Relationships between Histopathology Type and Neoadjuvant Chemotherapy Response for Cervical Cancer Stage IB2 and IIA2

  • Syamel Muhammad Department of Obstetrics and Gynecology, Andalas University, Dr M. Djamil General Hospital, Padang, Indonesia
  • Jamsari Jamsari Department of Biotechnology, Andalas University, Padang, Indonesia
  • Netti Suharti Department of Biotechnology, Andalas University, Padang, Indonesia
  • Yudi Mulyana Hidayat Department of Obstetrics and Gynecology, Padjadjaran University, Bandung, Indonesia
  • Gistin Husnul Khatimah Department of Obstetrics and Gynecology, Andalas University, Dr M. Djamil General Hospital, Padang, Indonesia
Keywords: Histopathology, Chemotherapy, Cervical cancer


BACKGROUND: Cervical cancer was the fourth common women cancer in the world and the second most in Indonesia. Chemotherapy has been evaluated as a therapy strategy to treat cervical cancer stage IB2 and IIA2 prior the radical hysterectomy. Neoadjuvant chemotherapy was still being a controversy for the chemotherapy resistance patient and will delay the definitive therapy. A marker is needed to identify patient which more relatively resistant to chemotherapy. Squamous cell carcinoma (SCC) type was known to have a better response to neoadjuvant chemotherapy than non-SCC (nSCC) type, but they are no studies at Dr. M. Djamil Padang General Hospital yet on this matter before.

OBJECTIVE: The objectives of the study were to obtain the relationship between histopathology type and neoadjuvant chemotherapy response for cervical cancer stage IB2 and IIA2.

METHODS: This cohort analytic study conducted at Dr. M Djamil Padang Hospital which obtained 35 samples of stage IB2 and IIA2 cervical cancer patients whom treated with neoadjuvant chemotherapy. Results of histopathology are based on biopsy at diagnosis done for cervical cancer and chemotherapy response is based on transrectal ultrasound examinations before and after given neoadjuvant chemotherapy with response evaluation criteria in solid tumors criteria.

RESULTS: Complete response and partial response in the SCC and nSCC group were 32%–50%, while stable disease (SD) and progressive disease were 68% in the SCC group to 50% in the nSCC group.

CONCLUSION: There was no significant relationship between histopathological type and neoadjuvant chemotherapy response for cervical cancer stage IB2 and IIA2 (p = 0.44).


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Capote G, Negrin L. Epidemiology of cervical cancer in Latin America. Ecancermedicalscience 2015;9:1-14. https://doi. org/10.3332/ecancer.2015.577 PMid:26557875

HPV Infermation Centre. Human Papillomavirus and Related Diseases Report. HPV Infermation Centre; 2019.

Ministry of Health. Indonesia Health Profile 2009. Indonesia: Ministry of Health; 2009.

Wang PH, Chang YH, Yang YH, Chang WH, Huang SY, Lai CR, et al. Outcome of Patients with bulky IB ( Huang SY, Lai CRmerica. Ecancermedicalscienceherapy is needed, as degree of tumor differentiation and tumor vascularizatio 2014;53(3):330- 6. PMid:25286786

McCormack M, Colombo N, Landoni F, Marth C, Gonzalez- Martin A, Mahner S. Cervical cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017;28(Suppl 4):iv72-83. mdx220 PMid:28881916

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics in 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424. https:// PMid:30207593

Fajriah RA. Distribution overview histopathology cervix uteri cancer patients at hospital Dr. Zainoel Abidin Banda Aceh. SyahKuala Medical Journal 2013;13:1-5.

Shen Y, Yang L, Wang Z. Treatment of early bulky cervical cancer with neoadjuvant paclitaxel, carboplatin and cisplatin prior to laparoscopical radical hysterectomy and pelvic lymphadenectomy. Oncol Lett 2012;3(3):641-5. https://doi. org/10.3892/ol.2011.529 PMid:22740967

Shirali E, Yarandi D, Behtash N, Hemmati O. Neoadjuvant chemotherapy in cervical cancer: A review article. J Obstet Gynecol Cancer Res 2018;3(2):87-91.

