Objective  To analyze the prognostic value of preoperative red cell distribution width (RDW) in patients with non-small cell lung cancer.

  Methods  A retrospective study of 513 patients with NSCLC who underwent surgery was conducted at the Tianjin Medical University Cancer Institute and Hospital from March 2008 to December 2012. The preoperative RDW cut-off value was determined using a receiver operating characteristic (ROC) curve analysis. The Chi-square test, t test, or Mann-Whitney U test was used to analyze the correlations between preoperative RDW and clinicopathological and clinicolaboratory variables. The Kaplan-Meier method and the Log-rank test were used to compare the survival curves. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated by univariate and multivariate analyses, using the Cox proportional hazards model.

  Results  According to the ROC curve analysis, the optimal preoperative RDW cut-off value was 12.95%. The RDW≤12.95% cut-off identified 250 patients, and the RDW ≤12.95% identified 263 patients. The preoperative RDW was associated with age, hemoglobin, albumin, fibrinogen, and D-dimer (all P < 0.05). The univariate analysis showed that tumor location, pathological stage, platelet count, albumin, hemoglobin, fibrinogen, and the preoperative RDW affected the prognosis of patients with NSCLC (all P < 0.05). The multivariate analysis demonstrated that the preoperative RDW remained an independent prognostic factor of disease-free and overall survivals, along with pathological stage (all P < 0.05).

  Conclusions  The preoperative RDW was able to predict the prognosis of NSCLC patients who undergo radical operation.