Prognostic factors influencing recurrence in patients with endometrial cancer: a systematic review and meta-analysis
https://doi.org/10.13181/mji.oa.268139
- Author:
Fitriyadi Kusuma
1
;
Kemal Akbar Suryoadji
2
;
Vira Nur Arifa
2
;
Geraldus Sigap Gung Binathara
2
;
Marshaly Safira Masrie
2
;
Salsa Billa As'syifa
2
Author Information
1. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
2. Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Publication Type:Journal Article
- Keywords:
endometrial cancer;
meta-analysis;
neoplasm recurrence;
prognostic factors;
systematic review
- MeSH:
endometrial cancer;
meta-analysis;
neoplasm recurrence;
prognostic factors;
systematic review
- From:
Medical Journal of Indonesia
2026;35(3):228-237
- CountryIndonesia
- Language:English
-
Abstract:
BACKGROUND :Endometrial cancer (EC) ranks as the 6th most common cancer among women worldwide. Despite early detection often yielding favorable outcomes, approximately 13% of early-stage EC patients still experience recurrence. This study aimed to identify prognostic factors for EC recurrence.
METHODS :A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses guidelines (International Prospective Register of Systematic Reviews ID: CRD42024501501). PubMed, Scopus, and Cochrane Library were searched for cohort and case-control studies published on January 1, 2018–January 1, 2024. The primary outcome was disease recurrence (any, locoregional, or distant). Inclusion criteria included adult women with histologically confirmed EC after primary surgery, ≥12-month follow-up, and sample size ≥100. Risk of bias was assessed using Quality in Prognosis Studies; certainty was rated using Grading of Recommendations Assessment, Development and Evaluation.
RESULTS :8 studies met inclusion criteria from 5,633 records screened. Significant prognostic factors included lymphovascular space invasion (LVSI) (relative risk [RR]: 4.83, 95% confidence interval [CI]: 3.49–6.69), cancer grade (RR: 2.15, 95% CI: 1.86–2.48), histology type (RR: 0.46, 95% CI: 0.34–0.61), cancer stage (RR: 2.58, 95% CI: 2.13–3.12), cervical stromal invasion (RR: 3.36, 95% CI: 1.30–8.73), myometrial invasion (RR: 2.60, 95% CI: 2.03–3.32), and chemotherapy history (RR: 1.81, 95% CI: 1.41–2.31). High heterogeneity was observed for chemotherapy history (I² = 92%) and cancer stage (I² = 77%).
CONCLUSIONS :Various clinicopathological factors, particularly LVSI, grade, stage, histology, and myometrial invasion, significantly influence EC recurrence. These findings support the need for individualized risk stratification and treatment planning.
- Full text:202611051128463446835-3-8139-Fitriyadi-Kusuma-Djajasasmita_xmp.pdf
