ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
Meta-Analysis of Risk Factors for Recurrence in Cervical Cancer Patients Following Fertility-Sparing Treatment
Provisionally accepted
- Shijiazhuang Maternity & Child Healthcare Hospital, Shijiazhuang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background To identify and evaluate the main risk factors for recurrence in cervical cancer patients who undergo fertility- sparing treatment. Methods A comprehensive search of multiple databases, including PubMed, Embase, and Web of Science, was performed to identify studies assessing the recurrence risk in cervical cancer patients treated with fertility-sparing procedures. Data from eligible studies were pooled, and the relative risks (RR) with 95% confidence intervals (CI) were calculated to evaluate the association between various risk factors and recurrence risk. Results Ten studies met inclusion criteria. Recurrence risk was significantly higher in patients aged ≤30 years (RR 2.03, 95% CI 1.89–2.19), those with tumor size ≥2 cm (RR 1.94, 95% CI 1.82–2.06), stage >IA within the fertility-sparing spectrum (RR 2.46, 95% CI 2.29–2.64), lymphovascular space invasion (LVSI) positivity (RR 2.09, 95% CI 1.90–2.30), and lymph-node metastasis (RR 3.10, 95% CI 2.76–3.48). Heterogeneity was low across comparisons (I²≈0%), and no significant small-study effects were detected. Conclusion Age ≤30 years, tumor size ≥2 cm, stage >IA, LVSI positivity, and lymph-node metastasis are robust predictors of recurrence following fertility-sparing treatment in cervical cancer. Incorporating these variables into preoperative counseling, operative strategy, and follow-up planning may enhance oncologic safety while preserving reproductive potential in appropriately selected patients. Our findings are consistent with current guideline recommendations, which generally limit fertility-sparing approaches to tumors ≤2 cm, while tumors exceeding this threshold require cautious consideration and are usually not regarded as appropriate candidates outside of clinical trials or exceptional multidisciplinary contexts.
Keywords: cervical cancer, fertility-sparing treatment, Recurrence, Risk factors, Meta-analysis
Received: 26 May 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Shi, Hou, Gao, Sun, Ling and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yaru Ma
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.