ArticleBMC gastroenterology2026
Impact of jaundice-induced elevated red blood cell distribution width on survival outcomes in pancreatic cancer patients: a retrospective cohort study.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo investigate the clinical significance of jaundice-related elevation in red cell distribution width (RDW) for predicting survival outcomes in patients with pancreatic cancer.
methodsWe established a multi-etiology cohort of 611 patients. Patients were stratified according to the underlying etiology and RDW status. We examined correlations between RDW and markers of inflammation, nutritional status, and bilirubin levels. We evaluated the independent prognostic impact of the "jaundice-high RDW" phenotype. This phenotype was defined as total bilirubin > 17.1 µmol/L, combined with RDW-CV > 15.4% or RDW-SD > 46 fL. We assessed survival in pancreatic cancer patients using Kaplan-Meier survival analysis with the log-rank test. We also used univariate and multivariate Cox proportional hazards models. Receiver operating characteristic (ROC) analysis was performed to assess the ability of total bilirubin to predict high RDW-CV and high RDW-SD status.
resultsRDW levels showed distinct distributions across different causes of jaundice; malignant obstructive jaundice, including pancreatic cancer, was associated with markedly higher RDW. In patients with pancreatic cancer, RDW was strongly positively correlated with total bilirubin (r > 0.7). Across tumor stages, patients with the "jaundice with high RDW" phenotype had the shortest median survival (5.6 months) and a substantially increased risk of death (HR = 3.52). Bilirubin demonstrated excellent discriminatory performance for high RDW status (AUC > 0.93).
conclusionIn pancreatic cancer, the combination of jaundice and high RDW constitutes a simple and practical tool for risk stratification. Patients presenting with both jaundice and elevated RDW should be prioritized in clinical management, and more intensive, comprehensive therapeutic strategies should be considered to improve outcomes. This study provides readily applicable clinical parameters for precision prognostic assessment in pancreatic cancer.
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