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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

  • Authors:
    • Yi-Chia Hsieh
    • Tsung-Han Cheng
    • Chu-An Wang
    • Che-Yuan Hu
    • Wen-Horng Yang
    • Chien-Hui Ou
    • Hau-Chern Jan
  • View Affiliations / Copyright

    Affiliations: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan, R.O.C., Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan, R.O.C.
    Copyright: © Hsieh et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 32
    |
    Published online on: December 10, 2024
       https://doi.org/10.3892/br.2024.1910
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Abstract

The aim of the present study was to determine the prognostic significance of a novel marker, the red cell distribution width to lymphocyte percentage (RDW‑to‑LYM%) ratio, in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). The clinical and follow‑up data of 625 patients with UTUC receiving RNU were retrospectively analyzed. The optimal cut‑off value of the pre‑treatment RDW‑to‑LYM% ratio was determined as 0.80 using receiver operating characteristic (ROC) analysis according to cancer‑specific death. The associations between low (≤0.80) and high (>0.8) RDW‑to‑LYM% ratio and other clinicopathological parameters were evaluated using the χ2 test and logistic regression analysis. The impact of the RDW‑to‑LYM% ratio on overall survival (OS), cancer‑specific survival (CSS) and progression‑free survival (PFS) rates was assessed using the Kaplan‑Meier method and Cox regression analysis. A high RDW‑to‑LYM% ratio (>0.80) was significantly associated with impaired kidney function, previous/concurrent bladder cancer, tumors involving both the pelvis and ureter, advanced pathological T stage, lymph node involvement and lymphovascular invasion (LVI). Kaplan‑Meier analysis revealed that a high RDW‑to‑LYM% ratio was associated with poorer OS, CSS and PFS than a low RDW‑to‑LYM% ratio (all P<0.001). The multiple logistic regression analysis revealed that high RDW‑to‑LYM% ratio was associated with non‑organ‑confined (NOC) disease [odd ratio (OR), 2.107; 95% confidence interval (CI), 1.446‑3.069; P<0.001] and positive LVI (OR, 1.978; 95% CI, 1.338‑2.916; P<0.001). Furthermore, the multivariate analysis showed that the RDW‑to‑LYM% ratio was an independent factor for predicting OS [hazard ratio (HR), 2.046; P<0.001], CSS (HR, 2.041; P<0.001) and PFS (HR, 1.502; P=0.009). In conclusion, the pre‑treatment RDW‑to‑LYM% ratio was found to be a significant predictor of both NOC and the presence of LVI in patients with UTUC. Moreover, an elevated pre‑treatment RDW‑to‑LYM% ratio was identified as an independent factor for unfavorable survival outcomes in patients with UTUC undergoing RNU.
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Copy and paste a formatted citation
Spandidos Publications style
Hsieh Y, Cheng T, Wang C, Hu C, Yang W, Ou C and Jan H: Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma. Biomed Rep 22: 32, 2025.
APA
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., & Jan, H. (2025). Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma. Biomedical Reports, 22, 32. https://doi.org/10.3892/br.2024.1910
MLA
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., Jan, H."Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma". Biomedical Reports 22.2 (2025): 32.
Chicago
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., Jan, H."Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma". Biomedical Reports 22, no. 2 (2025): 32. https://doi.org/10.3892/br.2024.1910
Copy and paste a formatted citation
x
Spandidos Publications style
Hsieh Y, Cheng T, Wang C, Hu C, Yang W, Ou C and Jan H: Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma. Biomed Rep 22: 32, 2025.
APA
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., & Jan, H. (2025). Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma. Biomedical Reports, 22, 32. https://doi.org/10.3892/br.2024.1910
MLA
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., Jan, H."Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma". Biomedical Reports 22.2 (2025): 32.
Chicago
Hsieh, Y., Cheng, T., Wang, C., Hu, C., Yang, W., Ou, C., Jan, H."Increased ratio of red cell distribution width to lymphocyte percentage as a new preoperative marker for unfavorable survival outcomes in upper tract urothelial carcinoma". Biomedical Reports 22, no. 2 (2025): 32. https://doi.org/10.3892/br.2024.1910
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