Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BACKGROUND: Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC). METHODS: We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries. RESULTS: According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDW(High) (≥ 16.75%), PDW(Low) (< 16.75%), RDW(High) (≥ 14.25%), and RDW(Low) (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDW(High) than in those with PDW(Low) (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDW(High) than in those with RDW(Low) (P < 0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDW(High) and RDW(High); 0 points for PDW(Low) and RDW(Low)). OS significantly differed by PDW-RDW score (P < 0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator. CONCLUSIONS: The prognosis of GC patients can be precisely predictable by using both PDW and RDW.