He L, Wu L, Su G, Wei W, Liang L, Han L, et al. The efficacy of neoadjuvant chemotherapy in different histological types of cervical cancer. Gyncologic Oncology, 134 (2): 419-425. PMid:24918866

Taneja A, Rajaram S, Agarwal S, Singh KC, Sahni S, Goel N. Cinoma of cervix carcinoma. Indian Journal of Pharmacology 2005;37(5):320-4.

Were EM, Mwaka AD, Roland M, Wabinga H, Orach CG, Lyratzopoulos G. Awareness of cervical cancer risk factors and symptoms: A cross-sectional community surveys in post-conflict northern Uganda. Expect Health 2015;19:854-67. https://doi. org/10.1111/hex.12382

Ca Rasjidi IC. Epidemiology. Indones J Cancer 2009;3(3):103-8.

Hidayat E. Cervical cancer incidence relations with the amount of parity. J Med Health Indones 2014;6(3):128-36.

Wulandari V. Relations risk factors oral contraceptive use and sexual activity with cervical cancer incidence. Jurnal Berkala Epidemiologi 2015;1:432-42.

World Health Organization. State of the Art of the New Vaccine and Development. World Health Organization; 2006. p. 1-112.

Ashlesha D, Gupta N. Diagnosis and treatment of cervical cancer: A review. J Nurs Sci Health 2016;2(3):1-11.

Rahayu AA. Inveksi human papilloma virus (HPV) and its prevention in adolescents and young adults. Andalas Medical Journal 2010;2(2):81-8.

Kelloff GJ, Sigman CC. Assessing intraepithelial neoplasia and drug safety in cancer-preventive drug development. Nat Rev Cancer 2007;7(7):508-18. PMid:17568791

Parkin DM. The global health burden of infection-associated cancers in the year 2002. 2006;3044:3030-44. https://doi. org/10.1002/ijc.21731 PMid:16404738

Hacker NF, Vermoken JB. Cervical cancer. In: Berek JS, editor. Berek and Hacker’s Gynecologic Oncology. 6th ed. Philadephia, PA: Wolters Kluwer Health, Lippincott Williams & Wilkins; 2015.

Burd EM. Human papillomavirus and cervical cancer. Clinical Microbiology Review 2003;16(1):1128. cmr.16.1.1-17.2003

Shepherd LJ, Bryson SC. Human papillomavirus-lessons from history and challenges for the future. J Obstet Gynaecol Canada 2008;30(11):1025-33. s1701-2163(16)32997-8 PMid:19126284

Chakrabarti O, Krishna S. Molecular interactions of “high risk” human papillomaviruses E6 and E7 oncoproteins: Implications for tumor progression. J Biosci 2003;28(3):337-48. https://doi. org/10.1007/bf02970152 PMid:12734411

Guidelines CP. Cervical cancer: ESMO clinical practice guidelines for clinical practice guidelines. Ann Oncol 2017;28(Suppl 4):72-83. PMid:28881916

Bosch FX, Munoz N. The viral etiology of cervical cancer. Virus Res 2002;89(2):183-90. s0168-1702(02)00187-9 PMid:12445658

Obrzut B, Cush M, Semczuk A, Obrzut M, Kluska J. Prediction of the 5-year overall survival in cervical cancer treated with radical hysterectomy Patients using computational intelligence methods. BMC Cancer 2017;17(1):840. s12885-017-3806-3 PMid:29233120

Lapresa M, Parma G, Portuesi R, Colombo N. Neoadjuvant chemotherapy in cervical cancer: An update. Expert Rev Anticancer Ther 2015;15(10):1171-81. 4737140.2015.1079777 PMid:26402247

Khatun S, Sharmin F, Ferdous J. Role of neoadjuvant chemotherapy in the treatment of cervical cancer: A case series of thirty-eight patients treated at Bangabandhu Sheikh Mujib medical University in Dhaka, Bangladesh. Open J Obestet Gynecol 2018;8:446-55. ojog.2018.85051

