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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

18-08-2022 | Breast Cancer | Breast Oncology

Residual Cancer Burden Class Associated with Survival Outcomes in Women with Different Phenotypic Subtypes of Breast Cancer After Neoadjuvant Chemotherapy

Authors: Erin A. Elder, MD, Chad A. Livasy, MD, Erin E. Donahue, PhD, Brittany Neelands, MS, Alicia Patrick, MA, Mckenzie Needham, BS, Terry Sarantou, MD, Lejla Hadzikadic-Gusic, MD, Arielle L. Heeke, MD, Richard L. White Jr., MD

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Background

The residual cancer burden class informs survival outcomes after neoadjuvant chemotherapy. We evaluated the prognostic ability of the RCB for survival outcomes in women with different phenotypic subtypes of breast cancer treated with neoadjuvant chemotherapy. Additional variables were assessed for inclusion with the RCB to further improve the model’s discriminative ability.

Patients and Methods

We conducted a retrospective review of patients completing at least 75% of the recommended cycles of neoadjuvant chemotherapy between 1 January 2010 and 31 December 2016. Phenotypic subtypes were defined by hormone receptor and human epidermal growth factor receptor 2 (HER2) status at diagnosis, classified as HR+/HER2−, HER2+, or triple-negative breast cancer (TNBC). The RCB class was calculated and survival endpoints of overall survival, recurrence-free survival, and distant recurrence-free survival were analyzed using Kaplan–Meier and Cox proportional hazards methods. The discriminative ability of the models was quantified by Harrell’s C-index.

Results

Overall, 532 women met the inclusion criteria. Median follow-up was 65 months. In univariate models, RCB was significantly associated with OS, RFS, and DRFS. The RCB class had good discriminative ability for OS, RFS, and DRFS survival, with Harrell’s C-indices of 0.68, 0.67, and 0.68, respectively. The RCB class discriminated well for each survival endpoint within HER2+ and TNBC, but did not discriminate well for HR+/HER2− (OS Harrell’s C-indices of 0.77, 0.75, and 0.52, respectively).

Conclusions

The RCB class was prognostic for OS, RFS, and DRFS after neoadjuvant chemotherapy, but prognostic discrimination between patients with subtype HR+/HER2− was not observed during the follow-up period for which the overall event rate was low.
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Metadata
Title
Residual Cancer Burden Class Associated with Survival Outcomes in Women with Different Phenotypic Subtypes of Breast Cancer After Neoadjuvant Chemotherapy
Authors
Erin A. Elder, MD
Chad A. Livasy, MD
Erin E. Donahue, PhD
Brittany Neelands, MS
Alicia Patrick, MA
Mckenzie Needham, BS
Terry Sarantou, MD
Lejla Hadzikadic-Gusic, MD
Arielle L. Heeke, MD
Richard L. White Jr., MD
Publication date
18-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12300-x

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