Zeng Siyuan, Li Xin, Xiao Simin, Yang Peina, Lin Changsheng, Chen Huiling, Zhao Hu, Xiao Xue
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, China.
BMC Cancer. 2025 Mar 18;25(1):502. doi: 10.1186/s12885-025-13827-4.
OBJECTIVE: This study was conducted to evaluate the prognosis of cervical cancer in pregnancy (CCIP) and analyze the clinicopathological factors affecting the prognosis of this cancer.
The studies published through July 2024 were systematically retrieved from PubMed, Embase, Web of Science, and Cochrane Library.
The cohort studies, case-control studies, randomized controlled trials, and non-randomized controlled trials involving CCIP patients with data on 5-year overall survival (OS) were included in this study.
The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using Stata 15.0, focusing on the 5-year OS and relevant clinicopathological factors.
The results demonstrated that the 5-year OS of patients with CCIP was similar to that of non-pregnant patients with cervical cancer (RR = 1.00, 95% CI: 0.94-1.06, P = 0.978). The subgroup analysis results revealed that tumor size (≥ 4 cm), International Federation of Gynecology and Obstetrics (FIGO) stage (≥ IB2), and timing of diagnosis (postpartum) were prognostic factors with statistical significance (P < 0.05). However, such factors as pregnancy termination and timing of delivery did not significantly affect the 5-year OS (P > 0.05). The delivery mode required further validation despite its borderline significance (P = 0.05).
The results of this study suggest that pregnancy does not exert a significant adverse effect on the long-term survival of patients with cervical cancer. Tumor size (≥ 4 cm), FIGO stage (≥ IB2), and time of diagnosis (postpartum) are identified as unfavorable prognostic factors for CCIP patients, while delivery mode requires further investigation. These findings provide strong evidence to support the optimization of personalized treatment strategies for CCIP patients.
目的：本研究旨在评估妊娠合并宫颈癌（CCIP）的预后，并分析影响该癌症预后的临床病理因素。
通过系统检索PubMed、Embase、Web of Science和Cochrane图书馆获取截至2024年7月发表的研究。
本研究纳入了涉及CCIP患者且有5年总生存率（OS）数据的队列研究、病例对照研究、随机对照试验和非随机对照试验。
采用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。使用Stata 15.0进行荟萃分析，重点关注5年OS及相关临床病理因素。
结果表明，CCIP患者的5年OS与非妊娠宫颈癌患者相似（RR = 1.00，95%CI：0.94 - 1.06，P = 0.978）。亚组分析结果显示，肿瘤大小（≥4 cm）、国际妇产科联盟（FIGO）分期（≥IB2）和诊断时间（产后）是具有统计学意义的预后因素（P < 0.05）。然而，终止妊娠和分娩时间等因素对5年OS没有显著影响（P > 0.05）。尽管分娩方式具有临界显著性（P = 0.05），但其仍需进一步验证。
本研究结果表明，妊娠对宫颈癌患者的长期生存没有显著不利影响。肿瘤大小（≥4 cm）、FIGO分期（≥IB2）和诊断时间（产后）被确定为CCIP患者的不良预后因素，而分娩方式需要进一步研究。这些发现为优化CCIP患者的个性化治疗策略提供了有力证据。
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