09 March 2022>: Meta-Analysis
Prognostic Significance of Clinicopathological Factors Influencing Overall Survival and Event-Free Survival of Patients with Cervical Cancer: A Systematic Review and Meta-Analysis
Shengwei Kang 12BDE , Junxiang Wu 2C , Jie Li 2F , Qing Hou 1DEF , Bin Tang 2AG*DOI: 10.12659/MSM.934588
Med Sci Monit 2022; 28:e934588
Table 1 The baseline characteristics of included studies.
Study | Country | Study design | Sample size | Age (years) | FIGO stage | Follow-up (years) | Reported outcomes | Prognostic factors | NOS score |
---|---|---|---|---|---|---|---|---|---|
Sevin 1995 []27 | USA | Retro | 301 | 43.5 | I–II | 5.0 | DFS | DI, TS, LVSI, LNI, TV, FIGO, RM, CT, TG, age | 6 |
Werner-Wasik 1995 []28 | USA | Retro | 125 | 55.0 | I–II | 5.0 | DFS | LNI, LVSI, PI, He, TS, FIGO, CT, TG | 5 |
Tsai 1999 []29 | China | Retro | 222 | 50.0 | I–II | 5.0 | DFS | FIGO, TS, age, CT, SCC, He, LNI, PI, LVSI, RM | 6 |
Lai 1999 []30 | China | Retro | 891 | NA | I–II | 5.0 | DFS | TG, FIGO, TS,DI | 7 |
Nakanishi 2000 []31 | Japan | Retro | 509 | 49.3 | I | 9.3 | OS, DFS | CT, LNI, and TS | 6 |
Hernandez 2000 []32 | USA | Retro | 291 | 49.7 | II–IV | 5.0 | PFS | Th, LNI, TS, age, and FIGO | 7 |
Alfsen 2001 []33 | Norway | Retro | 505 | 53.0 | I–IV | 5.0 | OS | CT, LVSI, LNI, and age | 7 |
Flores-Luna 2001 []34 | Mexico | Retro | 378 | 52.2 | I–IV | 12.5 | OS | FIGO, TG, TS, and age | 5 |
Trattner 2001 []35 | Austria | Retro | 113 | 46.1 | I–II | 4.7 | OS | TV, LNI, LVSI, FIGO, PI, RM, CT, TG, and age | 5 |
Yanoh 2001 []36 | Japan | Retro | 751 | 45.0 | I | > 5.0 | DFS | LNI, PI, TS, DI, and LVSI | 6 |
Takeda 2002 []37 | Japan | Retro | 187 | 48.2 | I–II | 6.9 | OS | FIGO, CT, LVSI, TS, DI, PI, and LNI | 6 |
Gasinska 2002 []38 | Poland | Retro | 152 | 55.0 | I–III | 2.2 | OS | Age, TG, and He | 6 |
Martin-Loeches 2002 []39 | Spain | Retro | 114 | 49.1 | I–II | 10.0 | OS | TS, TV, DI | 5 |
Brun 2003 []40 | France | Retro | 308 | 53.0 | I–IV | 7.8 | OS | Age, TG, and PI | 6 |
Morice 2003 []41 | France | Retro | 193 | 37.0 | I–II | 5.0 | OS | FIGO, TS, LVSI, and LNI | 6 |
Kodaira 2003 []42 | Japan | Retro | 164 | 68.0 | II–III | 1.9 | DFS | TV, LNI, and FIGO | 6 |
Grisaru 2003 []43 | Canada | Pro | 871 | 42.1 | I | 4.1 | DFS | LNI, TG, LVSI, RM, and CT | 7 |
Huang 2003 []44 | China | Pro | 157 | 44.0 | I–II | 5.0 | OS, DFS | TS, age, CT | 6 |
Shinohara 2004 []45 | Japan | Retro | 130 | 49.0 | I–II | 14.4 | DFS | LVSI, LNI, and DI | 6 |
