Apoptosis is the final common pathway in cellular death induced by radiation and chemotherapy. Antiapoptotic protein bcl-2 plays an essential role in the determination of cellular threshold in the process of apoptosis. Immunohistochemical evaluation of bcl-2 has been one of the most widely investigated prognostic markers in cervical cancer. Given the lack of conclusive evidence in the literature, we aimed to systematically review the evidence to use bcl-2 as a prognostic marker for overall (OS) and disease-free survival (DFS) in cervical cancer. We reviewed the studies after a systematic literature search, reporting either OS or DFS. Estimates were extracted from these studies, and a meta-analysis was done. Positive bcl-2 expression was associated with a decreased risk ratio (RR) for OS. The estimated log RR was −0.52 (confidence interval = −0.91–−0.13, RR = 0.60\0.40, 0.88], P < 0.001). No significant association was found with DFS. There was significant heterogeneity among the studies. Bcl-2 can be used as a molecular marker for OS in cervical cancer. It can be helpful to identify a group of patients who might be good responders in locally advanced cervical cancer and help in clinical decision-making to prognosticate the disease.
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