Study Design

From 2001, all data of the patients who underwent liver resection at the University Hospital in Heidelberg were prospectively gathered in our data bank. Up to 2020, a total of 3870 liver resections were documented in our database. Among these, 417 patients underwent liver resection with HCC. After excluding patients with (1) inflammatory disorders influencing the level of RDW, such as rheumatoid arthritis, systemic lupus erythematosus, and spondyloarthritis; (2) hematological diseases, such as anemia or malignancies; (3) recent iron supplementation therapy or blood transfusion; (4) status after splenectomy; (5) infection; (6) autoimmune diseases; and (7) neoadjuvant or adjuvant chemotherapy or immunotherapy, 395 HCC cases were included in this study. The study protocol was approved by the independent ethics committee of the University of Heidelberg (approval number: S-754/2018). All procedures were performed according to the most recent revision of the Declaration of Helsinki. Informed consent to participate in the study was obtained from all patients before their data were entered into the database.