Clinical Relevance of Red Blood Cell Distribution Width (RDW) in Endometrial Cancer: A Retrospective Single-Center Experience from Korea

SIMPLE SUMMARY: This study aims to investigate the potential use of the red blood cell distribution width (RDW) as a biomarker for predicting prognosis and recurrence in patients with endometrial cancer. We believe that our study makes a significant contribution to the literature because it presents a retrospective analysis of clinical data from 431 patients diagnosed with endometrial cancer, which was conducted to investigate the association between RDW and survival outcomes. The study found that patients with high RDW values had significantly worse overall survival (OS) and disease-free survival (DFS) compared to those with low RDW values. RDW was also found to be an independent prognostic factor for OS and DFS. Further, we believe that this paper will be of interest to the readership of this journal because the study identifies a simple and cost-effective biomarker that can aid in the prognostic evaluation of patients with endometrial cancer. ABSTRACT: Background: Red blood cell distribution width (RDW) is a standard parameter of complete blood count and indicates the variability in red blood cell size. This study aimed to determine whether preoperative RDW can be used to predict the recurrence and prognosis of endometrial carcinoma. Methods: The medical records of 431 patients diagnosed with endometrial carcinoma were retrospectively reviewed between May 2006 and June 2018. In addition to RDW, the clinicopathological factors, survival curves, and prognoses of the patients with endometrial carcinoma were compared between the high (n = 213) and low (n = 218) groups according to the median RDW value (12.8%). Results: The patients with high RDW had significantly advanced-stage (p = 0.00) pelvic lymph node metastasis (p = 0.01) and recurrence (p = 0.01) compared to those in the low-RDW group. In univariate analysis with DFS as the endpoint, surgical stage, type II histology, grade, RDW, and lymph node metastasis were independently associated with survival. Patients with high RDW values had significantly shorter disease-free survival and overall survival than those with low RDW values (log-rank p = 0.03, log-rank p = 0.04, respectively). Conclusion: Our results demonstrate that RDW is a simple and convenient indicator of endometrial carcinoma recurrence. Prospective studies are needed to validate the findings of the current study.