Ho 2004 []46 | China | Retro | 197 | 47.4 | I–II | 5.8 | OS, DFS | Age, FIGO, CT, TG, TS, DI, LVSI, LNI, PI | 5 |
Ayhan 2004 []47 | Turkey | Retro | 393 | 48.5 | I | 2.6 | OS, DFS | TS, LVSI, PI, | 6 |
Choi 2006 []48 | Korea | Retro | 85 | 50.0 | I–IV | 3.0 | OS, DFS | Age, CT, FIGO, TS, LNI, SCC, and He | 5 |
Chittithaworn 2007 []49 | Thailand | Retro | 205 | 44.2 | I | 4.7 | DFS | DI, LVSI, RM, and LNI | 5 |
Grigiene 2007 []50 | Lithuania | Retro | 162 | 52.0 | II–III | 2.7 | OS, DFS | FIGO, He | 7 |
Horn 2007 []51 | Germany | Retro | 245 | 43.0 | II | 4.5 | OS | TS, LNI, FIGO | 6 |
Atahan 2007 []52 | Turkey | Retro | 183 | 54.0 | I–III | 3.8 | OS, DFS | Age, PI, FIGO, TS, CT, LNI | 7 |
Garcia-Arias 2007 []53 | Mexico | Retro | 294 | 49.4 | I–IV | 2.3 | OS | Le, He, age, CT, and FIGO | 7 |
Choi 2008 []54 | Korea | Retro | 143 | 58.0 | I–IV | 2.2 | PFS | FIGO, TS | 6 |
Behtash 2009 []55 | Iran | Retro | 203 | 49.8 | I–II | 3.5 | OS, DFS | Age, CT, FIGO, TS, LNI, PI, LVSI, DI | 6 |
Jacobson 2009 []56 | USA | Retro | 436 | 52.3 | I–IV | 8.0 | OS | FIGO, CT | 7 |
Zusterzeel 2009 []57 | Netherlands | Retro | 167 | 42.0 | I–IV | 2.8 | OS, DFS | FIGO, CT, TG, LVSI, DI, TS | 7 |
Polterauer 2010 []58 | Austria | Retro | 88 | 49.9 | I–IV | 3.1 | OS, DFS | FIGO, TG, CT | 7 |
Munagala 2010 []59 | India | Retro | 89 | 46.0 | I–III | 5.0–7.0 | OS, DFS/PFS | Age, FIGO, LNI, PI, CT, TG, and TS | 6 |
Huang 2010 []60 | China | Retro | 960 | 45.0 | I–II | 5.0 | OS | FIGO,SCC, DI, PI | 6 |
Touboul 2010 []61 | France | Retro | 150 | 47.0 | I–IV | 3.6 | OS | FIGO, CT, RM, LNI | 7 |
Horn 2010 []62 | Germany | Retro | 194 | 44.0 | I–II | 5.1 | OS | LNI, TG, FIGO | 6 |
Kodama 2010 []63 | Japan | Retro | 97 | 46.0 | I–II | 8.4 | OS, DFS | Age, FIGO, DI, TS, PI, LVSI, LNI | 5 |
Lee 2010 []64 | Korea | Retro | 134 | 58.0 | II–IV | 3.2 | OS, PFS | FIGO | 5 |
Tseng 2010 []65 | China | Pro | 251 | 48.6 | II–IV | 6.3 | OS | SCC, TS, PI, LNI | 6 |
Nugent 2010 []66 | USA | Retro | 111 | 51.0 | I–IV | 1.4 | OS, PFS | FIGO | 6 |
Srisomboon 2011 []67 | Thailand | Retro | 680 | 44.5 | I | 4.0 | DFS | LNI, LVSI, CT, DI, PI, TG, RM | 6 |
Seamon 2011 []68 | USA | Retro | 381 | 47.0 | I–IV | 3.3 | OS, DFS | FIGO, CT, TG | 7 |
Polterauer 2011 []69 | Austria | Retro | 178 | 49.2 | I–IV | 3.8 | OS, DFS | FIGO, LNI, TG, age, CT | 7 |
Mabuchi 2011 []70 | Japan | Retro/Pro | 536 | 57.5 | I–IV | 6.4 | OS, PFS | Age, FIGO, CT, TS | 6 |
