The Residual Cancer Burden index as a valid prognostic indicator in breast cancer after Neoadjuvant chemotherapy

Purpose: The residual cancer burden index (RCB) was proposed as a response evaluation criterion in breast cancer patients treated with Neoadjuvant chemotherapy (NAC). This study evaluated the relevance of RCB with replase-free survival (RFS). Methods: The clinical data of 254 breast cancer patients who received NAC between 2016 and 2020 were retrospectively collected. The relationship between clinicopathologic factors and RFS was evaluated using Cox proportional hazards regression models. RFS estimates were determined by Kaplan-Meier(K-M) analysis and compared using the log-rank test. Multivariate logistic regression analysis was used to evaluate the risk factors associated with RCB 0.Receiver operating characteristic (ROC) curves showed the potential of the RCB and MP grading systems as biomarkers for RFS. Results: At a median follow-up of 26 months, 42 patients(16.5%) developed relapse. Multivariate Cox regression showed that older age (P=0.007), high Ki-67 expression (P=0.015) and a high RCB score(P=0.001) were risk factors for relapse. The outcomes of the multivariate logistic analysis indicated that RCB 0 (pathologic complete response [pCR]) was associated with HER-2-positive patients (P=0.002) and triple-negative breast cancer (TNBC) patients (P=0.009).In addition, the RCB and MP scoring systems served as prognostic markers for patients who received NAC, and their areas under the curve (AUCs) were 0.711 and 0.682, respectively. Conclusion: These data suggest that RCB can be equally applied to predict RFS in Chinese patients with NAC, which may guide the selection of treatment strategies.