Prognostic Significance of Pre- and Post-operative Red-Cell Distribution Width in Patients with Gastric Cancer

Background High red cell distribution width (RDW) is reportedly provoked by chronic inflammation and poor nutritional status; high pre-operative RDW is related to poor prognosis in some cancers. However, the prognostic significance of post-operative RDW in gastric cancer (GC) patients is unclear. Methods We enrolled 221 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma. Results Optimal cutoff values were determined by ROC analysis to be 14.85 (pre-operative) and 14.05 (post-operative). We accordingly divided patients into the high (pre-RDWHigh; >= 14.85) and low (pre-RDWLow; < 14.85) pre-operative RDW groups, and the high (post-RDWHigh; >= 14.05) and low (post-RDWLow; < 14.05) post-operative RDW subgroups. Five-year overall survival (OS) rates differed significantly in pre-RDWHigh group (52.4%) and pre-RDWLow group (78.0%; P < 0.0001). Five-year OS rates also differed significantly in post-RDWHigh (52.7%) and post-RDWLow subgroups (88.3%; P < 0.0001). Multivariate analysis showed post-operative RDW, but not pre-operative RDW, to be an independent prognostic indicator for OS. Conclusions Post-operative RDW may be a useful prognostic indicator in GC patients.