Min 2011 []71 | China | Retro | 88 | NA | I–II | 5.0 | OS | Age, TS, CT, TG, FIGO, LNI | 5 |
Biewenga 2011 []72 | Netherlands | Retro | 710 | 41.0 | I–II | 5.2 | DFS | CT, TG, DI, PI, LNI, LVSI, RM | 7 |
Polterauer 2012 []73 | Austria | Retro | 528 | 47.9 | I–IV | 3.8 | OS | Age, FIGO, TS, CT, LNI, PI | 7 |
Kim 2012 []74 | Korea | Retro | 174 | NA | I–IV | 2.5 | OS, PFS | FIGO, LNI, TS | 6 |
Lee 2012 []75 | Korea | Retro | 1,061 | 50.0 | I–IV | 4.4 | OS, PFS | NLR, FIGO, CT | 7 |
Okazawa 2012 []76 | Japan | Retro | 311 | 51.0 | I–II | 5.2 | PFS | Age, CT, LNI, PI, RM, DI, LVSI, TS, He | 7 |
Wang 2012 []77 | China | Retro | 179 | 47.0 | I–IV | 4.3 | OS, DFS | FIGO, LNI, RM | 6 |
Yan 2012 []78 | China | Retro | 148 | 42.0 | I | 2.3 | OS | Age, CT, TG, TS, DI, LVSI, LNI | 5 |
Cibula 2012 []79 | Czech Republic | Retro | 645 | 46.0 | I–II | 3.3 | OS, DFS | Age, FIGO, PI, LNI | 6 |
Singh 2012 []80 | Australia | Retro | 196 | NA | I–II | 6.1 | OS, DFS | Age, LVSI, LNI, PI, TS, DI | 7 |
Wang 2013 []81 | China | Retro | 424 | NA | I–II | 7.0 | DFS | Age, CT, TG, FIGO, LNI | 5 |
Tsubamoto 2013 []82 | Japan | Retro | 73 | 47.0 | I–II | 5.9 | OS, DFS | Age, FIGO, CT, TS, LNI | 6 |
Song 2013 []83 | Korea | Retro | 268 | 57.0 | I–IV | 5.0 | OS, DFS | FIGO, age, LNI, CT, He | 6 |
Cho 2013 []84 | Korea | Retro | 185 | 50.0 | I–II | 5.9 | DFS | Age, FIGO, LNI, RM, PI, TS, DI, LVSI | 6 |
Zhang 2014 []85 | China | Retro | 460 | 44.0 | I–II | 5.8 | OS, PFS | FIGO, LNI, NLR | 7 |
Horn 2014 []86 | Germany | Retro | 366 | 40.0 | I | 7.8 | OS, DFS | TS, LNI, TG | 7 |
Noh 2014 []87 | Korea | Retro | 1,323 | 50.0 | I–II | 6.3 | OS, DFS | CT, age, FIGO, TS, LNI, PI, LVSI, DI, RM | 7 |
Yu 2014 []88 | China | Retro | 153 | NA | II | 5.0 | DFS | TS, LVSI, LNI | 6 |
Liu 2014 []89 | China | Retro | 184 | 46.0 | I–II | 5.8 | OS, DFS | Age, TS, CT, TG, FIGO, DI, LVSI, LNI | 6 |
Kawano 2015 []90 | Japan | Retro | 286 | 63.6 | I–IV | 6.7 | OS | Age, FIGO, PNI, CT, TS, He, Th | 7 |
Ruengkhachorn 2015 []91 | Thailand | Retro | 331 | 48.6 | I–II | 7.0 | DFS | He, CT, FIGO, PNI, PI, RM, DI, LVSI | 6 |
Bradbury 2015 []92 | UK | Retro | 92 | 39.5 | I | 4.8 | OS, PFS | Age, TS, CT, TG, LVSI, LNI, RM | 7 |
Yuan 2015 []93 | China | Retro | 38 | 40.4 | I–II | 5.0 | OS, DFS | PI | 6 |
Mizunuma 2015 []94 | Japan | Retro | 56 | 65.1 | I–IV | 6.7 | OS, PFS | FIGO, TS, He, NLR | 6 |
Endo 2015 []95 | Japan | Retro | 84 | 62.0 | I–IV | 6.7 | OS | Age, CT, He, TS, LNI | 6 |
