Research Article
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Can gustave roussy ımmune score predict the prognosis and survival in patients with operabl colorectal cancers?

Year 2023, Volume: 14 Issue: 3, 496 - 507, 30.09.2023
https://doi.org/10.18663/tjcl.1324390

Abstract

Aim: It was aimed to evaluate the effect of GRIm score measured at the time of diagnosis on recurrence, prognosis, and survival in patients with operated early-stage colorectal cancer.
Material and Methods: Our study was planned as a multicenter retrospective study and data were obtained from four different centers. The patients in our clinics consist of patients diagnosed between 2010 and 2023. In order to determine the Gustave Roussy Immune Score (GRIm-Score), the patients' preoperative neutrophil, lymphocyte, neutrophil/lymphocyte ratio (NLR), serum albumin (ALB) and serum lactate dehydrogenase (LDH) levels, as well as Kras, Braf mutation status and CEA levels were evaluated. The patients were divided into two groups according to their GRIm scores. Disease-free survival (DFS) and overall survival (OS) were then analyzed.
Results: Our study population consisted of 405 operated colorectal cancer patients who were not metastatic at diagnosis. Patients were grouped according to their general demographic data and oncological characteristics, whether their GRIm score levels were high or low. With a high GRIm-score; high N (Lymph Node) positivity and advanced TNM stage, high CEA level, presence of RAS and RAF mutations coincided with high mean age and high VKİ. In survival analyzes, it was found that being female decreased the risk of death, while a high GRIm score and having a RAS mutation increased the risk of death.
Conclusion: In our study, it was found that the GRIm-score, which is an inflammatory and nutritional risk scoring system in patients with early-stage colorectal cancer, is determinative in terms of disease-free survival, especially overall survival. In Çok değişkenli analysis, it was shown that while the effect of GRIm-score disappeared in DFS, it was affected independently from other factors in survival. In this respect, GRIm-score is recommended to be evaluated as a practical parameter since it predicts survival in patients with operated colorectal cancer.

References

  • Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023; 73(1):17-48. doi: 10.3322/caac.21763
  • Tian S, Cao Y, Duan Y, Liu Q, Peng P. Gustave Roussy Immune Score as a Novel Prognostic Scoring System for Colorectal Cancer Patients: A Propensity Score Matching Analysis. Front Oncol 2021; 11:737283. doi: 10.3389/fonc.2021.737283
  • Bai X, Feng L. Correlation Between Prognostic Nutritional Index, Glasgow Prognostic Score, Systemic Inflammatory Response, and TNM Staging in Colorectal Cancer Patients. Nutr Cancer 2020; 72(7):1170–7. doi: 10.1080/01635581.2019.1675725
  • Huang Q, Cao Y, Wang S, Zhu R. Creation of a Novel Inflammation-Based Score for Operable Colorectal Cancer Patients. J Inflammation Res 2020; 13:659–71. doi: 10.2147/JIR.S271541
  • Bigot F, Castanon E, Baldini C, et al. Prospective Validation of a Prognostic Score for Patients in Immunotherapy Phase I Trials: The Gustave Roussy Immune Score (GRIm-Score). Eur J Cancer 2017; 84:212–8. doi: 10.1016/j.ejca.2017.07.027
  • Minami S, Ihara S, Komuta K. Gustave Roussy Immune Score Is a Prognostic Factor for Chemotherapy-Naive Pulmonary Adenocarcinoma With Wild-Type Epidermal Growth Factor Receptor. World J Oncol 2019;10(1):55-61. doi:10.14740/wjon1184
  • Hatanaka T, Naganuma A, Hiraoka A, et al. Real-life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan). The hepatocellular carcinoma modified Gustave Roussy Immune score (HCC-GRIm score) as a novel prognostic score for patients treated with atezolizumab and bevacizumab: A multicenter retrospective analysis. Cancer Med 2023;12(4):4259-4269. doi: 10.1002/cam4.5294
  • Feng JF, Wang L, Yang X, Chen S. Gustave Roussy Immune Score (GRIm-Score) is a prognostic marker in patients with resectable esophageal squamous cell carcinoma. J Cancer 2020;11(6):1334-1340. doi: 10.7150/jca.37898
  • Bigot F, Castanon E, Baldini C, et al. Prospective Validation of a Prognostic Score for Patients in Immunotherapy Phase I Trials: The Gustave Roussy Immune Score (GRIm-Score). Eur J Cancer 2017; 84:212–8. doi: 10.1016/j.ejca.2017.07.027
  • Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer‐related inflammation and treatment effectiveness. Lancet Oncol 2014;15(11):e493‐e503. doi: 10.1016/S1470-2045(14)70263-3.
  • Ahechu P, Zozaya G, Marti P, et al. NLRP3 Inflammasome: A Possible Link Between Obesity-Associated Low-Grade Chronic Inflammation and Colorectal Cancer Development. Front Immunol 2018; 9: 2918. doi: 10.3389/fimmu.2018.02918.
  • Petrelli F, Barni S, Coinu A, et al. The Modified Glasgow Prognostic Score and Survival in Colorectal Cancer: A Pooled Analysis of the Literature. Rev Recent Clin Trials 2015; 10(2):135–41. doi: 10.2174/1574887110666150317121413.
  • Lenci E, Cantini L, Pecci F, et al. The Gustave Roussy Immune (GRIm)-Score Variation Is an Early-on-Treatment Biomarker of Outcome in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients Treated with First-Line Pembrolizumab. J Clin Med 2021;10(5):1005. doi: 10.3390/jcm10051005.
  • Feng W, Wang Y, Zhu X. Baseline Serum Lactate Dehydrogenase Level Predicts Survival Benefit in Patients With Metastatic Colorectal Cancer Receiving Bevacizumab as First-Line Chemotherapy: A Systematic Review and Meta-Analysis of 7 Studies and 1,219 Patients. Ann Transl Med 2019; 7(7):133. doi: 10.21037/atm.2019.02.45.
  • Li H, Zhao Y, Zheng F. Prognostic Significance of Elevated Preoperative Neutrophil-to-Lymphocyte Ratio for Patients With Colorectal Cancer Undergoing Curative Surgery: A Meta-Analysis. Med (Baltimore) 2019; 98(3):e14126. doi: 10.1097/MD.0000000000014126.
  • Wei Y, Xu H, Dai J, et al.. Prognostic Significance of Serum Lactic Acid, Lactate Dehydrogenase, and Albumin Levels in Patients With Metastatic Colorectal Cancer. BioMed Res Int 2018; 2018:1804086. doi: 10.1155/2018/1804086.
  • Formica V, Sera F, Cremolini C, Riondino S, Morelli C, Arkenau HT, Roselli M. KRAS and BRAF Mutations in Stage II and III Colon Cancer: A Systematic Review and Meta-Analysis. J Natl Cancer Inst. 2022; 114(4): 517-527. doi: 10.1093/jnci/djab190.

Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?

Year 2023, Volume: 14 Issue: 3, 496 - 507, 30.09.2023
https://doi.org/10.18663/tjcl.1324390

Abstract

Amaç: Opere olan metastatik olmayan kolorektal kanserli hastalarda, tanı anında bakılan GRIm skorunun, nüks, prognoz ve sağkalım üzerine etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Çok merkezli retrospektif bir çalışma olarak planlanmış olup, toplam dört farklı merkezden veriler elde edildi. Kliniklerimizdeki hastalar 2010 yılı ile 2023 yılı tarihleri arasında tanı almış hastalardan oluşmaktadır. Gustave Roussy İmmün Skoru (GRIm-Score) belirlenmesi için hastaların operasyon öncesindeki nötrofil, lenfosit, nötrofil/lenfosit oranı (NLR) serum albümin (ALB) ve serum laktat dehidrogenaz (LDH) düzeyleri yanı sıra Kras, Braf mutasyon durumları ve CEA düzeyleri değerlendirildi. Hastalar GRIm skorlarına göre 0-1 düşük ve 2-3 yüksek olmak üzere iki gruba ayrıldı. Sonrasında hastalıksız sağkalım ve genel sağkalım analizleri yapıldı.
Bulgular: Çalışma popülasyonumuz tanıda metastatik olmayan, opere olmuş 405 kolorektal kanserli hastadan oluşmaktadır. Hastalar genel demografik verileri ve onkolojik özellikleri açısından GRIm skor düzeylerinin yüksek veya düşük olmasına göre gruplandırıldı. Yüksek GRIm-skor gurubuyla; yüksek N (Lenf Nodu) pozitifliği ve ileri TNM (T tümör boyutu, N lenf nodu ve M metastaz durumu) evresi, yüksek CEA düzeyi, RAS ve RAF mutasyonun varlığı, yüksek yaş ortalaması ve yüksek VKİ(>25) ile örtüşüyordu. Yapılan sağkalım analizlerinde kadın olmak (HR:0.53;%95CI: 0.33-0,85; p=0.010) ölüm riskini azaltırken, GRIm skorunu yüksek olması (HR:1.86;%95CI: 1.06-3.26; p=0.030) ve RAS mutasyonun olması ise (HR:2.01;%95CI: 1.14-3.54; p=0.016) ölüm riskini arttırdığı bulundu. Hastalıksız sağkalım açısından da benzer analiz yapıldığında ise CEA’nın 5 ng/ml ve üstü olması (HR:1.98;%95CI: 1.09-3,60; p=0.025), RAS mutasyonun olması (HR:2.41;%95CI: 1.56-3.74; p<0.001), nüks riskini artırdığı bulundu nüks/progresyon yerinin kemik metastazı olması ise (HR:0.42;%95CI: 0.20-0.89; p=0.024) nüks riskini azalttığı bulundu (p<0.001, -2 loglikelihood= 1102,47) olarak
Sonuç: Çalışmamızda erken evre kolorektal kanserli hastalarda bir inflamatuar ve beslenme risk puanlama sistemi olan GRIm-skor ’un başta genel sağkalım olmak üzere hastalıksız sağkalımı açısından belirleyici olduğu bulundu. Çok değişkenli analizde hastalıksız sağ kalımda GRIm-skoru’ nun etkisi kaybolurken, genel sağkalım da ise diğer faktörlerden bağımız olarak etki ettiği gösterildi. Bu yönüyle GRIm-skor opere kolorektal kanserli hastalarda sağkalımı ön görmesi nedeniyle pratikte kullanışlı bir parametre olarak değerlendirilmesi önerilir.

