Hemoglobin red cell distribution width ratio as a prognostic marker in patients with locally advanced lung adenocarcinoma

Abstract

Background and objectives: Hemoglobin / red cell distribution width ratio (HRR) has been defined as an effective prognostic factor in various malignancies. The aim of this study is to investigate the prognostic role of HRR in locally advanced lung adenocarcinoma. Methods: 626 patients diagnosed with locally advanced lung adenocarcinoma from January 2010 to January 2020 were screened. We excluded 356 patients with chronic diseases with inflammatory process, secondary malignancy and infectious diseases affecting HRR. Demographic and clinical data were recorded. The best cut-off point of HRR for OS and PFS was determined by ROC analysis. A HRR cut-off value was determined, and patients were classified as having lower or higher HRR. Both groups' clinical, demographic, and laboratory values were compared. To identify independent predictors of prognosis, multivariate cox regression analysis was used. Results: A total of 119 patients were included. The best cut-off point of HRR in determining OS was 0.963% (p=0.042). HRR below the cut-off value increased mortality by 2.2-fold. The group with HRR<0.963% had higher mean age and RDW fL (p=0.020 and p<0.001) and lower mean albumin g/dL (p<0.001). At the same time, the 5-year OS value of the group with HRR≥0.9632 was 52.6% and the median OS of this group was 62.7 months (95% CI: 48.0-77.4), while the 5-year OS vale of the group with HRR<0.9632 was 24.7% and the median OS was 32.4 months (95% CI: 23.6-41.1). In multivariate cox-regression analysis, HRR was not independent predictor of mortality risk. Conclusion: HRR is a potential biomarker for prognosis in patients with Locally Advanced Lung Adenocarcinoma.