Haiyan Zhang1, Wei Peng2, Yangde Zhang2. 1. National Hepatobiliary and Enteric Surgery Research Centre, Changsha, Hunan Province, China zhanghaiyan_nhec@163.com. 2. National Hepatobiliary and Enteric Surgery Research Centre, Changsha, Hunan Province, China.
Abstract
OBJECTIVE: To investigate if the administration of neoadjuvant chemotherapy (NACT) reduces pelvic lymph node metastasis by inducing tumour cell apoptosis in patients with cervical cancer. METHODS: This study enrolled patients with stage Ib2-IIb cervical cancer who underwent surgery with (NACT group) or without (control group) prior cisplatin-based chemotherapy. Immunohistochemical staining of caspase-3 and an in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling assay were used to measure the levels of apoptosis in primary tumours and pelvic lymph nodes. RESULTS: A total of 185 patients participated in the study: 102 in the NACT group and 83 in the control group. Treatment was considered to be clinically effective in 69.6% (71/102) of the NACT group. The rate of metastasis in the NACT group (20.6%; 21/102) was significantly lower than the control group (42.2%; 35/83). The level of caspase-3 immunostaining and the rate of apoptosis in primary tumours and pelvic lymph nodes in the NACT group were significantly higher than in the control group. CONCLUSIONS: NACT appeared to limit pelvic node metastasis by inducing tumour cell apoptosis in patients with cervical cancer.
OBJECTIVE: To investigate if the administration of neoadjuvant chemotherapy (NACT) reduces pelvic lymph node metastasis by inducing tumour cell apoptosis in patients with cervical cancer. METHODS: This study enrolled patients with stage Ib2-IIb cervical cancer who underwent surgery with (NACT group) or without (control group) prior cisplatin-based chemotherapy. Immunohistochemical staining of caspase-3 and an in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling assay were used to measure the levels of apoptosis in primary tumours and pelvic lymph nodes. RESULTS: A total of 185 patients participated in the study: 102 in the NACT group and 83 in the control group. Treatment was considered to be clinically effective in 69.6% (71/102) of the NACT group. The rate of metastasis in the NACT group (20.6%; 21/102) was significantly lower than the control group (42.2%; 35/83). The level of caspase-3 immunostaining and the rate of apoptosis in primary tumours and pelvic lymph nodes in the NACT group were significantly higher than in the control group. CONCLUSIONS:NACT appeared to limit pelvic node metastasis by inducing tumour cell apoptosis in patients with cervical cancer.