{"title":"早期宫颈癌患者术后复发的预测因素：一项meta分析。","authors":"Weili Hou, Yaru Ma, Suli Sun, Yanlei Gao, Jia Ling, Rui Shi","doi":"10.3389/fsurg.2025.1588558","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early-stage cervical cancer generally has a favorable prognosis with treatment, yet recurrence remains a significant risk for a subset of patients. Identifying reliable prognostic factors can help refine risk stratification, optimize follow-up strategies, and guide adjuvant therapy decisions. This meta-analysis evaluates the association between key prognostic factors-tumor diameter, HPV status, depth of invasion, LVSI status, and positive lymph nodes-and recurrence risk in early-stage cervical cancer.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Embase, Cochrane Library, and Scopus was conducted to identify studies assessing the relationship between prognostic factors and recurrence in early-stage cervical cancer. Studies meeting predefined inclusion criteria were selected, and data were extracted on patient demographics, tumor characteristics, and recurrence outcomes. The NOS was used to assess study quality. Pooled ORs with 95% CIs were calculated using both fixed-effects and random-effects models, with heterogeneity and publication bias assessed through I² statistics and funnel plot analysis, respectively.</p><p><strong>Results: </strong>A total of 10 studies were included in the meta-analysis. Tumor diameter >4 cm (OR = 2.49; 95% CI: 1.69-3.69), depth of invasion >1/2 (OR = 2.82; 95% CI: 1.66-4.80), LVSI positivity (OR = 2.54; 95% CI: 1.36-4.73), and positive lymph nodes (OR = 2.86; 95% CI: 1.99-4.11) were all significantly associated with an increased risk of recurrence. However, HPV-positive status showed no consistent association with recurrence risk (OR = 2.12; 95% CI: 0.31-14.52), likely due to high heterogeneity among the studies (I² = 86%). Sensitivity analyses confirmed the robustness of the results, and publication bias was minimal.</p><p><strong>Conclusion: </strong>This meta-analysis identified tumor diameter >4 cm, depth of invasion >1/2, LVSI positivity, and positive lymph nodes as significant prognostic factors for recurrence in early-stage cervical cancer. These findings underscore the importance of comprehensive assessment in clinical practice to better identify high-risk patients who may benefit from intensified monitoring or adjuvant therapies. Further research, particularly on the role of HPV status, is needed to enhance the predictive accuracy of recurrence risk models.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024599867, PROSPERO CRD42024599867.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1588558"},"PeriodicalIF":1.6000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222122/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictive factors for postoperative recurrence in early cervical cancer patients: a meta-analysis.\",\"authors\":\"Weili Hou, Yaru Ma, Suli Sun, Yanlei Gao, Jia Ling, Rui Shi\",\"doi\":\"10.3389/fsurg.2025.1588558\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early-stage cervical cancer generally has a favorable prognosis with treatment, yet recurrence remains a significant risk for a subset of patients. Identifying reliable prognostic factors can help refine risk stratification, optimize follow-up strategies, and guide adjuvant therapy decisions. This meta-analysis evaluates the association between key prognostic factors-tumor diameter, HPV status, depth of invasion, LVSI status, and positive lymph nodes-and recurrence risk in early-stage cervical cancer.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Embase, Cochrane Library, and Scopus was conducted to identify studies assessing the relationship between prognostic factors and recurrence in early-stage cervical cancer. Studies meeting predefined inclusion criteria were selected, and data were extracted on patient demographics, tumor characteristics, and recurrence outcomes. The NOS was used to assess study quality. Pooled ORs with 95% CIs were calculated using both fixed-effects and random-effects models, with heterogeneity and publication bias assessed through I² statistics and funnel plot analysis, respectively.</p><p><strong>Results: </strong>A total of 10 studies were included in the meta-analysis. Tumor diameter >4 cm (OR = 2.49; 95% CI: 1.69-3.69), depth of invasion >1/2 (OR = 2.82; 95% CI: 1.66-4.80), LVSI positivity (OR = 2.54; 95% CI: 1.36-4.73), and positive lymph nodes (OR = 2.86; 95% CI: 1.99-4.11) were all significantly associated with an increased risk of recurrence. However, HPV-positive status showed no consistent association with recurrence risk (OR = 2.12; 95% CI: 0.31-14.52), likely due to high heterogeneity among the studies (I² = 86%). Sensitivity analyses confirmed the robustness of the results, and publication bias was minimal.</p><p><strong>Conclusion: </strong>This meta-analysis identified tumor diameter >4 cm, depth of invasion >1/2, LVSI positivity, and positive lymph nodes as significant prognostic factors for recurrence in early-stage cervical cancer. These findings underscore the importance of comprehensive assessment in clinical practice to better identify high-risk patients who may benefit from intensified monitoring or adjuvant therapies. Further research, particularly on the role of HPV status, is needed to enhance the predictive accuracy of recurrence risk models.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024599867, PROSPERO CRD42024599867.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"12 \",\"pages\":\"1588558\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-06-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222122/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2025.1588558\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1588558","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Predictive factors for postoperative recurrence in early cervical cancer patients: a meta-analysis.
Background: Early-stage cervical cancer generally has a favorable prognosis with treatment, yet recurrence remains a significant risk for a subset of patients. Identifying reliable prognostic factors can help refine risk stratification, optimize follow-up strategies, and guide adjuvant therapy decisions. This meta-analysis evaluates the association between key prognostic factors-tumor diameter, HPV status, depth of invasion, LVSI status, and positive lymph nodes-and recurrence risk in early-stage cervical cancer.
Materials and methods: A systematic search of PubMed, Embase, Cochrane Library, and Scopus was conducted to identify studies assessing the relationship between prognostic factors and recurrence in early-stage cervical cancer. Studies meeting predefined inclusion criteria were selected, and data were extracted on patient demographics, tumor characteristics, and recurrence outcomes. The NOS was used to assess study quality. Pooled ORs with 95% CIs were calculated using both fixed-effects and random-effects models, with heterogeneity and publication bias assessed through I² statistics and funnel plot analysis, respectively.
Results: A total of 10 studies were included in the meta-analysis. Tumor diameter >4 cm (OR = 2.49; 95% CI: 1.69-3.69), depth of invasion >1/2 (OR = 2.82; 95% CI: 1.66-4.80), LVSI positivity (OR = 2.54; 95% CI: 1.36-4.73), and positive lymph nodes (OR = 2.86; 95% CI: 1.99-4.11) were all significantly associated with an increased risk of recurrence. However, HPV-positive status showed no consistent association with recurrence risk (OR = 2.12; 95% CI: 0.31-14.52), likely due to high heterogeneity among the studies (I² = 86%). Sensitivity analyses confirmed the robustness of the results, and publication bias was minimal.
Conclusion: This meta-analysis identified tumor diameter >4 cm, depth of invasion >1/2, LVSI positivity, and positive lymph nodes as significant prognostic factors for recurrence in early-stage cervical cancer. These findings underscore the importance of comprehensive assessment in clinical practice to better identify high-risk patients who may benefit from intensified monitoring or adjuvant therapies. Further research, particularly on the role of HPV status, is needed to enhance the predictive accuracy of recurrence risk models.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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