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Research article
Jianqiang Cai
Chinese Academy of Medical Sciences and Peking Union Medical College
Corresponding Author
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Background
Recent studies suggest red blood cell distribution width (RDW) was a prognostic factor in various types of cancer patients, although the results are controversial. The objective of this study was to investigate the significance of RDW in patients with Intrahepatic cholangiocarcinoma (ICC) after radical resection.
Method:
The relationship between the preoperative serum RDW value and clinic pathological characteristics was analyzed in 157 ICC patients between January 2012 and June 2018 who underwent curative resection. X-tile software was used to determine 40.2 fl, 12.6% as the optimal cut-off value for RDW-SD and RDW-CV respectively. 153 patients were classified into the low RDW-SD (≤ 40.2, n = 53) group and the high RDW-SD (> 40.2, n = 104) group, low RDW-CV (≤ 12.6, n = 94) group and the high RDW-CV (> 12.6, n = 63). Based on the RDW-SD combined with RDW-CV(SCC), classified into SCC = 0, 1 and 2 group. Kaplan-Meier survival analysis and Cox proportional hazard models were used to examine the effect of RDW on survival.
Results
Kaplan-Meier curve analysis showed that Patients with RDW-SD > 40.2 were significantly associated with better OS (P = 0.004, median OS: 68.0 months versus 17.0 months). Patients with RDW-CV > 12.6 were significantly associated with better OS (P = 0.030, median OS: not reach versus 22.0 months). Compared with a SCC = 0 or SCC = 1, SCC = 2 was significantly associated with better OS (P < 0.001, median OS: not reach versus 33.0 months versus 16, respectively). In the multivariate analysis, RDW-SD > 40.2 fl (HR = 0.446, 95% CI: 0.262–0.760, P = 0.003), RDW-CV > 12.6% (HR = 0.425, 95%CI: 0.230–0.783, P = 0.006), SCC = 2 (HR = 0.270, 95%CI: 0.133–0.549, P < 0.001) were associated with favorable OS. The multivariate analysis showed RDW-SD, RDW-CV and SCC level were not independent prognostic factors for PFS.
Conclusions
Preoperative low levels of RDW are associated with poor survival in ICC after curative resection. This provides a new way for predicting the prognosis of ICC patients and more targeted intervention measures.
Keywords
Intrahepatic cholangiocarcinoma (ICC), liver resection, RDW, prognosis
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CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 1
Posted 25 Aug, 2020
No community comments so far
Editorial decision: Major revision
On 30 Dec, 2020
Review #3 received
Received 18 Dec, 2020
Review #2 received
Received 15 Dec, 2020
Reviewer #3 agreed
On 10 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Reviewers invited
Invitations sent on 29 Sep, 2020
Reviewer #1 agreed
On 29 Sep, 2020
Review #1 received
Received 29 Sep, 2020
Editor assigned
On 03 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
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See the published version of this preprint at BMC Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Jianqiang Cai
Chinese Academy of Medical Sciences and Peking Union Medical College
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 1
Posted 25 Aug, 2020
No community comments so far
Editorial decision: Major revision
On 30 Dec, 2020
Review #3 received
Received 18 Dec, 2020
Review #2 received
Received 15 Dec, 2020
Reviewer #3 agreed
On 10 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Reviewers invited
Invitations sent on 29 Sep, 2020
Reviewer #1 agreed
On 29 Sep, 2020
Review #1 received
Received 29 Sep, 2020
Editor assigned
On 03 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Surgery.
Background
Recent studies suggest red blood cell distribution width (RDW) was a prognostic factor in various types of cancer patients, although the results are controversial. The objective of this study was to investigate the significance of RDW in patients with Intrahepatic cholangiocarcinoma (ICC) after radical resection.
Method:
The relationship between the preoperative serum RDW value and clinic pathological characteristics was analyzed in 157 ICC patients between January 2012 and June 2018 who underwent curative resection. X-tile software was used to determine 40.2 fl, 12.6% as the optimal cut-off value for RDW-SD and RDW-CV respectively. 153 patients were classified into the low RDW-SD (≤ 40.2, n = 53) group and the high RDW-SD (> 40.2, n = 104) group, low RDW-CV (≤ 12.6, n = 94) group and the high RDW-CV (> 12.6, n = 63). Based on the RDW-SD combined with RDW-CV(SCC), classified into SCC = 0, 1 and 2 group. Kaplan-Meier survival analysis and Cox proportional hazard models were used to examine the effect of RDW on survival.
Results
Kaplan-Meier curve analysis showed that Patients with RDW-SD > 40.2 were significantly associated with better OS (P = 0.004, median OS: 68.0 months versus 17.0 months). Patients with RDW-CV > 12.6 were significantly associated with better OS (P = 0.030, median OS: not reach versus 22.0 months). Compared with a SCC = 0 or SCC = 1, SCC = 2 was significantly associated with better OS (P < 0.001, median OS: not reach versus 33.0 months versus 16, respectively). In the multivariate analysis, RDW-SD > 40.2 fl (HR = 0.446, 95% CI: 0.262–0.760, P = 0.003), RDW-CV > 12.6% (HR = 0.425, 95%CI: 0.230–0.783, P = 0.006), SCC = 2 (HR = 0.270, 95%CI: 0.133–0.549, P < 0.001) were associated with favorable OS. The multivariate analysis showed RDW-SD, RDW-CV and SCC level were not independent prognostic factors for PFS.
Conclusions
Preoperative low levels of RDW are associated with poor survival in ICC after curative resection. This provides a new way for predicting the prognosis of ICC patients and more targeted intervention measures.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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