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Table 2 Summary of evidence credibility assessment of 17 unique meta-analyses of observational studies investigating the associations between risk factors and CRC recurrence

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
 CRC Overall recurrence in CRC Tumor budding 802/2773 = 29% 5.50 (3.65–8.29) Highly suggestive
 CRC Overall recurrence in CRC Extranodal extension (ENE) 376/877 = 43% 2.07 (1.65–2.61) Highly suggestive
 Rectal cancer Local recurrence in rectal cancer Perineural invasion (PNI) 336/1700 = 20% 3.21 (2.33–4.44) Highly suggestive
 Rectal cancer Distant metastatic recurrence in rectal cancer MRI-detected extramural vascular invasion (mrEMVI) 350/1262 = 28% 3.91 (2.61–5.86) Highly suggestive
 CRC Local recurrence in CRC Intramural vascular invasion (IMVI) 137/503 = 27% 1.55 (0.11–21.28) No association
Biomarker
 CRC Overall recurrence in CRC Absence of peritoneal free tumor cells in pre-resection 524/593 = 88% 0.38 (0.16–0.91) Weak
 CRC Overall recurrence in CRC Absence of peritoneal free tumor cells in post-resection 214/252 = 85% 0.07 (0.02–0.21) Weak
Genetic risk factor
 CRC Overall recurrence in CRC PTGS2 (also known as COX-2) 787/1516 = 52% 2.78 (1.76–4.40) Suggestive
Clinical risk factor
 CRC Local recurrence in CRC Anastomotic leakage (AL) 3929/39,745 = 10% 1.90 (1.48–2.43) Suggestive
 Rectal cancer Local recurrence in rectal cancer Anastomotic leakage (AL) 1300/13,665 = 10% 1.61 (1.25–2.08) Suggestive
 CRC Distant recurrence in CRC Anastomotic leakage (AL) 865/10,392 = 8% 1.20 (0.94–1.52) No association
 Rectal cancer Distant recurrence in rectal cancer Anastomotic leakage (AL) 566/5221 = 11% 1.06 (0.72–1.58) No association
 Colon cancer Local recurrence in colon cancer Anastomotic leakage (AL) 91/1990 = 5% 2.19 (0.55–8.68) No association
Comorbidity
 CRC Overall recurrence in CRC Diabetes 429/4979 = 9% 1.26 (0.70–2.30) No association
Anthropometric indices
 CRC Overall recurrence in CRC Underweight 2752/17,636 = 16% 1.13 (1.05–1.21) Weak
 CRC Overall recurrence in CRC Obese 6362/21,246 = 30% 1.07 (1.02–1.13) Weak
 CRC Overall recurrence in CRC Overweight 13,225/28,109 = 47% 1.00 (0.96–1.05) No association
  1. Abbreviation: CI confidence interval, CRC colorectal cancer