Prognostic Significance of Clinicopathological Factors Influencing Overall Survival and Event-Free Survival of Patients with Cervical Cancer: A Systematic Review and Meta-Analysis

Abstract

Background Cervical cancer (CC) is the most frequent type of cancer among women and its poor prognosis is a main concern, while the prognostic factors for CC have still remained controversial. We conducted this systematic review and meta-analysis to identify the prognostic significance of clinicopathological factors, influencing overall survival (OS), and event-free survival (EFS) of CC patients. Material/Methods The electronic databases of PubMed, EmBase, and the Cochrane library were systematically searched for identification of eligible studies published until June 2021. The pooled hazard ratio (HR) with 95% confidence interval (CI) were calculated using the random-effects model. Sensitivity and subgroup analyses and assessment of publication bias were also conducted. Results We selected 140 studies that involved 47 965 patients for the meta-analysis. The results revealed that age, cell type, depth of tumor invasion, the International Federation of Gynecology and Obstetrics stage, hemoglobin level, histological grade, leukocytosis, lymph node involvement, lymph-vascular space invasion, neutrophil-to-lymphocyte ratio, parametrial invasion, platelet-to-lymphocyte ratio, resection margin, squamous cell carcinoma antigen level, thrombocytosis, tumor grade, tumor size, and tumor volume were clinicopathological factors influencing OS and EFS of CC patients ( P <0.05). Conclusions This study comprehensively identified the prognostic significance of clinicopathological factors, influencing OS, and EFS of CC patients. However, further large-scale prospective studies should be conducted to verify our findings and develop more accurate prognostic models for CC.

Prognostic value of 18F-FDG PET in uterine cervical cancer patients with stage IIICr allocated by imaging

“…In the present study, we have also evaluated the prognostic value and relevance of clinicopathological parameters and combined treatment with the PET and CT ndings. Contrary to the ndings of a metaanalysis 29 , we found no signi cant differences in clinicopathological parameters even for risk factors that have a high impact on survival (such as adenocarcinoma and the presence of parametrial invasion extending to pelvic wall), perhaps due to the small number of patients in the present study. In terms of combined treatment, our results showed that combined brachytherapy or chemotherapy with radiotherapy improved PFS and/or OS, in agreement with previous studies 28, 30 .…”

Prognostic value of 18F-FDG PET in uterine cervical cancer patients with stage IIICr allocated by imaging

“…In the present study, we have also evaluated the prognostic value and relevance of clinicopathological parameters and combined treatment with the PET and CT findings. Contrary to the findings of a meta-analysis 29 , we found no significant differences in clinicopathological parameters even for risk factors that have a high impact on survival (such as adenocarcinoma and the presence of parametrial invasion extending to pelvic wall), perhaps due to the small number of patients in the present study. In terms of combined treatment, our results showed that combined brachytherapy or chemotherapy with radiotherapy improved PFS and/or OS, in agreement with previous studies 28 , 30 .…”

Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women

“…This phenomenon is associated with systemic inflammation and an increase in WBC (Cho et al, 2016). Leukocytosis can be caused by the upregulated expression of hematological growth factors, including granulocyte colony-stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1, IL-6, or tumor necrosis factor (TNF)-α, which are associated with leukemoid reactions (Kang et al, 2022; Madeddu et al, 2022). Hematological growth factors stimulate WBC differentiation for a defensive response.…”