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 ( I 2 ≈ 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.
Shi et al. (Thu,) studied this question.