title: Clinical and prognostic significance of anisocytosis measured as a red cell distribution width in patients with colorectal cancer.
abstract: OBJECTIVE
  : colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide, and detection of new prognostic markers is mandatory for patients to receive optimal oncological treatment. The aim of the study was to assess clinical and prognostic value of red cell distribution width (RDW) in patients with CRC.
  
  
  METHODS
  : RDW values in 90 patients with CRC undergoing surgery for primary disease were analyzed in pre- and postoperative setting, and correlated with clinical and hematological parameters.
  
  
  RESULTS
  : Both pre- and postoperative RDW measurements were found to be associated with features of iron deficiency anemia, inflammatory response to tumor, advanced age and depth of tumor invasion. Optimal cutoff points were calculated to be 14% for preoperative and 13.6% for postoperative RDW measurements. Elevations in both pre- and postoperative RDW values had significant effects on survival in univariate and multivariate analyses. Effects were found to be independent of tumor related features, stage of the disease, development of anemia and aberrant inflammatory response to tumor.
  
  
  CONCLUSIONS
  : RDW is an integrative parameter reflecting tumor specific features and shows significant association with overall survival in patients with CRC. This is especially important in patients with stage 2 disease where elevation in preoperative RDW values can contribute to recognition of higher risk patients.
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Kust
authors.affiliation: Department of Hematology, Clinical Hospital "Dubrava", Avenija Gojka Šuška 6, Zagreb 10000, Croatia.
authors.forename: Marko
authors.initials: M
authors.lastname: Lucijanic
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Urch
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Samija
authors.affiliation: Department of Chemistry, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Celap
authors.affiliation: Deparment of Internal Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Kruljac
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Marin
authors.initials: M
authors.lastname: Prpic
authors.affiliation: Department of Orthopedics and Traumatology, General Hospital "Karlovac", Andrije Štampara 3, 47000 Karlovac.
authors.forename: Ivica
authors.initials: I
authors.lastname: Lucijanic
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Neven
authors.initials: N
authors.lastname: Matesa
authors.affiliation: From the Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", Vinogradska cesta 29, Zagreb 10000, Croatia.
authors.forename: Ante
authors.initials: A
authors.lastname: Bolanca
mesh_terms: D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000209:etiology; D015179:Colorectal Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000601:surgery; D004909:Erythrocyte Indices; D004913:Erythrocytes, Abnormal; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology