Myometrial invasion and its extent have been directly associated with the risk of relapse as well as the overall survival of endometrial cancer patients. Tumor free distance from the serosal surface of the uterine wall has been investigated the last years by several studies, however, to date, its importance remains unknown. The present meta-analysis is based on a systematic search of the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases and has been designed according to the PRISMA guidelines. Nine studies were included in the present systematic review that recruited pathology slides from 1,598 endometrial cancer patients and their meta-analysis indicated that TFD was significantly associated with the progression free survival of patients with endometrial cancer (OR 0.36, 95% CI 0.20, 0.65). The disease specific survival was not affected by the TFD (OR 0.30, 95% CI 0.09, 1.01). Sensitivity analyses revealed, however, that both the progression free and overall survival rates were associated with TFD. Significant discrepancies were observed in terms of histological subtypes and stage of the disease among included patients, hence, the actual importance of TFD in specific subgroups remains unknown. Future studies must evaluate the importance of this pathology marker particularly in patients with endometrioid subtypes and early-stage disease, as it is believed that in this group its importance will be more predictive as it will not be skewed by the presence of more important factors such as more aggressive histology and advanced stage disease.

子宫肌层浸润及其范围与复发风险以及子宫内膜癌患者的总生存率直接相关。过去几年，几项研究调查了距子宫壁浆膜表面的无肿瘤距离，然而，迄今为止，其重要性仍然未知。本荟萃分析基于对 Medline、Scopus、Clinicaltrials.gov 、EMBASE、Cochrane 对照试验中心注册中心和 Google Scholar 数据库的系统搜索，并根据 PRISMA 指南进行设计。本系统评价纳入了 9 项研究，这些研究从 1,598 名子宫内膜癌患者中招募了病理切片，他们的荟萃分析表明 TFD 与无进展生存期显着相关子宫内膜癌患者 (OR 0.36, 95% CI 0.20, 0.65)。疾病特异性生存不受 TFD 的影响（OR 0.30，95% CI 0.09，1.01）。然而，敏感性分析显示，无进展生存率和总生存率均与 TFD 相关。在纳入患者的组织学亚型和疾病阶段方面观察到显着差异，因此，TFD 在特定亚组中的实际重要性仍然未知。未来的研究必须评估这种病理学标志物的重要性，特别是在子宫内膜样亚型和早期疾病患者中，因为据信在这一组中它的重要性将更具预测性，因为它不会因更重要因素的存在而扭曲，例如作为更具侵袭性的组织学和晚期疾病。