Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
Institute of Mental Health, Peking University, No. 49 Hua Yuan North Street, Hai Dian District, Beijing 100191, China.
Breast. 2018 Aug;40:29-37. doi: 10.1016/j.breast.2018.03.010. Epub 2018 Apr 17.
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.
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.
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.
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.
术前全身治疗（PST）后的预后评估对于确定乳腺癌患者的治疗至关重要。许多研究人员试图开发一种系统来定量残余肿瘤及其与 PST 后预后的相关性。本回顾性研究在中国的一个中心验证了 CPS+EG 分期系统和 Neo-Bioscore。
回顾性分析 2008 年 1 月至 2014 年 12 月期间在中国北京大学第一医院乳腺疾病中心接受 PST 和手术治疗的非转移性原发性乳腺癌患者的数据。采用 K-M 曲线和 AUC 计算 DFS、DSS 和 OS。采用多变量分析 Cox 比例风险模型。所有计算均使用 SAS 9.4 进行。
本研究共纳入 403 例患者。中位随访时间为 45 个月（范围 11-107 个月）。五年 DFS、DSS 和 OS 率分别为 86.4%、91.2%和 90.5%。CS、PS、CPS+EG 分期系统和 Neo-Bioscore 根据 PST 后 DFS、DSS 和 OS 对患者进行分层，所有 P 值均<0.0001。CPS+EG 分期系统和 Neo-Bioscore 比 CS 更好地分层 PST 后的预后。未接受曲妥珠单抗治疗的 HER2 阳性患者的 DFS 和 OS 明显差于 Neo-Bioscore 系统评分不同的其他 HER2 状态亚组的患者。
CPS+EG 分期系统和 Neo-Bioscore 可提高 PST 后非 pCR 乳腺癌患者的预后预测能力，并且在纳入了治疗不足等不利预后因素后，将具有更广泛的临床适用性。