Zhao 2015 []96 | China | Retro | 220 | NA | I–II | 5.0 | OS, DFS | Age, FIGO, TG, CT, DI, TS, LNI | 7 |
Takatori 2015 []97 | Japan | Retro | 33 | 42.0 | I–II | 2.8 | OS | Age, FIGO, TS, SCC | 5 |
Huang 2016 []98 | China | Retro | 643 | NA | I–II | 3.1 | OS, DFS | Age, CT, TG, TS, FIGO, DI, LVSI, LNI, PI, RM | 7 |
Li 2016 []99 | China | Retro | 347 | 51.6 | I–II | 3.1 | OS, DFS | Age, CT, FIGO, TG, DI, LVSI, RM, LNI, PI, SCCA | 7 |
Cho 2016 []100 | Korea | Retro | 2,456 | 56.0 | I–IV | 5.4 | OS, DFS | Age, FIGO, CT, TS, LNI, He, Le, NLR | 7 |
Matsumiya 2016 []101 | Japan | Retro | 54 | 55.0 | I–IV | 1.0 | OS | CT | 6 |
Usami 2016 []102 | Japan | Retro | 111 | 51.0 | I–IV | 1.4 | OS | Age, CT | 6 |
Chen 2016 []103 | China | Retro | 407 | 44.0 | I–II | 5.0 | OS, DFS | Age, CT, TG, DI, LVSI, LNI, FIGO, PI, PLR, NLR | 6 |
Oishi 2016 []104 | Japan | Retro | 85 | 55.0 | IV | 0.8 | OS | Age, CT, TS, TG, He, SCC | 5 |
Onal 2016 []105 | Turkey | Retro | 235 | 57.0 | I–IV | 5.8 | OS, PFS | Age, FIGO, TS, LNI, NLR | 7 |
Wu 2016 []106 | USA | Retro | 71 | 49.0 | I–IV | 2.1 | OS, PFS | FIGO, CT, TG | 6 |
Xia 2016 []107 | China | Retro | 274 | 43.0 | I–II | 2.4 | OS, DFS | Age, FIGO, CT, TS, TG, DI, LVSI, RM, PI, LNI | 6 |
Lee 2017 []108 | Korea | Retro | 231 | 58.0 | I–IV | 2.3 | OS, PFS | Age, LNI, FIGO, SCC, TV | 7 |
Barquet-Muñoz 2017 []109 | Mexico | Retro | 202 | 49.5 | I–II | 5.0 | OS, DFS | Age, CT, TS, DI, LVSI, RM, PI, LNI | 6 |
Jung 2017 []110 | Korea | Retro | 1,113 | 48.7 | I–II | 7.6 | OS, DFS | CT, FIGO, TS, DI, LNI, LVSI, PI, RM | 7 |
Chung 2017 []111 | Korea | Retro | 103 | 48.0 | I–II | 2.4 | PFS | FIGO, TS, LNI, PI, DI, LVSI | 5 |
Zheng 2017 []112 | China | Retro | 795 | 49.5 | I–II | 5.2 | OS | FIGO, He, TG, LVSI, LNI, TS, PI, RM | 6 |
Obrzut 2017 []113 | Poland | Pro | 102 | 48.0 | I–II | 10.0 | OS, DFS | FIGO, CT, TG, LNI, LVSI, RM | 6 |
Cho 2017 []114 | Korea | Retro | 105 | NA | II | 4.8 | PFS | Age, CT, TS, LNI, NLR | 5 |
Chandeying 2017 []115 | Thailand | Retro | 626 | 45.0 | I | 7.7 | OS, DFS | CT, age, TS, FIGO, RM, PI, LNI, LVSI, DI | 7 |
Yokoi 2017 []116 | Japan | Retro | 249 | 61.5 | II–IV | 5.0 | PFS | Age, FIGO, LNI, CT, He | 7 |
Lim 2017 []117 | Korea | Retro | 180 | NA | I–II | 5.0 | OS, DFS | PI, LNI | 5 |
Xu 2018 []118 | China | Retro | 40 | 45.5 | I–IV | 5.0 | OS | Age, FIGO, LNI, LVSI, DI, TS | 6 |
Wen 2018 []119 | China | Retro | 99 | NA | II–IV | 4.0 | DFS | Age, TS, CT, FIGO, SCC, PI | 6 |
