Gustave Roussy Immune Score as a prognostic marker in patients with esophageal cancer after neoadjuvant...

Gustave Roussy Immune Score (GRIm-Score), a new prognostic index based on nutritional and inflammatory status, acts as an adverse prognostic factor in patients diagnosed with esophageal cancer (EC). However, the clinical prognostic significance of the GRIm-Score in these patients after receiving neoadjuvant chemoradiotherapy (nCRT) remains unclear. The aim of the study was to evaluate the prognostic value of GRIm-Score in patients with EC following nCRT.

A retrospective study was conducted involving 432 patients with EC who had undergone surgical resection. The GRIm-Score of each enrolled patient was calculated on the basis of three key parameters: lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR), and albumin (ALB). Overall survival (OS) and disease-free survival (DFS) were set as the primary study endpoints, which were analyzed utilizing Cox proportional hazards regression analysis, the Kaplan-Meier method, and propensity score matching (PSM).

The study cohort comprised 359 male patients (83.1%) and 73 female patients (16.9%), with a mean age of 62.1±7.7 years and an age range of 39 to 80 years. Following the implementation of PSM, the matched research cohort was divided into a high GRIm-Score group and a low GRIm-Score group, with 55 patients in each group respectively. Patients with a high GRIm-Score exhibited inferior OS (cohort: P<0.001; PSM: P=0.009) and DFS (cohort: P<0.001; PSM: P=0.01). Before PSM, the GRIm-Score was confirmed as an independent prognostic factor for OS (P=0.02) in multivariate regression analyses, while none of the individual indicators of NLR, LDH, and ALB exhibited such prognostic significance. However, after PSM, the GRIm-Score acted as a powerful independent prognostic factor for both OS (P=0.03) and DFS (P=0.04) in these multivariate analyses. Further subgroup analyses demonstrated that the GRIm-Score could effectively identify pT3-4 stage EC patients with inferior OS or DFS, which suggests that the GRIm-Score plays a complementary role in the clinical decision-making for adjuvant therapy in EC patients.

In patients with EC who underwent nCRT followed by surgical resection, the GRIm-Score was verified as an independent prognostic factor. Additionally, this study constitutes the first investigation to elucidate the prognostic significance of the GRIm-Score in EC patients after receiving nCRT.