Prognostic value of RDW in cancers: a systematic review and meta-analysis

Linhui Hu, Manman Li, Yangyang Ding, Lianfang Pu, Jun Liu, Jingxin Xie, Michael Cabanero, Jingrong Li, Ru Xiang and Shudao Xiong _

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Oncotarget. 2017; 8:16027-16035. https://doi.org/10.18632/oncotarget.13784

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Linhui Hu1, Manman Li1, Yangyang Ding1, Lianfang Pu1, Jun Liu1, Jingxin Xie2, Michael Cabanero3, Jingrong Li4, Ru Xiang5 and Shudao Xiong1

1 Department of Hematology/Hematological Lab, The Second Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China

2 Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, People’s Republic of China

3 University Health Network, University of Toronto, Ontario, Canada

4 Department of Emergency, The Second Hospital of Anhui Medical university, Hefei, Anhui, People’s Republic of China

5 School of Nursing, Anhui Medical University, Hefei, Anhui, People’s Republic of China

Correspondence to:

Shudao Xiong, email:

Keywords: red blood cell distribution width, prognosis, cancer, meta-analysis

Received: August 15, 2016 Accepted: November 22, 2016 Published: December 02, 2016


Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.

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