Risk factor/risk predictor | Outcome evaluated in the umbrella review | Risk factor prevalence | Effect size (95% CI)a | Credibility assessment | Outcome in the risk prediction models | Effect size (95% CI)b | Model performance |
---|---|---|---|---|---|---|---|
CRC metastasis | |||||||
Histopathological risk factor | |||||||
  Vascular invasion | Lymph node metastasis in pT1 CRC | 330/1731 = 19% | 2.73 (1.98–3.78) | Convincing | Lymph node metastasis in pT1 CRC | 8.45 (4.56–15.66) | AUC 0.812 (0.770–0.855); Hosmer–Lemeshow test: p = 0.737 (55) |
Lymph node metastasis in rectal cancer | 46/168 = 27% | 5.86 (0.77–44.62) | No association | ||||
Lymph node metastasis in small rectal NETs treated by local excision | 75/211 = 36% | 3.63 (0.05–268.57) | No association | ||||
  Tumor budding | Lymph node metastasis in pT1 CRC | 2401/10,128 = 24% | 6.39 (5.23–7.80) | Highly suggestive | Lymph node metastasis in pT1 CRC | 1.70 (1.03–2.80) | AUC 0.812 (0.770–0.855); Hosmer–Lemeshow test: p = 0.737 (55) |
Lymph node metastasis in CRC | 1955/6739 = 29% | 4.96 (3.97–6.19) | Highly suggestive | ||||
  Tumor differentiation | Lymph node metastasis in pT1 CRC | 94/2722 = 4% | 5.61 (2.90–10.83) | Suggestive | Lymph node metastasis in pT1 CRC | 11.77 (0.77–179.83) | AUC 0.90 (0.81–0.99) (49) |
Lymph node metastasis in pT1 CRC patients who underwent additional surgeries after an endoscopic resection | 122/209 = 58% | 3.77 (1.12–123.16) | No association | Synchronous bone metastasis | 1.69 (1.22–2.32) | AUC 0.903; sensitivity 0.851; specificity 0.845 (54) | |
  Submucosal invasion ≥ 1 mm | Lymph node metastasis in pT1 CRC | 2389/2922 = 82% | 2.95 (1.39–6.27) | Weak | Lymph node metastasis in pT1 CRC | 2.14 (1.19–3.86) | AUC 0.812 (0.770–0.855); Hosmer–Lemeshow test: p = 0.737 (55) |
  Tumor size > 1 cm | Lymph node metastasis in rectal cancer | 203/348 = 58% | 6.76 (3.25–14.04) | Highly suggestive | Peritoneal metastasis in colon cancer | 1.04 (1.00–1.09) | ROC 0.753 (57) |
Demographic risk factor | |||||||
  Sex/gender | Lymph node metastasis in pT1 CRC | 465/1329 = 35% | 2.23 (0.78–6.42) | No association | Liver metastasis in CRC | NA | Sensitivity 0.74; specificity 0.62 (50) |
Distant metastasis in CRC | 1.40 (0.46–4.28) | AUC 0.80 (0.67–0.93); calibration plot (56) | |||||
CRC recurrence | |||||||
Histopathological risk factor | |||||||
  Vascular invasion (intramural) | Local recurrence in CRC | 137/503 = 27% | 1.55 (0.11–21.28) | No association | Overall recurrence in stage II CRC | 1.30 (1.07–1.58) | C statistic 0.64; calibration plot (61) |
  Vascular invasion (extramural) | Distant metastatic recurrence in rectal cancer | 350/1262 = 28% | 3.91 (2.61–5.86) | Highly suggestive | Overall recurrence in stage II colon cancer | 2.48 (1.22–5.57) | C statistic 0.675; external C statistic 0.552 (68) |
Anthropometric indices | |||||||
  BMI (underweight) | Overall recurrence in CRC | 2752/17,636 = 16% | 1.13 (1.05–1.21) | Weak | Overall recurrence in stage III colon cancer | NA | C statistic 0.65; calibration plot (69) |
  BMI (overweight) | Overall recurrence in CRC | 13,225/28,109 = 47% | 1.00 (0.96–1.05) | No association | |||
  BMI (obese) | Overall recurrence in CRC | 6362/21,246 = 30% | 1.07 (1.02–1.13) | Weak |