{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:44:54Z","timestamp":1792176294623,"version":"4.4.0"},"reference-count":79,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer (CC) is a major global health problem, and distant metastasis is a critical determinant of prognosis and survival. However, comprehensive data on the incidence and distribution of non\u2010lymphatic distant organ metastases are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis aimed to quantify the incidence of non\u2010lymphatic distant organ metastasis in patients with CC and to identify the most commonly reported organ sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>A systematic search was conducted across PubMed\/Medline, Web of Science, Scopus, and Embase from inception to March 1, 2025. To supplement the database searches and minimize publication bias, we also searched Google Scholar to identify potentially relevant studies. Reference lists of included studies were screened for additional eligible articles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Observational studies reporting the incidence or distribution of non\u2010lymphatic distant organ metastases (bone, brain, liver, and lung) in CC cohorts were included. Case reports, reviews, and studies restricted exclusively to patients with established stage IVB\/M1 disease at presentation were excluded, to avoid overrepresenting patients with already documented metastatic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>\n                      Data were extracted using a standardized form. Pooled incidence rates per 100 patients with 95% confidence intervals (CIs) were calculated using a random\u2010effects model. Heterogeneity was assessed using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>A total of 42 studies, comprising 238\u2009387 patients, were included in the analysis. The pooled incidence rate of metastasis was 2.91 per 100 CC patients (95% CI: 2.84\u20132.97). Regional analysis showed that the Western Pacific region had the highest pooled incidence at 4.66 per 100 patients (95% CI: 4.52\u20134.79), followed by the European region at 2.50 per 100 patients (95% CI: 2.09\u20132.97) and the Americas at 1.68 per 100 patients (95% CI: 1.61\u20131.75). Among site\u2010specific non\u2010lymphatic distant organ metastases, bone was the most common, with a pooled incidence of 3.67 per 100 patients (95% CI: 2.37\u20135.06), followed by lung metastases (3.00 per 100 patients, 95% CI: 2.13\u20134.21), brain metastases (1.83 per 100 patients, 95% CI: 0.91\u20132.75), and liver metastases (1.70 per 100 patients, 95% CI: 0.45\u20132.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that the incidence of distant metastasis varies substantially by anatomic site, with bone and lung being the most common locations. However, due to large heterogeneity, these findings should be interpreted as descriptive trends rather than precise estimates. The predominance of bone and lung metastases emphasizes the need for enhanced clinical awareness regarding these organs and underscores the importance of standardized prospective studies to validate these patterns and guide surveillance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71092","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:55:13Z","timestamp":1779458113000},"page":"554-564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Distant metastasis in patients with cervical cancer: A systematic review and meta\u2010analysis of incidence rates and common sites"],"prefix":"10.1002","volume":"175","author":[{"given":"Yun","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiping","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Outpatient Treatment, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minli","family":"Zeng","sequence":"additional","affiliation":[{"name":"Clinical Trial Institution, Shenzhen Baoan Women's and Children's Hospital Obstetric and Pediatric Center [Shenzhen] under Hong Kong Hub of Pediatric Excellence [HOPE] The Chinese University of Hong Kong  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32470-X"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1541452"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9070687"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102467"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2016.27.e43"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2010.21.3.186"},{"key":"e_1_2_10_9_1","unstructured":"National Cancer Institute. 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