Evidence map›Paper›PMID 32586325›Full record

SynthesisBMC medicine2020

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

Wei Xu, Yazhou He, Yuming Wang, Xue Li, Jane Young, John P A Ioannidis, Malcolm G Dunlop, Evropi Theodoratou

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  9. First-line treatment efficacy and prognostic model in RAS-mutant metastatic colorectal cancer: a real-world study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Wei XuCentre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK.
Yazhou HeCentre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK.
Yuming WangHenan Provincial People's Hospital, Henan, 450003, People's Republic of China.
Xue LiCentre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK.
Jane YoungSydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.
John P A IoannidisDepartment of Medicine, School of Medicine, Stanford University, Stanford, CA, 94305, USA.
Malcolm G DunlopColon Cancer Genetics Group, Medical Research Council Human Genetics Unit, Medical Research Council Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK.
Evropi TheodoratouCentre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK. E.Theodoratou@ed.ac.uk.ORCID 0000-0001-5887-9132

Funding

Cancer Research UK 12076Cancer Research UK 18927Cancer Research UK 22804Cancer Research UK C31250/A22804Cancer Research UK C348/A18927Medical Research Council MC_PC_U127527198Medical Research Council MC_U127527198Medical Research Council MC_UU_00007/1Medical Research Council U127527198Medical Research Council U127527202
6 · The paper itself

Abstract

backgroundThere is a clear need for systematic appraisal of models/factors predicting colorectal cancer (CRC) metastasis and recurrence because clinical decisions about adjuvant treatment are taken on the basis of such variables.

methodsWe conducted an umbrella review of all systematic reviews of observational studies (with/without meta-analysis) that evaluated risk factors of CRC metastasis and recurrence. We also generated an updated synthesis of risk prediction models for CRC metastasis and recurrence. We cross-assessed individual risk factors and risk prediction models.

resultsThirty-four risk factors for CRC metastasis and 17 for recurrence were investigated. Twelve of 34 and 4/17 risk factors with p < 0.05 were estimated to change the odds of the outcome at least 3-fold. Only one risk factor (vascular invasion for lymph node metastasis [LNM] in pT1 CRC) presented convincing evidence. We identified 24 CRC risk prediction models. Across 12 metastasis models, six out of 27 unique predictors were assessed in the umbrella review and four of them changed the odds of the outcome at least 3-fold. Across 12 recurrence models, five out of 25 unique predictors were assessed in the umbrella review and only one changed the odds of the outcome at least 3-fold.

conclusionsThis study provides an in-depth evaluation and cross-assessment of 51 risk factors and 24 prediction models. Our findings suggest that a minority of influential risk factors are employed in prediction models, which indicates the need for a more rigorous and systematic model construction process following evidence-based methods.

Indexed as

Colorectal NeoplasmsFemaleHumansMaleNeoplasm MetastasisNeoplasm Recurrence, LocalPrognosisRisk FactorsColorectal cancerMetastasisRecurrenceRisk factorsRisk prediction modelsUmbrella review

Identifiers

PMID32586325
PMCPMC7318747

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.