Prediction of the prognosis by the preoperative red blood cell distribution width in distal cholangiocarcinoma

ABSTRACT Cholangiocarcinoma has a very poor prognosis, with no specific tumor markers or clear prognostic factors. The red blood cell distribution width (RDW) was recently suggested as an independent prognostic factor in cancer patients; however, no report has examined the association with distal cholangiocarcinoma. In this retrospective analysis of 38 patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma at Nagasaki Medical Center in Japan from January 2011 to December 2020, we explored whether or not the preoperative RDW was a prognostic factor in distal cholangiocarcinoma. Patients were divided into two groups (RDW-high: n = 20 vs. RDW-low: n = 18) according to the median preoperative RDW (13.6%). The T-Bil (1.75 vs. 0.9 mg/dl, p = 0.022) and CEA (2.95 vs. 1.95 ng/ml, p = 0.043) values were higher and the ALB (3.35 vs. 3.95 g/dl, p = 0.007) value was lower in the RDW-high group than in the RDW-low group. The RDW-high group had a poorer survival than the RDW-low group. The overall survival for the RDW-high group was 29.1 months, and that for the RDW-low group was 37.9 months (p = 0.042). However, there was no significant difference in the recurrence-free survival between the groups (p = 0.140). In conclusion, the preoperative RDW was suggested to be a possible prognostic factor in distal cholangiocarcinoma. Highlights