Prognostic significance and therapeutic potential of pyroptosis in gynecological malignancies.

[BACKGROUND] Pyroptosis, an inflammatory form of programmed cell death, has emerged as a critical regulator of tumor biology. Its prognostic value in gynecologic malignancies remains unclear.

[METHODS] We performed a review of studies evaluating pyroptosis-related targets (PRTs) in ovarian, cervical, and endometrial cancers. Eligible studies were identified through multiple databases up to August 31, 2025. Data extraction and quality assessment were conducted independently by two reviewers. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to determine the association between PRT expression and survival outcomes.

[RESULTS] 16 studies involving 19 PRTs met the inclusion criteria. Inhibitory PRTs were significantly associated with poor prognosis (HR = 1.52, 95% CI: 1.41-1.63), whereas enhancing PRTs correlated with favorable survival (HR = 0.89, 95% CI: 0.81-0.99). The overall trends remained consistent across different study characteristics, with heterogeneity largely influenced by variations in expression levels, cancer types, and detection methods. Sensitivity analyses confirmed the robustness of findings, although publication bias was detected in the inhibitory group.

[CONCLUSION] This study provides the first systematic evidence that PRTs hold prognostic significance in gynecologic malignancies. Pyroptosis appears to function as a tumor-suppressive mechanism, supporting its role as a prognostic biomarker and potential therapeutic target. Large-scale, multicenter, and mechanistic studies are warranted to validate and expand these findings.