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 (differentiationthe 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 {[}<13\% (25th percentile) (n=31), 13-14.4\% (50th percentile) (n=72), and >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 <13\% (25th percentile) (p = 0.014). Patients 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) 1.25-26.97p= 0.024) than patients with a normal red cell distribution width (<13\%). Conclusion: We found that the pretreatment red cell distribution width was independently prognostic of disease free survival rate in patients with laryngeal cancer and may serve as a new, accurate, and reproducible means of identifying early-stage laryngeal cancer patients with poorer prognoses. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.