Prognostic significance of red cell distribution width in esophageal squamous cell carcinoma.

Background: Red cell distribution width (RDW) is routinely assessed as part of the complete blood count (CBC) to gather information on the heterogeneity in the size of circulating erythrocytes. RDW is a more sensitive screening marker for anemia, inflammation, and nutritional deficiencies. The purpose of this study was to explore the prognostic value of RDW in esophageal squamous cell carcinoma (ESCC) patients.

Methods: We conducted a retrospective study of data from 148 ESCC consecutive patients who underwent potentially curative esophagectomy and analyzed the correlation of RDW with various clinicopathological factors.

Results: Multivariate analyses identified a high RDW (HR, 2.061; P = 0.0286) as a significant risk factor for cancer-specific survival (CSS). Kaplan-Meier analysis and the log-rank test demonstrated that patients with a high RDW had a significantly worse prognosis in terms of CSS than those with a low RDW (P = 0.0011). In multivariate analysis, there was no significant relationship between RDW and CSS in pathological tumor node metastasis stage I or II patients. However, a high RDW (HR, 2.386; P = 0.0471) was confirmed to be an independent worse prognostic factor for CSS in pathological tumor node metastasis stage III cancer patients. Kaplan-Meier analysis and the log-rank test showed a significant relationship between RDW and CSS in patients with pathological tumor node metastasis stage III (P = 0.0175).

Conclusions: The RDW was a significant and independent predictor of poor survival in ESCC patients after curative esophagectomy. RDW may aid clinicians in detecting signs of recurrence very early and effectively customize treatment regimens. RDW is thus a convenient, cost-effective, and readily available biomarker to predict survival in ESCC.