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025). Compared to those with RS less then 31, patients with RS ≥ 31 had significantly worse OS (P = 0.025), worse PR-OS (P = 0.026), and a trend of inferior PR-PFS (P = 0.106). Multivariate analysis demonstrated that primary ER expression level (OS P = 0.009; PR-OS P = 0.017) and histological grade (OS P = 0.003; PR-OS P = 0.009), but not primary 21-gene RS (OS P = 0.706; PR-OS P = 0.12, were independently associated with worse OS and PR-OS. Conclusions High primary 21-gene RS tended to be associated with worse disease outcome in loco-re
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