Skip to main content

Table 1 Summary of evidence credibility assessment of 34 unique meta-analyses of observational studies investigating the associations between risk factors and CRC metastasis

From: Risk factors and risk prediction models for colorectal cancer metastasis and recurrence: an umbrella review of systematic reviews and meta-analyses of observational studies

Population Outcome Risk factor Risk factor prevalence Effect size (95% CI) Evidence classification
Histopathological risk factor
 pT1 CRC Lymph node metastasis in pT1 CRC Vascular invasion 330/1731 = 19% 2.73 (1.98–3.78) Convincing
 pT1 CRC Lymph node metastasis in pT1 CRC Lymphatic invasion 906/3347 = 27% 6.78 (5.29–8.69) Highly suggestive
 pT1 CRC Lymph node metastasis in pT1 CRC Tumor budding 2401/10,128 = 24% 6.39 (5.23–7.80) Highly suggestive
 CRC Lymph node metastasis in CRC Tumor budding 1955/6739 = 29% 4.96 (3.97–6.19) Highly suggestive
 Rectal cancer Lymph node metastasis in rectal cancer Tumor size > 1 cm 203/348 = 58% 6.76 (3.25–14.04) Highly suggestive
 pT1 CRC Lymph node metastasis in pT1 CRC Lymphovascular invasion 340/1695 = 20% 4.81 (3.14–7.36) Suggestive
 pT1 CRC Lymph node metastasis in pT1 CRC patients who underwent additional surgeries after an endoscopic resection Lymphovascular invasion 91/313 = 29% 5.29 (2.34–11.98) Suggestive
 pT1 CRC Lymph node metastasis in pT1 CRC Poor differentiation 94/2722 = 4% 5.61 (2.90–10.83) Suggestive
 Rectal cancer Lymph node metastasis in rectal cancer Muscularis properia invasion 122/322 = 38% 5.08 (2.32–11.11) Suggestive
 pT1 CRC Lymph node metastasis in pT1 CRC Submucosal invasion ≥ 1 mm 2389/2922 = 82% 2.95 (1.39–6.27) Weak
 Small rectal NETs Lymph node metastasis in small rectal NETs treated by local excision Lymphovascular invasion 104/517 = 20% 5.02 (1.16–21.72) Weak
 Rectal cancer Lymph node metastasis in rectal cancer Central depression 32/76 = 42% 3.00 (2.10–4.28) Weak
 Rectal cancer Synchronous metastasis in rectal cancer MRI-detected extramural vascular invasion (mrEMVI) 212/804 = 26% 5.65 (2.12–15.05) Weak
 Small rectal NETs Lymph node metastasis in small rectal NETs treated by local excision Lymphatic invasion 73/493 = 15% 5.54 (0.02–1752.46) No association
 Rectal cancer Lymph node metastasis in rectal cancer Vascular invasion 46/168 = 27% 5.86 (0.77–44.62) No association
 Small rectal NETs Lymph node metastasis in small rectal NETs treated by local excision Vascular invasion 75/211 = 36% 3.63 (0.05–268.57) No association
 pT1 CRC Lymph node metastasis in pT1 CRC patients who underwent additional surgeries after an endoscopic resection Poor or moderate differentiation 122/209 = 58% 3.77 (1.12–123.16) No association
Biomarker
 CRC Lymph node metastasis in CRC Downregulated E-cadherin expression 829/1573 = 53% 0.49 (0.34–0.72) Highly suggestive
 CRC Hepatic metastasis (distant) in CRC Circulating tumor cells 103/310 = 33% 6.38 (2.67–15.26) Suggestive
 CRC Lymph node metastasis in CRC Low MUC2 expression level 613/1335 = 46% 1.42 (1.19–1.69) Suggestive
 CRC Distant metastasis in CRC Downregulated E-cadherin expression 509/1027 = 50% 0.45 (0.23–0.91) Weak
 CRC Lymph node metastasis in CRC Circulating tumor cells 797/1802 = 44% 1.62 (1.17–2.23) Weak
 CRC Lymph node metastasis in CRC p16 protein expression 482/800 = 60% 0.50 (0.30–0.84) Weak
 CRC Distant metastasis in CRC Cyclin D1 overexpression 952/1515 = 63% 0.60 (0.36–0.99) Weak
 CRC Distant metastasis in CRC β-catenin overexpression in the nucleus 283/531 = 53% 0.48 (0.29–0.79) Weak
 CRC Lymph node metastasis in CRC CD147 expression 603/815 = 74% 1.41 (0.39–5.01) No association
 CRC Distant metastasis in CRC CD147 expression 405/538 = 75% 2.32 (1.34E−06 to 4.03E+06) No association
 CRC Lymph node metastasis in CRC CD133 expression 550/1629 = 34% 1.15 (0.82–1.62) No association
 CRC Distant metastasis in CRC CD133 expression 300/1064 = 28% 1.54 (0.39–6.09) No association
 CRC Lymph node metastasis in CRC HER-2 immunohistochemical expression 440/1289 = 34% 1.90 (0.90–4.02) No association
Genetic risk factor
 CRC Lymph node metastasis in CRC BRAF mutation 736/1142 = 64% 0.75 (0.49–1.14) No association
 CRC Lymph node metastasis in CRC RASSF1A promoter methylation 100/184 = 54% 1.61 (0.16–16.16) No association
 CRC Distant metastasis in CRC RASSF1A promoter methylation 153/417 = 37% 2.57 (0.64–10.24) No association
Demographic risk factor
 pT1 CRC Lymph node metastasis in pT1 CRC Female gender 465/1329 = 35% 2.23 (0.78–6.42) No association
  1. Abbreviation: CI confidence interval, CRC colorectal cancer, NET neuroendocrine tumor