Clinical significance of preoperative red cell distribution width-to-albumin ratio in predicting survival after curative surgery for gastric cancer: A retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Reliable methods for survival risk stratification in gastric cancer remain limited. We evaluated the prognostic utility of preoperative red cell distribution width and the red cell distribution width-to-albumin ratio in patients undergoing curative surgery for gastric cancer. Materials and Methods: Clinicopathological data from 214 consecutive patients who underwent R0 resection for gastric cancer were retrospectively analyzed. The prognostic significance of red cell distribution width and red cell distribution width-to-albumin ratio was assessed using time-dependent receiver operating characteristic curves and Cox proportional hazards regression. Optimal cutoff values were determined with X-tile software. Results: Time-dependent receiver operating characteristic analyses demonstrated that red cell distribution width-to-albumin ratio consistently yielded higher areas under the curve than red cell distribution width for predicting relapse-free survival, indicating superior discriminatory capacity. In univariate Cox analyses, both red cell distribution width and red cell distribution width-to-albumin ratio were significantly associated with overall survival and relapse-free survival. Multivariate analyses confirmed that elevated red cell distribution width independently predicted poorer overall survival (hazard ratio 1.85, 95% confidence interval 1.11–3.08, P = 0.019) and relapse-free survival (hazard ratio 1.67, 95% confidence interval 1.03–2.71, P = 0.039). Similarly, elevated red cell distribution width-to-albumin ratio independently predicted worse overall survival (hazard ratio 1.77, 95% confidence interval 1.06–2.94, P = 0.029) and relapse-free survival (hazard ratio 1.76, 95% confidence interval 1.07–2.89, P = 0.025). Conclusions: Preoperative red cell distribution width-to-albumin ratio, together with red cell distribution width, serves as an independent prognostic marker for long-term outcomes in patients with resectable gastric cancer. These easily available markers may represent more reliable and practical tools for mortality risk stratification for gastric cancer in clinical practice.
Source: Formosan Journal of Surgery
Institution: Omori Red Cross Hospital
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7155046557