Prognostic Significance of Pre- and Post-operative Red-Cell Distribution Width in Patients with Gastric Cancer

  • Shimizu Shota
  • Hiroaki SaitoEmail author
  • Yusuke Kono
  • Yuki Murakami
  • Yuji Shishido
  • Kozo Miyatani
  • Tomoyuki Matsunaga
  • Yoji Fukumoto
  • Yoshiyuki Fujiwara
Original Article



High red cell distribution width (RDW) is reportedly provoked by chronic inflammation and poor nutritional status; high pre-operative RDW is related to poor prognosis in some cancers. However, the prognostic significance of post-operative RDW in gastric cancer (GC) patients is unclear.


We enrolled 221 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma.


Optimal cutoff values were determined by ROC analysis to be 14.85 (pre-operative) and 14.05 (post-operative). We accordingly divided patients into the high (pre-RDWHigh; ≥ 14.85) and low (pre-RDWLow; < 14.85) pre-operative RDW groups, and the high (post-RDWHigh; ≥ 14.05) and low (post-RDWLow; < 14.05) post-operative RDW subgroups. Five-year overall survival (OS) rates differed significantly in pre-RDWHigh group (52.4%) and pre-RDWLow group (78.0%; P < 0.0001). Five-year OS rates also differed significantly in post-RDWHigh (52.7%) and post-RDWLow subgroups (88.3%; P < 0.0001). Multivariate analysis showed post-operative RDW, but not pre-operative RDW, to be an independent prognostic indicator for OS.


Post-operative RDW may be a useful prognostic indicator in GC patients.


Gastric cancer Prognosis Recurrence Red cell distribution width 



We thank Marla Brunker from Edanz Group ( for editing a draft of this manuscript.

Author Contributions

Study conception and design: S; acquisition of data: M, S, K, M, S, M, and F; analysis and interpretation of data: S and S; drafting of manuscript: S, S, K, M, S, M, and F; critical revision: S and F; final approval of the article: all authors.

Compliance with Ethical Standards

Conflict of Interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or with comparable ethical standards.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.Division of Surgical Oncology, Department of Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan

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