Systematic review and meta analysis of the global incidence and clinicopathological characteristics of liver metastasis in patients with cervical cancer
摘要
Cervical cancer remains a major malignancy among women, with poor survival rates below 20% despite advances in care. Patients with cervical cancer are most likely to develop hematogenous metastases in the liver, followed by the lungs and bones. Although less commonly involved than other organs, the liver is associated with the poorest prognosis among metastatic sites. This study aims to estimate the global incidence of liver metastasis in cervical cancer patients and explore its clinicopathological characteristics.
MethodsThis is a systematic review and meta-analysis conducted to assess the global incidence and clinicopathological characteristics of liver metastasis in cervical cancer patients. The review followed PRISMA guidelines, and a comprehensive search was performed in Embase, PubMed, Web of Science, Scopus, and Google Scholar up to February 28, 2025. Eligibility criteria included studies that explicitly reported the incidence of liver metastases following a diagnosis of cervical cancer, and provided data on both total cervical cancer cases and cases with liver metastases. Exclusion criteria were studies lacking clear incidence data, case reports, reviews, or studies not specific to cervical cancer. The pooled incidence was calculated using a random-effects model implemented in STATA version 17, based on raw proportions. Results were presented with 95% confidence intervals (CI), and heterogeneity was assessed using the I² statistic.
ResultsOut of an initial 7508 articles identified across five databases, 11 studies (comprising 20 records) met the eligibility criteria and were included in the final analysis. The global pooled incidence of liver metastasis among cervical cancer patients was estimated at 1.88% (95% CI: 1.27–2.48). To explore variability among populations, we conducted subgroup analyses based on development indices. Countries with a very high Human Development Index (HDI) reported a higher incidence (2.12%, 95% CI: 1.40–2.84) than those with high (1.96%, 95% CI: 0.98–2.94) and medium (0.75%, 95% CI: 0.0–1.57) HDI levels. The incidence of liver metastasis in combination with metastases to other organs was nearly three times greater (1.76%, 95% CI: 0.99–2.53) than that of isolated liver metastasis. Furthermore, in a subgroup analysis based on histological subtype, the highest pooled incidence was observed in patients with cervical adenocarcinoma (2.36%, 95% CI: 1.35–3.37).
ConclusionThis meta-analysis demonstrates that while liver metastasis in cervical cancer is relatively rare, its occurrence appears more frequently in patients with advanced disease. These results underscore the need for routine liver screening in high-risk patients and support the refinement of therapeutic strategies.