Ling Xu1, Xuening Duan2, Bin Zhou3, Yinhua Liu4, Jingming Ye5, Zhaorui Liu6, Chao Ma7, Hong Zhang8, Shuang Zhang9, Lanbo Zhang10, Jianxin Zhao11, Yuanjia Cheng12. 1. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: xuling_en@126.com. 2. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: xueing666@126.com. 3. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: byzhoubin@163.com. 4. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: liuyinhua7520@163.com. 5. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: md_ye@sina.com. 6. Institute of Mental Health, Peking University, No. 49 Hua Yuan North Street, Hai Dian District, Beijing 100191, China. Electronic address: Zhaoruiliu@bjmu.edu.cn. 7. Institute of Mental Health, Peking University, No. 49 Hua Yuan North Street, Hai Dian District, Beijing 100191, China. Electronic address: c.ma@ruc.edu.cn. 8. Pathology Department, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: 13810215225@163.com. 9. Pathology Department, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: candida2008@hotmail.com. 10. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: zhanglanbo@medmail.com.cn. 11. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: zjxcn@aliyun.com. 12. Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China. Electronic address: chengyuanjia@163.com.
Abstract
BACKGROUND: Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancer patients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. METHODS: Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. RESULTS: A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. CONCLUSIONS: The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancer patients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability.
BACKGROUND: Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancerpatients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. METHODS: Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. RESULTS: A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. CONCLUSIONS: The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancerpatients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability.
Authors: Olga Kantor; Alison Laws; Ricardo G Pastorello; Claire King; Stephanie Wong; Tanujit Dey; Stuart Schnitt; Tari A King; Elizabeth A Mittendorf Journal: Ann Surg Oncol Date: 2021-05-06 Impact factor: 5.344