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Meta-Analysis
. 2023 Sep-Oct;29(5):279-284.
doi: 10.1097/PPO.0000000000000683.

Evaluation of the Prognostic Role of Liver Metastases on Patient Outcomes: Systematic Review and Meta-analysis

Jessica J Waninger  1 , Vincent T Ma, Zoey Chopra  2 , Ashley N Pearson, Michael D Green
Affiliations
Meta-Analysis

Evaluation of the Prognostic Role of Liver Metastases on Patient Outcomes: Systematic Review and Meta-analysis

Jessica J Waninger et al. Cancer J. 2023 Sep-Oct.

Abstract

The liver is a common site of metastasis for many primary malignancies, but the quantitative impact on survival is unknown. We performed a systematic review and meta-analysis of 83 studies (604,853 patients) assessing the overall hazard associated with liver metastases by primary tumor type and treatment regimen. The pooled overall survival hazard ratio (HR) for all included studies was 1.77 (95% confidence interval [CI], 1.62-1.93). Patients with breast cancer primaries fared the worst (HR, 2.37; 95% CI, 1.64-3.44), as did patients treated with immunotherapies (HR, 1.86; 95% CI, 1.42-2.42). Liver metastases negatively impact survival, necessitating new approaches to disease management.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. This article was funded in part by the National Institutes of Health.

Figures

Figure 1:
Figure 1:. PRISMA Analysis
Flowchart of study selection.
Figure 2:
Figure 2:. Forest Plot of Included Studies
Hazard Ratio (HR) of Overall Survival (OS) for each included study.
Figure 3:
Figure 3:. Heterogeneity Analysis
Funnel Plot evaluating potential publication bias in meta-analysis.
Figure 4:
Figure 4:. Liver metastases are negatively prognostic regardless of primary histology.
Forest plot of summary hazard ratios of liver metastases vs. other metastases by primary histology. OS: overall survival, HR: hazard ratio.
Figure 5:
Figure 5:. Patients with liver metastases have worse overall survival regardless of therapeutic intervention.
Forest plot of summary hazard ratios by therapy type. OS: overall survival, HR: hazard ratio.
Figure 6:
Figure 6:. Liver metastases portend worse overall survival in lung cancer patients irrespective of therapeutic intervention.
Forest plot of summary hazard ratios of liver metastases vs. other metastases in patients with NSCLC by treatment type. OS: overall survival, HR: hazard ratio. *Indicates this study analyzed small cell lung cancer.
See this image and copyright information in PMC

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