Table 3. Subgroup analyses for comparing postoperative urinary and anorectal functions between conventional and nerve sparing radical surgery for cervical cancer.
Category | No. of studies | SDM or OR | 95% CI | Heterogeneity | Model used | |
---|---|---|---|---|---|---|
p-value | I2 | |||||
DPC* | ||||||
Study design | ||||||
RCT | 2 | -1.907 | -2.600 to -1.214 | <0.001 | 93.268 | Random effects |
Prospective | 4 | -2.167 | -3.524 to -0.810 | <0.001 | 92.750 | Random effects |
Retrospective | 6 | -0.813 | -1.330 to -0.296 | <0.001 | 89.152 | Random effects |
Quality of study (NOS) | ||||||
≥8 | 6 | -1.002 | -1.495 to -0.508 | <0.001 | 88.011 | Random effects |
<8 | 4 | -1.874 | -3.331 to -0.418 | <0.001 | 93.695 | Random effects |
Surgical approach | ||||||
Laparotomy | 7 | -1.958 | -2.914 to -1.003 | <0.001 | 93.118 | Random effects |
Laparoscopy | 4 | -0.978 | -1.586 to -0.370 | <0.001 | 87.814 | Random effects |
Radicality | ||||||
Type III or C | 10 | -1.622 | -2.236 to -1.007 | <0.001 | 91.472 | Random effects |
Postvoid residual urine not requiring DPC (mL) | ||||||
<50 | 6 | -2.178 | -3.243 to -1.113 | <0.001 | 93.632 | Random effects |
<100 | 5 | -0.616 | -0.805 to -0.428 | 0.001 | 77.275 | Random effects |
Adjustment for potential confounding factors | ||||||
Age, extent of lymphadenectomy, FIGO stage | 6 | -0.982 | -1.510 to -0.454 | <0.001 | 86.496 | Random effects |
Age, extent of lymphadenectomy, FIGO stage, no. of resected LNs | 2 | -1.653 | -1.989 to -1.318 | 0.786 | <0.001 | Fixed effect |
Urinary incontinence† | ||||||
Study design | ||||||
Prospective | 3 | 0.325 | 0.023 to 4.634 | 0.041 | 68.702 | Random effects |
Retrospective | 5 | 0.592 | 0.403 to 0.869 | 0.103 | 48.005 | Fixed effect |
Quality of study (NOS) | ||||||
≥8 | 4 | 0.519 | 0.242 to 1.117 | 0.105 | 51.099 | Random effects |
<8 | 3 | 0.750 | 0.121 to 4.639 | 0.057 | 65.199 | Random effects |
Radicality | ||||||
Type III or C | 7 | 0.509 | 0.230 to 1.128 | 0.050 | 52.390 | Random effects |
Follow-up for evaluating dysfunctions (mo) | ||||||
6 | 2 | 0.214 | 0.018 to 2.507 | 0.090 | 65.272 | Random effects |
12 | 6 | 0.743 | 0.273 to 2.025 | 0.072 | 50.492 | Random effects |
Adjustment for potential confounding factors | ||||||
Age, adjuvant treatment, FIGO stage | 5 | 0.539 | 0.361 to 0.803 | 0.159 | 39.262 | Fixed effect |
Age, adjuvant treatment, extent of lymphadenectomy, FIGO stage | 4 | 0.489 | 0.288 to 0.830 | 0.098 | 52.298 | Random effects |
Urinary frequency† | ||||||
Surgical approach, radicality, and adjustment for potential confounding factors | ||||||
Laparotomy, and type III or C, and age, adjuvant treatment, extent of lymphadenectomy, FIGO stage | 2 | 0.269 | 0.914 to 0.568 | 0.342 | <0.001 | Fixed effect |
Urinary retention† | ||||||
Follow-up for evaluating dysfunctions (mo) | ||||||
6 | 2 | 0.143 | 0.006 to 3.183 | 0.039 | 76.601 | Random effects |
Quality of study (NOS), and adjustment for potential confounding factors | ||||||
≥8, and age, adjuvant treatment, extent of lymphadenectomy, FIGO stage | 2 | 0.301 | 0.051 to 1.762 | 0.173 | 46.252 | Fixed effect |
Constipation† | ||||||
Study design | ||||||
Prospective | 2 | 0.648 | 0.153 to 2.749 | 0.491 | <0.001 | Fixed effect |
Retrospective | 3 | 0.353 | 0.088 to 1.420 | 0.005 | 81.351 | Random effects |
Quality of study (NOS) | ||||||
≥8 | 4 | 0.343 | 0.102 to 1.159 | 0.012 | 72.430 | Random effects |
Surgical approach | ||||||
Laparotomy | 3 | 0.457 | 0.106 to 1.965 | 0.005 | 81.459 | Random effects |
Radicality | ||||||
Type III or C | 4 | 0.426 | 0.140 to 1.292 | 0.011 | 73.119 | Random effects |
Follow-up for evaluating dysfunctions (mo) | ||||||
12 | 4 | 0.765 | 0.426 to 1.371 | 0.519 | <0.001 | Fixed effect |
Adjustment for potential confounding factors | ||||||
Age, adjuvant treatment, FIGO stage | 4 | 0.343 | 0.102 to 1.159 | 0.012 | 72.430 | Random effects |
Age, adjuvant treatment, extent of lymphadenectomy, FIGO stage | 3 | 0.177 | 0.078 to 0.401 | 0.509 | <0.001 | Fixed effect |
CI, confidence interval; DPC, duration of postoperative catheterization; FIGO, International Federation of Gynecology and Obstetrics; LN, lymph node; NOS, the Newcastle-Ottawa Scale; RCT, randomized controlled trial.
*SDM, standard difference in mean; †OR, odds ratio.