Measurement of Residual Breast Cancer Burden to Predict Survival After Neoadjuvant Chemotherapy

摘要: Purpose To measure residual disease after neoadjuvant chemotherapy in order to improve the prognostic information that can be obtained from evaluating pathologic response. Patients and Methods Pathologic slides reports were reviewed 382 patients two different treatment cohorts: sequential paclitaxel (T) then fluorouracil, doxorubicin, cyclophosphamide (FAC) 241 patients; a single regimen of FAC 141 patients. Residual cancer burden (RCB) was calculated as continuous index combining measurements primary tumor (size cellularity) nodal metastases (number size) for prediction distant relapse-free survival (DRFS) multivariate Cox regression analyses. Results RCB independently model included age, pretreatment clinical stage, hormone receptor status, therapy, response (pathologic complete [pCR] v [RD]; hazard ratio 2.50; 95% CI 1.70 3.69; P .001). Minimal RD (RCB-I) 17% carried same prognosis pCR (RCB-0). Extensive (RCB-III) 13% associated with poor prognosis, regardless adjuvant or American Joint Committee on Cancer stage disease. The generalizability relapse confirmed FAC-treated validation cohort. Conclusion determined routine materials represented distribution RD, significant predictor DRFS, used define categories near-complete resistance. J Clin Oncol 25:4414-4422. © 2007 by Society Clinical Oncology