References

  • Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023; 73(1):17-48. doi: 10.3322/caac.21763
  • Tian S, Cao Y, Duan Y, Liu Q, Peng P. Gustave Roussy Immune Score as a Novel Prognostic Scoring System for Colorectal Cancer Patients: A Propensity Score Matching Analysis. Front Oncol 2021; 11:737283. doi: 10.3389/fonc.2021.737283
  • Bai X, Feng L. Correlation Between Prognostic Nutritional Index, Glasgow Prognostic Score, Systemic Inflammatory Response, and TNM Staging in Colorectal Cancer Patients. Nutr Cancer 2020; 72(7):1170–7. doi: 10.1080/01635581.2019.1675725
  • Huang Q, Cao Y, Wang S, Zhu R. Creation of a Novel Inflammation-Based Score for Operable Colorectal Cancer Patients. J Inflammation Res 2020; 13:659–71. doi: 10.2147/JIR.S271541
  • Bigot F, Castanon E, Baldini C, et al. Prospective Validation of a Prognostic Score for Patients in Immunotherapy Phase I Trials: The Gustave Roussy Immune Score (GRIm-Score). Eur J Cancer 2017; 84:212–8. doi: 10.1016/j.ejca.2017.07.027
  • Minami S, Ihara S, Komuta K. Gustave Roussy Immune Score Is a Prognostic Factor for Chemotherapy-Naive Pulmonary Adenocarcinoma With Wild-Type Epidermal Growth Factor Receptor. World J Oncol 2019;10(1):55-61. doi:10.14740/wjon1184
  • Hatanaka T, Naganuma A, Hiraoka A, et al. Real-life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan). The hepatocellular carcinoma modified Gustave Roussy Immune score (HCC-GRIm score) as a novel prognostic score for patients treated with atezolizumab and bevacizumab: A multicenter retrospective analysis. Cancer Med 2023;12(4):4259-4269. doi: 10.1002/cam4.5294
  • Feng JF, Wang L, Yang X, Chen S. Gustave Roussy Immune Score (GRIm-Score) is a prognostic marker in patients with resectable esophageal squamous cell carcinoma. J Cancer 2020;11(6):1334-1340. doi: 10.7150/jca.37898
  • Bigot F, Castanon E, Baldini C, et al. Prospective Validation of a Prognostic Score for Patients in Immunotherapy Phase I Trials: The Gustave Roussy Immune Score (GRIm-Score). Eur J Cancer 2017; 84:212–8. doi: 10.1016/j.ejca.2017.07.027
  • Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer‐related inflammation and treatment effectiveness. Lancet Oncol 2014;15(11):e493‐e503. doi: 10.1016/S1470-2045(14)70263-3.
  • Ahechu P, Zozaya G, Marti P, et al. NLRP3 Inflammasome: A Possible Link Between Obesity-Associated Low-Grade Chronic Inflammation and Colorectal Cancer Development. Front Immunol 2018; 9: 2918. doi: 10.3389/fimmu.2018.02918.
  • Petrelli F, Barni S, Coinu A, et al. The Modified Glasgow Prognostic Score and Survival in Colorectal Cancer: A Pooled Analysis of the Literature. Rev Recent Clin Trials 2015; 10(2):135–41. doi: 10.2174/1574887110666150317121413.
  • Lenci E, Cantini L, Pecci F, et al. The Gustave Roussy Immune (GRIm)-Score Variation Is an Early-on-Treatment Biomarker of Outcome in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients Treated with First-Line Pembrolizumab. J Clin Med 2021;10(5):1005. doi: 10.3390/jcm10051005.
  • Feng W, Wang Y, Zhu X. Baseline Serum Lactate Dehydrogenase Level Predicts Survival Benefit in Patients With Metastatic Colorectal Cancer Receiving Bevacizumab as First-Line Chemotherapy: A Systematic Review and Meta-Analysis of 7 Studies and 1,219 Patients. Ann Transl Med 2019; 7(7):133. doi: 10.21037/atm.2019.02.45.
  • Li H, Zhao Y, Zheng F. Prognostic Significance of Elevated Preoperative Neutrophil-to-Lymphocyte Ratio for Patients With Colorectal Cancer Undergoing Curative Surgery: A Meta-Analysis. Med (Baltimore) 2019; 98(3):e14126. doi: 10.1097/MD.0000000000014126.
  • Wei Y, Xu H, Dai J, et al.. Prognostic Significance of Serum Lactic Acid, Lactate Dehydrogenase, and Albumin Levels in Patients With Metastatic Colorectal Cancer. BioMed Res Int 2018; 2018:1804086. doi: 10.1155/2018/1804086.
  • Formica V, Sera F, Cremolini C, Riondino S, Morelli C, Arkenau HT, Roselli M. KRAS and BRAF Mutations in Stage II and III Colon Cancer: A Systematic Review and Meta-Analysis. J Natl Cancer Inst. 2022; 114(4): 517-527. doi: 10.1093/jnci/djab190.
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Clinical Oncology
Journal Section Research Article
Authors

