Gustave Roussy Immune Score Is a Prognostic Marker in Patients With Esophageal Cancer After Neoadjuvant Therapy: A Multicenter Retrospective Study

Abstract Background GRIm-Score (Gustave Roussy Immune Score), a novel nutritional and inflammatory-based prognostic score, is an unfavorable prognostic factor in patients with esophageal carcinoma (EC). However, the prognostic importance of GRIm-Scores after neoadjuvant chemo-radiotherapy in these patients remains unclear. Methods A retrospective study including 432 EC patients undergoing surgical resection was performed. The GRIm-Score was calculated by lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR), and albumin (ALB). The over survival (OS) and disease-free survival (DFS) were analyzed for the current study with Cox regression analyses, Kaplan-Meier methods, and propensity score matching (PSM). Results There were 374 (86.6%) men and 58 (13.4%) women with a mean age of 62.1 ± 7.7 years (range: 39-80 years). After PSM, cohorts consisted of 55 patients in the high GRIm-Score group and 55 in the low GRIm-Score group. Patient with a high GRIm-Score had poor OS (Cohort: p = 0.001; PSM: p = 0.007) and DFS (Cohort: p = 0.001; PSM: p = 0.008). The GRIm-Score, instead of NLR, LDH, or ALB in multivariate analyses, was an independent prognostic factor for OS (p = 0.019) before PSM. However, after PSM, it was a powerful independent prognostic factor for both OS (p = 0.028) and DFS (p = 0.039). Subgroup analyses showed that GRIm-Score could identify cases with worse OS or DFS among pT3-4 patients, indicating the complementary role of GRIm-Score in the decision-making of adjuvant therapy. Conclusion The GRIm-Score was an independent prognostic marker in patients with EC undergoing surgical resection after neoadjuvant therapy. Our study is also the first to discuss the prognostic value of GRIm-Score in patients with EC after neoadjuvant treatment.