Gustave Roussy Immune score for predicting postoperative complications and non-cancer death in elderly patients with colon cancer

Abstract

Abstract Purpose Gustave Roussy Immune (GRIm) score is prognostic marker in various cancers. The aim of this study was to investigate the relationship between GRIm score and short- and long-term outcomes in elderly patients with colon cancer. Methods Patients aged ≥ 75 years who underwent colectomy between 2008 and 2019 were eligible in the study. Patients were divided into high GRIm (GRIm-H, score 1–3) and low GRIm (GRIm-L, score 0) groups. Results A total of 430 patients were enrolled (GRIm-H, n = 126; GRIm-L, n = 304). High GRIm score was an independent predictive factor for postoperative complications (odds ratio, 4.146; 95%CI, 2.536–6.777; p < 0.001). Median follow-up was 42 months (range, 1–160 months). Five-year relapse-free survival (GRIm-H, 79.3% vs. GRIm-L, 92.7%; p = 0.001), overall survival (76.0% vs. 92.2%, p = 0.001), and non-cancer-specific survival (84.7% vs. 94.6%, p = 0.003) were lower in the GRIm-H group. Multivariate analysis revealed high GRIm as an independent predictive factor for overall survival (hazard ratio, 2.875; 95%CI, 1.451–5.698; p = 0.002) and non-cancer-specific survival (hazard ratio, 3.650; 95%CI, 1.612–8.265; p = 0.001). Conclusions GRIm score is useful for predicting postoperative complications and non-cancer cause of death in elderly patients, and might be suitable as a surrogate marker for selecting candidates for surgery or perioperative treatment.