Abstract：
BACKGROUND: The CPS+EG scoring system was initially described in unselected early breast cancer (eBC) patients treated with neoadjuvant chemotherapy (NAC), leading to refined prognostic stratification, and thus helping to select patients for additional post-NAC treatments. It remains unknown whether the performance is the same in new biological breast cancer entities such as the HER2-low subtype.
METHODS: Outcomes (disease-free (DFS) and overall survival OS)) of 608 patients with HER2-non amplified eBC and treated with NAC were retrospectively analyzed according to CPS-EG score. We compared the prognostic stratification abilities of the CPS+EG in HER2-low and HER2-0 eBC, analyzing ER+ and ER- tumors separately.
RESULTS: In ER+ eBC, the CPS+EG scoring system seems to retain a prognostic value, both in HER2-low and HER2-0 tumors, by distinguishing populations with significantly different outcomes (good: score 0-1, poor: score 2-3, and very poor: score 4-5). Using C-indices for DFS and OS, CPS+EG provided the highest prognostic information in ER+ eBC, especially in HER2-0 tumors. In contrast, in ER- eBC, the CPS+EG does not appear to be able to distinguish different outcome groups, either in HER2-low or HER2-0 tumors. In ER- eBC, C-indices for DFS and OS were highest for pathological stage, reflecting the predominant prognostic importance of residual disease in this subtype.
CONCLUSIONS: HER2-low status does not influence the prognostic performance of the CPS+EG score. Our results confirm the usefulness of the CPS+EG score in stratifying the prognosis of ER+ eBC after NAC, for both HER2-0 and HER2-low tumors. For ER- eBC, HER2-low status does not influence the performance of the CPS+EG score, which was lower than that of the pathological stage alone.
METHODS: Outcomes (disease-free (DFS) and overall survival OS)) of 608 patients with HER2-non amplified eBC and treated with NAC were retrospectively analyzed according to CPS-EG score. We compared the prognostic stratification abilities of the CPS+EG in HER2-low and HER2-0 eBC, analyzing ER+ and ER- tumors separately.
RESULTS: In ER+ eBC, the CPS+EG scoring system seems to retain a prognostic value, both in HER2-low and HER2-0 tumors, by distinguishing populations with significantly different outcomes (good: score 0-1, poor: score 2-3, and very poor: score 4-5). Using C-indices for DFS and OS, CPS+EG provided the highest prognostic information in ER+ eBC, especially in HER2-0 tumors. In contrast, in ER- eBC, the CPS+EG does not appear to be able to distinguish different outcome groups, either in HER2-low or HER2-0 tumors. In ER- eBC, C-indices for DFS and OS were highest for pathological stage, reflecting the predominant prognostic importance of residual disease in this subtype.
CONCLUSIONS: HER2-low status does not influence the prognostic performance of the CPS+EG score. Our results confirm the usefulness of the CPS+EG score in stratifying the prognosis of ER+ eBC after NAC, for both HER2-0 and HER2-low tumors. For ER- eBC, HER2-low status does not influence the performance of the CPS+EG score, which was lower than that of the pathological stage alone.
摘要：
背景：最初在接受新辅助化疗（NAC）治疗的未选择的早期乳腺癌（eBC）患者中描述了CPSEG评分系统，导致精细的预后分层，从而帮助患者选择额外的NAC后治疗。尚不清楚在新的生物学乳腺癌实体中的性能是否相同，例如HER2低亚型。
方法：根据CPS-EG评分，回顾性分析608例HER2非扩增eBC患者的预后（无病（DFS）和总生存期OS）。我们比较了低HER2和HER2-0eBC中CPS+EG的预后分层能力，分别分析ER+和ER-肿瘤。
结果：在ER+eBC中，CPS+EG评分系统似乎保留了预后价值，在HER2低和HER2-0肿瘤中，通过区分具有显着不同结果的人群（好：得分0-1，差：得分2-3，非常差：得分4-5）。为DFS和OS使用C索引，CPS+EG在ER+eBC中提供了最高的预后信息，尤其是HER2-0肿瘤。相比之下,在ER-EBC中，CPS+EG似乎无法区分不同的结果组，无论是在HER2低或HER2-0肿瘤。在ER-eBC中，病理阶段的DFS和OS的C指数最高，反映了该亚型中残留疾病的主要预后重要性。
结论：HER2低状态不影响CPS+EG评分的预后表现。我们的结果证实了CPS+EG评分在NAC后对ER+eBC的预后进行分层的有用性，对于HER2-0和HER2低肿瘤。对于ER-eBC，低HER2状态不影响CPS+EG评分的表现，低于单独的病理阶段。
方法：根据CPS-EG评分，回顾性分析608例HER2非扩增eBC患者的预后（无病（DFS）和总生存期OS）。我们比较了低HER2和HER2-0eBC中CPS+EG的预后分层能力，分别分析ER+和ER-肿瘤。
结果：在ER+eBC中，CPS+EG评分系统似乎保留了预后价值，在HER2低和HER2-0肿瘤中，通过区分具有显着不同结果的人群（好：得分0-1，差：得分2-3，非常差：得分4-5）。为DFS和OS使用C索引，CPS+EG在ER+eBC中提供了最高的预后信息，尤其是HER2-0肿瘤。相比之下,在ER-EBC中，CPS+EG似乎无法区分不同的结果组，无论是在HER2低或HER2-0肿瘤。在ER-eBC中，病理阶段的DFS和OS的C指数最高，反映了该亚型中残留疾病的主要预后重要性。
结论：HER2低状态不影响CPS+EG评分的预后表现。我们的结果证实了CPS+EG评分在NAC后对ER+eBC的预后进行分层的有用性，对于HER2-0和HER2低肿瘤。对于ER-eBC，低HER2状态不影响CPS+EG评分的表现，低于单独的病理阶段。
