Gustative Roussy Immune Score is a Predictor for Major Pathological Response in Rectal Cancer: A Result from the Preoperative Intraarterial Chemoembolization Combined with Radiotherapy (PCAR) Study

Figures & data

Table 1. Clinicopathological characteristics of patients.

Characteristics	Patients (n = 123)
Sex, n (%)
Male/female	81 (65.85)/42 (34.15)
Age, years
Median (range)	59 (52–68)
ECOG PS, n (%)
0/1	74 (60.16)/49 (39.84)
BMI (kg/m^2), n (%)	23.8 ± 3.45
Clinical T category, n (%)
cT2/ cT3/ cT4	3 (2.44)/88 (71.54)/32 (26.02)
Clinical N category, n (%)
cN0/ cN1/ cN2	15 (12.20)/40 (32.52)/68 (55.28)
Clinical disease stage, n (%)
Stage II/ III / IV	16 (13.01)/97 (78.86)/10 (8.13)
Distance from the AV (cm), n (%)
0–5/>5–10/>10	59 (47.97)/56 (45.53)/8 (6.50)
Tumor length (cm)
Median (range)	4 (3–5)
CRM, n (%)
Positive/negative	62 (50.41)/61 (49.59)
EMVI, n (%)
Positive/negative	33 (26.83)/90 (73.17)
Baseline CEA level (ng/ml), n (%)
≤5/>5	73 (59.35)/50 (40.65)
Median (range)	3.73 (1.90–13.61)
Baseline CA199 level (U/ml), n (%)
≤37/>37	103 (83.74)/20 (16.26)
Median (range)	11.42 (7.52–26.51)
ypT category, n (%)
ypT0/ypTis/ypT1/ypT2/ypT3/ypT4	23 (18.70)/2 (1.63)/1 (0.81)/35 (28.46)/54 (43.90)/8 (6.50)
ypN category, n (%)
ypN0/ypN1/ypN2	89 (72.36)/27 (21.95)/7 (5.69)
TRG, n (%)
0/1/2/3	23 (18.70)/33 (26.83)/43 (34.96)/24 (19.51)
Pathological response rate, n (%)
pCR	23 (18.70)
MPR	56 (45.53)
Vascular invasion, n (%)	19 (15.45)
Perineural invasion, n (%)	27 (21.95)

Figure 1. Distribution of SII, NLR, and GRIm-Score indices in rectal cancer patients with different clinical cancer staging, tumor lengths, and baseline CEA levels. (A) Boxplot showing the distribution of log-transformed SII values in rectal cancer patients with cancer staging T2-3 and T4. (B) Boxplot showing the distribution of log-transformed NLR values in rectal cancer patients with cancer staging T2-3 and T4. (C) A stacked column diagram showing the proportion of GRIm-Score ≥ 1 in rectal cancer patients with tumor length > 4 cm. (D) A stacked column diagram showing the proportion of GRIm-Score ≥ 1 in rectal cancer patients with serum CEA concentration > 5 ng/mL.

Table 2. The final logistic model to predict MRP.

MPR model	OR (95% CI)	P value
GRIm-score (≥ 1 vs 0)	0.394 (0.177–0.876)	0.0115
pre-cT stage (T4 vs T2-3)	0.391 (0.160–0.954)	0.0336

GRIm-score, Gustative Roussy Immune score (reference range: 0–3).

Figure 2. Forest plot for the association between hematological and biochemical parameters and systemic inflammation indices and pCR (A) and MPR (B).

Figure 3. Kaplan-Meier survival curve for OS stratified by pre-cN stage, pre-cM stage, hemoglobin levels and DRS levels. (A) pre-cN stage. (B) pre-cM stage. (C) Hemoglobin. (D) DRS.

Table 3. The final prognostic model for OS.

Parameters	HR (95% CI)	P value
pre-cN stage (N1-2 vs N0)	5.7004 (0.7605–42.7275)	0.023
pre-cM stage (M1 vs M0)	9.729 (3.6761–25.7483)	2.437 × 10^−5
Hemoglobin (High vs Low)	0.4388 (0.2023–0.9515)	0.0318

The median value of hemoglobin in the whole population is 135 g/L. Patients with hemoglobin < 135 g/L is defined as low group and ≥135 g/L as high group.