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Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma

  • 0Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan, R.O.C.
Biomedical Reports +

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December 25, 2024

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December 25, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The red cell distribution width to lymphocyte percentage (RDW-to-LYM%) ratio is a novel prognostic marker for upper tract urothelial carcinoma (UTUC). An elevated RDW-to-LYM% ratio predicts worse survival outcomes in UTUC patients after radical nephroureterectomy (RNU).

Area Of Science

  • Urology
  • Oncology
  • Biomarkers

Background

  • Upper tract urothelial carcinoma (UTUC) is a rare malignancy with significant recurrence and mortality rates.
  • Accurate prognostic markers are crucial for guiding treatment and predicting outcomes in UTUC patients.
  • The RDW-to-LYM% ratio is a novel, easily accessible hematological marker with potential prognostic value.

Purpose Of The Study

  • To investigate the prognostic significance of the pre-treatment RDW-to-LYM% ratio in patients with UTUC undergoing radical nephroureterectomy (RNU).
  • To evaluate the association of the RDW-to-LYM% ratio with clinicopathological parameters and survival outcomes.

Main Methods

  • Retrospective analysis of clinical and follow-up data from 625 UTUC patients who underwent RNU.
  • Determination of the optimal cut-off value for the RDW-to-LYM% ratio using ROC analysis.
  • Evaluation of associations with clinicopathological parameters using chi-squared and logistic regression.
  • Assessment of impact on overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) using Kaplan-Meier and Cox regression analyses.

Main Results

  • A high RDW-to-LYM% ratio (>0.80) was significantly associated with impaired kidney function, previous/concurrent bladder cancer, tumor location, advanced pathological T stage, lymph node involvement, and lymphovascular invasion (LVI).
  • Patients with a high RDW-to-LYM% ratio exhibited significantly poorer OS, CSS, and PFS compared to those with a low ratio (all P<0.001).
  • The RDW-to-LYM% ratio independently predicted non-organ-confined disease (OR, 2.107; P<0.001) and positive LVI (OR, 1.978; P<0.001).

Conclusions

  • The pre-treatment RDW-to-LYM% ratio is a significant predictor of non-organ-confined disease and lymphovascular invasion in UTUC patients.
  • An elevated RDW-to-LYM% ratio serves as an independent prognostic factor for unfavorable survival outcomes in UTUC patients undergoing RNU.

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