Joo 2018 []120 | Korea | Retro | 397 | 45.0 | I–II | 4.0 | OS, DFS | CT, FIGO, LNI, PI, LVSI, DI, TS | 6 |
Dai 2018 []121 | China | Retro | 302 | 45.1 | I–II | 5.0 | OS | FIGO, TS, TG, DI, LVSI, PI, LNI | 6 |
Zhu 2018 []122 | China | Retro | 365 | 45.0 | I–II | 3.7 | OS, PFS | Age, DI, LNI, LVSI, PI | 5 |
Zhou 2018 []123 | China | Retro | 312 | 46.0 | I–II | 4.7 | OS, DFS | Age, FIGO, TS, TG, DI, LVSI, LNI | 5 |
Liu 2018 []124 | China | Retro | 98 | 52.0 | I–III | 3.1 | OS, PFS | TS, LNI | 5 |
Xie 2018 []125 | China | Retro | 810 | 46.3 | I–II | 5.0 | OS | FIGO, LNI | 5 |
Taarnhøj 2018 []126 | Denmark | Retro | 1,523 | NA | I | 5.0 | DFS | FIGO, CT, age, DI, LVSI | 6 |
Zhang 2018 []127 | China | Retro | 235 | 46.0 | I–II | 6.4 | OS, PFS | Age, FIGO, TS, CT, LVSI, LNI, DI, NLR | 7 |
Je 2018 []128 | Korea | Retro | 1,069 | 49.0 | I–II | 5.0 | DFS | CT, PI, LVSI, DI, TS, LNI | 7 |
Ishikawa 2018 []129 | Japan | Retro | 93 | NA | I–II | 10.0 | OS, DFS | CT, TS, DI, LVSI, PI, LNI, RM | 6 |
Kwon 2018 []130 | Korea | Retro | 259 | 47.0 | I–II | 5.8 | DFS | CT, LVSI | 6 |
Zhu 2019 []131 | China | Retro | 110 | 51.5 | I–II | 4.0 | OS, PFS | Age, TS, LNI, FIGO, TG, Ly | 6 |
Yan 2019 []132 | China | Retro | 347 | NA | I–II | 3.3 | OS, PFS | Age, FIGO, LNI, TG, LVSI, DI | 6 |
Wang 2019 []133 | China | Retro | 559 | 51.0 | I–IV | 3.3 | DFS | Age, SCC, FIGO, TS, LNI | 7 |
Farzaneh 2019 []134 | Iran | Retro | 307 | 40.4 | I–III | 5.0 | DFS | RM, NLR | 5 |
Sawada 2019 []135 | Japan | Retro | 107 | 46.0 | I–II | 4.8 | OS | FIGO, CT, TS, LNI, PI | 6 |
Khalkhali 2019 []136 | Iran | Retro | 109 | 50.1 | I–IV | 3.2 | OS | Age, FIGO | 5 |
Yildirim 2019 []137 | Turkey | Retro | 104 | 56.0 | I–IV | 4.4 | OS, DFS | TS, FIGO, LNI | 6 |
Gai 2019 []138 | China | Retro | 79 | 51.0 | I–IV | 5.0 | OS | FIGO, LNI, LVSI | 6 |
Chen 2019 []139 | China | Retro | 88 | 48.0 | I–II | 2.2 | DFS | Age, CT, FIGO, TG, LVSI | 5 |
Guani 2019 []140 | France | Pro | 139 | NA | I | 3.0 | DFS | LNI, CT, TS, FIGO, LVSI, age | 5 |
Huang 2019 []141 | China | Retro | 458 | 45.0 | I–II | 3.9 | OS | Age, TG, TS, LNI, LVSI, FIGO, NLR | 7 |
Queiroz 2019 []142 | Brazil | Retro | 127 | 50.8 | II–IV | 4.1 | OS, DFS | Age, CT, TS, LNI | 5 |
Gillani 2019 []143 | Malaysia | Pro | 3,797 | 57.3 | I–II | 6.1 | OS | Age, FIGO, TS, LNI, CT | 6 |
de Foucher 2019 []144 | France | Retro | 501 | 54.0 | I–II | 3.0 | OS, DFS | FIGO, LNI | 6 |
Yoshino 2019 []145 | Japan | Retro | 128 | 65.0 | I–IV | 2.5 | OS | FIGO, CT | 6 |
