cell lung cancer. Tunis Med 95(12):229–235PubMed
Metadata
Title
A prognostic parameter in advanced non-small cell lung cancer: the ratio of hemoglobin-to-red cell distribution width
Authors
Yakup Bozkaya
Bediz Kurt
Fatih Gürler
Publication date
01-07-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 7/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01417-x

Other articles of this Issue 7/2019

International Journal of Clinical Oncology 7/2019 Go to the issue

Original Article

Oncologic and reproductive outcomes of cystectomy as a fertility-sparing treatment for early-stage epithelial ovarian cancer

Original Article

Long-term outcomes and prognostic factors of pulmonary metastasectomy for osteosarcoma and soft tissue sarcoma

Original Article

Biweekly S-1 plus oxaliplatin (SOX) reintroduction in previously treated metastatic colorectal cancer patients (ORION 2 study): a phase II study to evaluate the efficacy and safety

Invited Review Article

Dawn of precision medicine on gastric cancer

Invited Review Article

Molecular carcinogenesis of gastric cancer: Lauren classification, mucin phenotype expression, and cancer stem cells

Original Article

Inflammation–nutrition score predicts prognosis of patients with resectable hepatocellular carcinoma
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits