关于新辅助化疗（NAC）后剩余癌症负担与患者预后的研究非常有限。本研究通过评估NAC后残留疾病的患者生存情况，旨在确定具有不同预后的亚人群。我们回顾性研究了2010年至2017年接受NAC治疗的728名患者。根据分期系统，患者根据术后残留疾病被分为四个亚组：病理完全缓解（pCR）组（ypT0/TisN0），最小残余病（MRD）组（ypT1mi/T1aN0或ypT0/Tis ypN0i+/N1mic），仅淋巴结pCR组（≥ ypT1b ypN0）和仅乳腺pCR组（ypT0/Tis ≥ ypN1a）。根据调整影响生存的因素，分析了临床病理特征和生存结果。总体而言，50.4%（n = 367）的患者达到了pCR，MRD组占16.5%（n = 120）。尽管年龄和临床分期在研究组间没有差异，但组织学分级、亚型、化疗反应和局部治疗存在差异。事件无病生存（EFS）和总生存（OS）在pCR组和MRD组之间没有显著差异。在多元分析中，pCR状态是EFS中唯一的显著因素，pCR组和MRD组之间没有统计学差异。然而，临床分期、pCR状态和亚型对OS产生了显著影响。除了三阴性乳腺癌亚型（TNBC）患者外，MRD在所有亚型中显示出有利的EFS和OS结果。MRD患者的结果与达到pCR的患者相当，并可能成为削减NAC后治疗的候选者，除了TNBC亚型患者。© 2023年。外科肿瘤学会。

Few studies have reported on patient prognosis according to residual cancer burden after neoadjuvant chemotherapy (NAC). Herein, we evaluated the survival of patients based on residual disease after NAC to identify subpopulations with distinct prognoses.We retrospectively reviewed 728 patients treated with NAC from 2010 to 2017. Patients were divided into four subgroups depending on post-surgical residual disease according to the staging system: pathological complete response (pCR) (ypT0/TisN0), minimal residual disease (MRD) (ypT1mi/T1aN0 or ypT0/Tis ypN0i+/N1mic), node-only pCR (≥ ypT1b ypN0), and breast-only pCR (ypT0/Tis ≥ ypN1a). Clinicopathological characteristics and survival outcomes were analyzed by adjusting for factors affecting survival.Overall, 50.4% (n = 367) of patients achieved pCR, with the MRD group accounting for 16.5% (n = 120). Although age and clinical stage were not different among the study groups, histologic grade, subtypes, chemotherapy response, and local treatment showed differences. Event-free survival (EFS) and overall survival (OS) demonstrated no significant difference between the pCR and MRD groups. In the multivariate analysis, pCR status was the only significant factor in EFS, and no statistical difference was noted between the pCR and MRD groups. However, clinical stage, pCR status, and subtype significantly affected the OS. MRD showed favorable outcomes in terms of both EFS and OS in all subtypes, except for those with triple-negative breast cancer (TNBC).Patients with MRD showed outcomes comparable to those of patients who achieved pCR and may be candidates for de-escalation of post-NAC treatment, except for those with a TNBC subtype.© 2023. Society of Surgical Oncology.