Department of Surgery, Institut Curie, Paris, France.
Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, PSL Research University, INSERM, U932 Immunity and Cancer, Institut Curie, Paris, France.
Br J Cancer. 2021 Apr;124(8):1421-1427. doi: 10.1038/s41416-020-01251-3. Epub 2021 Feb 9.
To compare RCB (Residual Cancer Burden) and Neo-Bioscore in terms of prognostic performance and see if adding pathological variables improve these scores.
We analysed 750 female patients with invasive breast cancer (BC) treated with neoadjuvant chemotherapy (NAC) at Institut Curie between 2002 and 2012. Scores were compared in global population and by BC subtype using Akaike information criterion (AIC), C-Index (concordance index), calibration curves and after adding lymphovascular invasion (LVI) and pre-/post-NAC TILs levels.
RCB and Neo-Bioscore were significantly associated to disease-free and overall survival in global population and for triple-negative BC. RCB had the lowest AICs in every BC subtype, corresponding to a better prognostic performance. In global population, C-Index values were poor for RCB (0.66; CI [0.61-0.71]) and fair for Neo-Bioscore (0.70; CI [0.65-0.75]). Scores were well calibrated in global population, but RCB yielded better prognostic performances in each BC subtype. Concordance between the two scores was poor. Adding LVI and TILs improved the performance of both scores.
Although RCB and Neo-Bioscore had similar prognostic performances, RCB showed better performance in BC subtypes, especially in luminal and TNBC. By generating fewer prognostic categories, RCB enables an easier use in everyday clinical practice.
比较 RCB（残留肿瘤负担）和 Neo-Bioscore 在预后性能方面的表现，观察添加病理变量是否能改善这些评分。
我们分析了 2002 年至 2012 年期间在居里研究所接受新辅助化疗（NAC）治疗的 750 例女性浸润性乳腺癌（BC）患者。通过 Akaike 信息准则（AIC）、C-指数（一致性指数）、校准曲线以及添加淋巴管浸润（LVI）和 NAC 前后 TILs 水平，在总体人群和 BC 亚型中比较了评分。
RCB 和 Neo-Bioscore 在总体人群和三阴性 BC 中与无病生存和总生存显著相关。RCB 在每种 BC 亚型中的 AIC 最低，提示预后性能更好。在总体人群中，RCB 的 C-指数值较差（0.66；CI [0.61-0.71]），而 Neo-Bioscore 的 C-指数值较好（0.70；CI [0.65-0.75]）。在总体人群中，评分的校准效果良好，但 RCB 在每种 BC 亚型中都表现出更好的预后性能。两种评分之间的一致性较差。添加 LVI 和 TILs 可提高两种评分的性能。
尽管 RCB 和 Neo-Bioscore 的预后性能相似，但 RCB 在 BC 亚型中表现更好，尤其是在 luminal 和 TNBC 中。RCB 生成的预后类别较少，因此更便于在日常临床实践中使用。
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