Sardi J, Sananes C, Giaroli A, Bayo J, Rueda NG, Vighi S, et al. Results of a prospective randomized trial with neoadjuvant chemotherapy in stage Ib, bulky, squamous carcinoma of the cervix. Gynecol Oncol 1993;49(2):156-65. https://doi. org/10.1006/gyno.1993.1100 PMid:7684993

Mahajan NN. Neoadjuvant chemotherapy for locally advanced cervical carcinoma. Int J Gynecol Cancer 2009;19(1):174. PMid:19258963

Follen M, Levenback CF, Iyer RB, Grigsby PW, Boss EA, Delpassand ES, et al. Imaging in cervical cancer. Cancer 2003;98(9 Suppl):2028-38.

Seiwert TY, Salama JK, Vokes EE. The concurrent chemoradiation paradigm general principles. Nat Clin Pract Oncol 2007;4(2):86-100. PMid:17259930

Haryani S, Defrin D, Yenita Y. Parity based cervical cancer prevalence in the department. Dr. M. Djamil Padang period of January 2011-December 2012. J Kesehat Andalas 2016;5(3):647-52.

Nuranna L, Prastasari R, Sutrisna B. Survival of cervical cancer and its prognostic factors at Cipto Mangunkusumo Hospital, Jakarta. Med J Indones 2014;23(3):163-8. https://doi. org/10.13181/mji.v23i3.739

Herlana F, Nur IM, Purbaningsih W. Cervical cancer patient characteristics based on age, parity, and a description of histopathology at Al-Ihsan Bandung hospital characteristics of cervical cancer patients base on age, parity and histopathologic pattern in Al-Ihsan Bandung regional hospital. 2017;1(22):138-42.

Prandana DA, Rusda M. Cervical cancer patients at Adam Malik hospital in 2011. E-J FK USU 2013;1(2):2011-4.

Achmadi T, Suhatno BA. Characteristics of patients with cervical cancer 2006- 2010 in dr. soetomo. Maj Ginekol Obstet 2011;19(3):128-33.

Hapsari K. Lymphocytes on cervical cancer squamous cell carcinoma abstract type. 2014;1(2):112-6.

Hapsari BK. Relationship between cell death by vascularity and lymphocyte reaction on cervical cancer squamous cell carcinoma type. 2015;1(2):112-6.

Tomao F, Papa A, Rossi L, Zaccarelli E, Caruso D, Zoratto F, et al. Angiogenesis and antiangiogenic agents in cervical cancer. Onco Ther Targets 2014;7:2237-48. s68286 PMid:25506227

Poujade O, Morice P, Rouzier R, Madelenat P, Lecuru F, Muray JM, et al. Pathologic response rate after concomitant neo-adjuvant radiotherapy and chemotherapy for adenocarcinoma of the uterine cervix: A retrospective multicentric study. Int J Gynecol Cancer 2010;20(5):815-20. PMid:20606528

Alexander-Sefre F, Singh N, Ayhan A, Salveson HB, Wilbanks G, Jacobs IJ. Detection of tumour lymphovascular space invasion using dual cytokeratin and CD31 immunohistochemistry. J Clin Pathol 2003;56(10):786-8. PMid:14514787

Zhu PF, Ou YJ, Dong YH, Xu PZ, Yuan L. Expression of VEGF and HIF-Iα in locally advanced cervical cancer: Potential biomarkers for predicting preoperative radiochemotherapy sensitivity and prognosis. Onco Ther Targets 2016;9:3031-7. PMid:27284254

Pirhonen JP, Grenman SA, Bredbacka AB, Bahado-Singh RO, Salmi TA. Effects of external radiotherapy on uterine blood flow in Patients with advanced cervical carcinoma assessed by color Doppler ultrasonography. Cancer 1995;76(1):67-71.<67::aid-cncr2820760109>;2-0 PMid:8630878

