Red Cell Distribution Width and High Grade Serous Ovarian Cancer: Prognostic Marker?

Red cell distribution width (RDW) has been evaluated as a potential prognostic marker in ovarian cancers, with higher baseline values being associated with poorer outcomes. The aim of this study was to evaluate the prognostic value of RDW in high grade serous cancer (HGSC) of ovary undergoing optimal debulking surgery. Patients undergoing interval debulking surgery with a primary diagnosis of HGSC from October 2012 to September 2013 were retrospectively analysed from a prospectively maintained database. Patients with baseline haemoglobin (Hb) of < 10 g/dL undergoing non-platinum based chemotherapy and those with gross residual disease (R2 resection) at surgery were excluded. RDW values were collected at baseline. Patients were dichotomised into 2 groups based on the median RDW value. Survival outcomes were analysed. Correlation analysis was done using Pearson’s Correlation. One hundred and twenty seven out of 182 patients were included in the final analysis. The median RDW was 14.9 (range 12.7–28). The 5-year overall survival (OS) and disease free survival (DFS) in patients with RDW < the median and > the median value was 60.8 and 63.8% (p = 0.609) and 14.5 and 17.4% (p = 0.457), respectively. RDW had significant negative correlation with neutrophil–lymphocyte ratio, platelet-lymphocyte ratio, Hb and CA 125. In our study, RDW did not prognosticate for both OS and DFS in patients with HGSC of the ovary achieving platinum sensitivity and optimal cytoreduction. The exact contribution of RDW as a prognostic variable in good biology HGSC (based on platinum response and optimal cytoreduction) should be compared with suboptimal responders (to both chemotherapy and surgery) to ascertain prognostic role in a larger, prospective trial.