Evaluation of the prognostic utility of the hemoglobin-to-red cell distribution width ratio in head and neck cancer

Tristan Tham, Caitlin Olson, Michael Wotman, Sireesha Teegala, Julian Khaymovich, Josephine Coury, Peter Costantino

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Purpose: Hemoglobin is a known prognostic marker in many cancers, including head and neck cancer (HNC). There is some evidence that the red cell distribution width, which is an index of variation in size of red blood cells (RBCs), might be associated with prognosis as well. Recently, a novel prognostic biomarker has been reported—the ratio of the hemoglobin-to-red cell distribution width (Hb/RDW). Our objective was to evaluate the prognostic utility of the pretreatment Hb/RDW in HNC, controlled with known prognostic indices. Methods: Retrospective cohort study in a tertiary academic hospital setting. Patients diagnosed with HNC treated with curative-intent surgery were eligible. Metastatic disease was excluded. The variables collected were age, sex, BMI, alcohol/tobacco exposure, performance scores, ACE-27, tumor characteristics, adjuvant treatment, and lab values. The primary endpoints were event-free survival (EFS) and overall survival (OS). OS was defined as time from start of treatment to death from any cause, and EFS was defined as time from start of treatment to any progression, recurrence, or death from any cause. Univariate and multivariate survival analysis was performed on the primary endpoints. Results: A total of 205 patients were enrolled from 2010 to 2016. In multivariate analysis, the factors independently associated with EFS were BMI (p = 0.0364), advanced T stage (p = 0.001), and low Hb/RDW ratio (p = 0.017). The factors independently associated with OS were ECOG score (p = 0.042), advanced T stage (p < 0.0001), positive nodes (p = 0.0195), and Hemoglobin (0.0134). Conclusion: A low Hb/RDW ratio was associated with poorer EFS (HR = 2.02, 95% CI 1.13–3.61, p = 0.017), but was not associated with OS. This is the first study reporting the prognostic utility of Hb:RDW in head and neck cancer.

Original languageEnglish
Pages (from-to)2869-2878
Number of pages10
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume275
Issue number11
DOIs
StatePublished - 1 Nov 2018
Externally publishedYes

Keywords

  • Head and neck cancer
  • Hemoglobin
  • Prognosis
  • Red cell distribution width

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