Endo D, Todo Y, Okamoto K, Minobe S, Kato HN. Nishiyama prognostic factors for Patients with cervical cancer treated with concurrent chemoradiotherapy: A retrospective analysis in a Japanese cohort. J Gynecol Oncol 2014;26(1):12-8. https://doi. org/10.3802/jgo.2015.26.1.12 PMid:25310853

Foster FS, Burns PN, Simpson DH, Wilson SR, Christopher DA, Goertz DE. Ultrasound for the visualization and Quantification of tumor microcirculation. Cancer Metastasis Rev 2000;19(1-2):131-8. PMid:11191052

Irie T, Kigawa J, Minagawa Y, Itamochi H, Sato S, Akeshima R, et al. Prognosis and clinicopathological characteristics of IbYIIb adenocarcinoma of the uterine cervix in Patients who have had radical hysterectomy. Eur J Surg Oncol 2000;26(5):464-7. PMid:11016467

Baalbergen A, Ewing-Graham PC, Hop WC, Struijk P, Helmerhorst TJ. Prognostic factors in adenocarcinoma of the uterine cervix. Gynecol Oncol 2004;92(1):262-7. PMid:14751169

Hsieh FJ, Chen CA, Cheng WF, Hsieh CY, Lee CN, Su YN. Power Doppler vascularity index for predicting the response of neoadjuvant chemotherapy in cervical carcinoma. Acta Obstet Gynecol Scand 2004;83(6):591-7. https://doi. org/10.1111/j.0001-6349.2004.00522.x 512 PMid:15144343

Donnelly EF, Yankeelov TE, Hallahan DE, Fleischer AC, Niermann KJ, Yankeelov TE, et al. Sonographic depiction of microvessel perfusion. J Ultrasound Med 2017;23(11):1499- 506. PMid:15498915

Bogani G, Ditto A, Martinelli F, Signorelli F, Chiappa V, Lopez C, et al. Impact of blood transfusions on survival of locally advanced cervical cancer patients undergoing radical neoadjuvant chemotherapy plus radical surgery. Int J Gynecol Cancer 2017;27(3):514-22. igc.0000000000000902 PMid:28129238

Alcd:15 JL, Castillo G, Martínez-Monge R, Jurado M. Transvaginal color Doppler sonography for predicting response to concurrent chemoradiotherapy for locally advanced cervical carcinoma. J Clin Ultrasound 2004;32(6):267-72. https://doi. org/10.1002/jcu.20033 PMid:15211671

Couvreur K, Naert E, De Jaeghere E, Tummers P, Makar A, De Visschere P, et al. Neo-adjuvant treatment of adenocarcinoma and squamous cell carcinoma of the cervix significantly different results in pathological complete response rates. BMC Cancer 2018;18:1101.

Wang J, Wang T, Yang YY, Chai YL, Shi F, Liu ZI. Patient age, tumor appearance and tumor size are risk factors for early recurrence of cervical cancer. Mol Clin Oncol 2015;3(2):363-6. PMid:25798268

Modares de Azevedo CR, Thuler LC, de Mello MJ, de Oliveira Lima JT, da Fonte AL, Fontão DF, et al. Phase II trial of neoadjuvant chemotherapy Followed by chemoradiation in locally advanced cervical cancer. Gynecol Oncol 2017;146(3):560-5. https://doi. org/10.26226/morressier.5770e29ad462b80290b4ba16 PMid:28709705

Osman M. The role of neoadjuvant chemotherapy in the management of locally advanced cervical cancer: A systematic review of commercial use on commercial use. Oncol Rev 2014;8(2):250. PMid:25992238

How to Cite
Muhammad S, Jamsari J, Suharti N, Hidayat YM, Khatimah GH. Relationships between Histopathology Type and Neoadjuvant Chemotherapy Response for Cervical Cancer Stage IB2 and IIA2. Open Access Maced J Med Sci [Internet]. 2020Jun.15 [cited 2020Oct.23];8(B):507-13. Available from: