title: A risk score to predict disease-free survival in patients not achieving a pathological complete remission after preoperative chemotherapy for breast cancer.
abstract: BACKGROUND
  We aimed to predict disease-free survival (DFS) in patients who failed to achieve a pathologic complete remission (pCR) after preoperative chemotherapy (PC).
  
  
  METHODS
  Data from 577 patients treated with PC and operated at the European Institute of Oncology (EIO) were used to develop a nomogram using Cox proportional hazards regression model based on both categorical (pT, positive nodes, human epidermal growth factor receptor 2 (HER2) status, vascular invasion) and continuous histological variables (estrogen receptors and Ki-67 expression) at surgery. The nomogram was tested on a second patient cohort (343 patients) treated in other institutions and subsequently operated at the EIO.
  
  
  RESULTS
  The nomogram for DFS based on both categorical and continuous variables had good discrimination in the training and the validation sets (concordance indices 0.73, 0.67).
  
  
  CONCLUSIONS
  The use of a nomogram based on the degree of selected histopathological variables can predict DFS and might help in the adjuvant therapeutic algorithm design.
authors.affiliation: Department of Medicine, Division of Medical Oncology, European Institute of Oncology, Milan, Italy. marco.colleoni@ieo.it
authors.forename: M
authors.initials: M
authors.lastname: Colleoni
authors.forename: V
authors.initials: V
authors.lastname: Bagnardi
authors.forename: N
authors.initials: N
authors.lastname: Rotmensz
authors.forename: S
authors.initials: S
authors.lastname: Dellapasqua
authors.forename: G
authors.initials: G
authors.lastname: Viale
authors.forename: G
authors.initials: G
authors.lastname: Pruneri
authors.forename: P
authors.initials: P
authors.lastname: Veronesi
authors.forename: R
authors.initials: R
authors.lastname: Torrisi
authors.forename: A
authors.initials: A
authors.lastname: Luini
authors.forename: M
authors.initials: M
authors.lastname: Intra
authors.forename: V
authors.initials: V
authors.lastname: Galimberti
authors.forename: E
authors.initials: E
authors.lastname: Montagna
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D049451:Nomograms; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D012074:Remission Induction; D012306:Risk; D016896:Treatment Outcome; D055815:Young Adult