Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma

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Title: Evaluation of the red cell distribution width as a biomarker of early mortality in hepatocellular carcinoma
Authors: Smirne, C
Grossi, G
Pinato, DJ
Burlone, ME
Mauri, FA
Januszewski, A
Oldani, A
Minisini, R
Sharma, R
Pirisi, M
Item Type: Journal Article
Abstract: Background: The red cell distribution width is a biomarker of early mortality across various disease states. Aim: To verify whether it may refine estimates of survival in hepatocellular carcinoma. Methods: The red cell distribution width measured at diagnosis was analyzed in relationship to mortality by any cause both in a retrospective training cohort (N = 208), and in an independent prospectively collected validation cohort (N = 106) of patients with hepatocellular carcinoma. Based on Cox proportional hazards modelling, a prognostic index was validated. Results: In the training and the validation cohort, median survival time was respectively 1026 and 868 days in patients with red cell distribution width ≤14.6%, vs. 282 and 340 days in patients with red cell distribution width >14.6%; the corresponding hazard ratios were 0.43 (95% CI: 0.31–0.60), p < 0.0001 and 0.28 (95% CI: 0.17–0.47), p < 0.0001. At multivariate analysis, the red cell distribution width remained an independent predictor of survival (p < 0.001) in a Cox model including other widely accepted prognostic factors. Applying to the validation dataset the prognostic index derived from the training dataset, the ability of the model to discriminate the survival probabilities of patients was confirmed (Harrell’s C = 0.769). Conclusions: The red cell distribution width is a novel, reproducible, prospectively validated predictor of survival in patients with hepatocellular carcinoma.
Issue Date: 19-Mar-2015
Date of Acceptance: 11-Mar-2015
URI: http://hdl.handle.net/10044/1/48973
DOI: https://dx.doi.org/10.1016/j.dld.2015.03.011
ISSN: 1590-8658
Publisher: WB Saunders
Start Page: 488
End Page: 494
Journal / Book Title: Digestive and Liver Disease
Volume: 47
Issue: 6
Copyright Statement: © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Inflammation
Liver cancer
Prognosis
Red cell distribution width
C-REACTIVE PROTEIN
COMPLETE BLOOD-COUNT
PROGNOSTIC INDEX
IRON-DEFICIENCY
CANCER
DIAGNOSIS
MECHANISMS
MANAGEMENT
SURVIVAL
OUTCOMES
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers
Carcinoma, Hepatocellular
Erythrocyte Indices
Female
Humans
Liver Neoplasms
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Retrospective Studies
Survival Analysis
Young Adult
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
National Heart and Lung Institute
Division of Cancer
Faculty of Medicine



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