Zhang 2019 []146 | China | Retro | 89 | 40.5 | I–IV | 4.8 | OS | FIGO, TS, LNI, LVSI, DI | 6 |
Seebacher 2019 []147 | Austria | Retro | 116 | 52.1 | I–IV | 1.7 | OS | Age, FIGO, CT, SCC | 5 |
Holub 2019 []148 | Spain | Retro | 151 | 52.8 | I–IV | 3.7 | OS | TS, FIGO, age, NLR | 6 |
Theplib 2020 []149 | Thailand | Retro | 196 | 41.0 | I | 5.0 | OS, DFS | LVSI, PI, LNI, DI | 6 |
Maulard 2020 []150 | France | Pro | 238 | 45.9 | I–IV | 4.4 | OS | FIGO, CT, LNI | 7 |
An 2020 []151 | China | Retro | 278 | 45.5 | I–II | 5.0 | OS, DFS | Age, CT, FIGO, TG, TS, LVSI, LNI, DI, RM, He | 6 |
Casarin 2020 []152 | Italy | Retro | 428 | 45.0 | I | 4.7 | DFS | TS, LVSI, TG, LNI | 7 |
Wang 2020 []153 | China | Retro | 120 | 59.0 | I–III | 3.2 | OS | LNI, age, FIGO, TG, TS | 6 |
Zyla 2020 []154 | Canada | Retro | 285 | 41.0 | I | 4.0 | OS, DFS | TG, CT, LVSI | 6 |
He 2020 []155 | China | Retro | 1,414 | NA | I–II | 3.6 | OS, DFS | Age, FIGO, TS, CT, TG, DI, LVSI, PI, RM, LNI | 7 |
Zeng 2020 []156 | China | Retro | 251 | 46.0 | I–III | 3.9 | OS, DFS | FIGO, LNI | 6 |
Liu 2020 []157 | China | Retro | 73 | NA | I–II | 5.7 | OS | Age, CT, FIGO, TG, TS, SCC | 5 |
Kim 2020 []158 | Korea | Retro | 47 | 45.0 | I–II | 2.4 | OS, DFS | FIGO, SCC, DI, RM, PI, LNI, LVSI | 5 |
Anfinan 2020 []159 | Saudi Arabia | Retro | 190 | 54.2 | I–IV | 3.1 | OS | FIGO, TG, PI | 6 |
Lee 2020 []160 | Korea | Retro | 125 | 53.7 | II–III | 4.2 | OS, DFS | Age, CT, TS, FIGO, LNI, SCC, NLR | 5 |
Zong 2020 []161 | China | Retro | 384 | 46.3 | I–II | 3.6 | OS, DFS | Age, FIGO, TG, TS, PI, LVSI, DI, RM | 6 |
Aslan 2020 []162 | Turkey | Retro | 185 | 50.0 | III | 3.8 | OS, DFS | Age, CT, DI, PI, TS, LVSI, RM, FIGO | 7 |
Gülseren 2020 []163 | Turkey | Retro | 194 | NA | I–II | 5.0 | DFS | FIGO, TS, PI, LVSI | 6 |
Kim 2021 []164 | Korea | Retro | 55 | 52.6 | I–II | 4.5 | DFS | Age, FIGO, PI, RM | 7 |
Okadome 2021 []165 | Japan | Retro | 82 | NA | II | 5.8 | DFS | CT, LNI, TS | 6 |
Buda 2021 []166 | Italy | Retro | 573 | 45.5 | I–II | 3.8 | DFS | Age, CT, FIGO, LVSI | 6 |
CT – cell type; DI – depth of invasion; He – hemoglobin; Retro – retrospective; Pro – prospective; PI – parametrial invasion; Le – leukocytosis; LVSI – lymph vascular space invasion; LNI – lymph node involvement; Ly – lymphocyte; RM – resection margin; SCC – squamous cell carcinoma antigen; TG – tumor grade; Th – thrombocytosis; TS – tumor size; TV – tumor volume; NA – not available; NLR – neutrophil/lymphocyte ratio. |