ArticleJournal of thoracic disease2026
Gustave Roussy Immune Score as a prognostic marker in patients with esophageal cancer after neoadjuvant chemoradiotherapy: a retrospective study.
Article in Journal of thoracic disease, 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
Background: 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. Methods: 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). Results: 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. Conclusions: 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.
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