The role of red cell distribution width in the locoregional recurrence of laryngeal cancer.

introductionAlthough 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.

objectiveWe aimed to explore whether the pretreatment red cell distribution width predicted recurrence in laryngeal cancer patients is a simple, reproducible, and inexpensive prognostic biomarker.

methodsAll 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 (differentiation; the 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)].

resultsHigh-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) 1.25-26.97; p=0.024) than patients with a normal red cell distribution width (<13%).

conclusionWe 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.