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Brain Metastases in Cervical Cancer: A Global Systematic Review and Meta-Analysis of Incidence and
Kimia Pakdaman1, Amirhossein Alizadeh-Nodehi2, Amir-Hossein Lashkarbolouki2
1School of Medicine, Babol University of Medical Sciences, Babol, Iran.
Background:
Cervical cancer (CC) remains the fourth most prevalent malignancy among women globally, with a disproportionate burden in low- and middle-income countries, where it is often diagnosed at advanced or metastatic stages.
Aims:
Despite an increasing number of case reports and institutional studies on brain metastases (BMs) arising from CC, current understanding of their epidemiology, clinical presentation, and prognostic implications remains fragmented and lacks comprehensive synthesis.
Methods:
We executed a systematic and unrestricted search of five major databases, PubMed/Medline, Scopus, Embase, Web of Science, and Google Scholar, covering all records up to April 19, 2025. Studies were eligible for inclusion if they provided a clear report on the incidence of BMs among CC patients. The quality and risk of bias of the selected studies were independently appraised using the Joanna Briggs Institute (JBI) assessment criteria. For statistical analysis, we utilized STATA version 17, implementing random-effects meta-analytical models to estimate the aggregated incidence along with corresponding 95% confidence intervals (CIs).
Results:
A total of 17 studies encompassing 33 datasets were included in the final analysis. The global pooled incidence of BMs among cervical cancer patients was estimated at 0.65% (95% CI: 0.46-0.85). Incidence was highest in Turkey (1.83%, 95% CI: 0.91-2.75) and lowest in South Africa (0.22%, 95% CI: 0.0-0.47). Among histologic subtypes, neuroendocrine carcinoma exhibited the highest pooled incidence of BMs at 10.60% (95% CI: 0.0-21.63), followed by adenocarcinoma at 0.89% (95% CI: 0.14-1.64). The pooled mean survival time following the diagnosis of BMs was 6.80 months (95% CI: 5.08-8.52), while the mean interval from the initial cervical cancer diagnosis to the development of BMs was 28.15 months (95% CI: 24.27-32.03).
Conclusion:
Although BMs in cervical cancer are rare, they are associated with dismal survival outcomes and poor prognosis. These findings underscore the importance of vigilant surveillance in high-risk patients and may inform the development of more targeted and effective therapeutic and preventive strategies.
