Red cell distribution width as a prognostic predictor for colorectal cancer: a meta-analysis.
Ruixue Fan, Yijiang Zhang, Junwei Feng
✦ AI-curated · Sources linked
In 30 seconds
This meta-analysis assessed whether preoperative red cell distribution width (RDW) predicts postoperative survival in people with colorectal cancer (CRC). It included 16 studies involving 20,500 individuals. Elevated RDW-CV was associated with poorer overall survival (multivariable-adjusted HR = 1.27, 95% CI 1.00-1.60) and disease-free survival (HR = 1.16, 95% CI 1.01-1.33). RDW-SD showed a stronger association with overall survival (HR = 1.89, 95% CI 1.31-2.72). The authors conclude that higher preoperative RDW is linked to adverse postoperative outcomes, while noting that the evidence is predominantly retrospective.
Key findings
- Elevated preoperative RDW-CV was associated with poorer overall survival (HR = 1.27, 95% CI 1.00-1.60; I 2 = 68%).
- RDW-SD had a stronger association with overall survival (HR = 1.89, 95% CI 1.31-2.72).
- High preoperative RDW-CV was associated with inferior disease-free survival (HR = 1.16, 95% CI 1.01-1.33; I 2 = 54%).
- Among patients who did not receive neoadjuvant therapy, RDW was associated with overall survival (HR = 1.64, 95% CI 1.15-2.34).
Why it matters
RDW is an accessible blood-test measure, and its association with postoperative survival suggests it may contribute to risk assessment in CRC. The findings also indicate that RDW-CV and RDW-SD may differ in prognostic performance. However, these associations do not establish that RDW itself causes poorer outcomes or that using it to guide care improves survival.
What to keep in mind
The evidence was predominantly retrospective, and standardized RDW thresholds and measurement timing were lacking. Heterogeneity was reported for the RDW-CV survival analyses.