Arif Hakan Onder 0000-0002-0121-5228

Yusuf İlhan 0000-0002-2875-6876

Onur Yazdan Balçık 0000-0002-3386-2075

Gökhan Karakaya 0000-0002-7970-307X

Publication Date September 30, 2023
Published in Issue Year 2023 Volume: 14 Issue: 3

Cite

APA Onder, A. H., İlhan, Y., Balçık, O. Y., Karakaya, G. (2023). Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?. Turkish Journal of Clinics and Laboratory, 14(3), 496-507. https://doi.org/10.18663/tjcl.1324390
AMA Onder AH, İlhan Y, Balçık OY, Karakaya G. Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?. TJCL. September 2023;14(3):496-507. doi:10.18663/tjcl.1324390
Chicago Onder, Arif Hakan, Yusuf İlhan, Onur Yazdan Balçık, and Gökhan Karakaya. “Gustave Roussy immün Skor Operabl Kolorektal Kanserli Hastalarda Prognozu Ve sağkalımı öngörebilir Mi?”. Turkish Journal of Clinics and Laboratory 14, no. 3 (September 2023): 496-507. https://doi.org/10.18663/tjcl.1324390.
EndNote Onder AH, İlhan Y, Balçık OY, Karakaya G (September 1, 2023) Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?. Turkish Journal of Clinics and Laboratory 14 3 496–507.
IEEE A. H. Onder, Y. İlhan, O. Y. Balçık, and G. Karakaya, “Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?”, TJCL, vol. 14, no. 3, pp. 496–507, 2023, doi: 10.18663/tjcl.1324390.
ISNAD Onder, Arif Hakan et al. “Gustave Roussy immün Skor Operabl Kolorektal Kanserli Hastalarda Prognozu Ve sağkalımı öngörebilir Mi?”. Turkish Journal of Clinics and Laboratory 14/3 (September 2023), 496-507. https://doi.org/10.18663/tjcl.1324390.
JAMA Onder AH, İlhan Y, Balçık OY, Karakaya G. Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?. TJCL. 2023;14:496–507.
MLA Onder, Arif Hakan et al. “Gustave Roussy immün Skor Operabl Kolorektal Kanserli Hastalarda Prognozu Ve sağkalımı öngörebilir Mi?”. Turkish Journal of Clinics and Laboratory, vol. 14, no. 3, 2023, pp. 496-07, doi:10.18663/tjcl.1324390.
Vancouver Onder AH, İlhan Y, Balçık OY, Karakaya G. Gustave roussy immün skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı öngörebilir mi?. TJCL. 2023;14(3):496-507.


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