Evidence mapPaperPMID 41163008Full record

SynthesisJournal of translational medicine2025

Factors affecting survival in patients with colorectal cancer: an umbrella review.

Lulin Yu, Jing Yuan, Simin Lou, Anmin Huang, Xinyu Cai, Jingmin Ji, Xinyang Dai, Xudong Mao, Yingying Mao, Leitao Sun

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
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

10 authors.

Lulin Yu *The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Jing Yuan *The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Simin LouThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Anmin HuangDepartment of Gastroenterology, Peking University Third Hospital, Beijing, 100191, China.
Xinyu CaiThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Jingmin JiThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Xinyang DaiThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China.
Xudong MaoSchool of Artificial Intelligence, Sun Yat-Sen University, Zhuhai, Guangdong, 519080, China.
Yingying MaoSchool of Public Health, Zhejiang Chinese Medical University, Hangzhou, China. myy@zcmu.edu.cn.
Leitao SunThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310022, China. sunnylt@zcmu.edu.cn.

Funding

Medical Science and Technology Project of Zhejiang Province 2024KY1226National Natural Science Foundation of China 82204824
6 · The paper itself

Abstract

backgroundThis study aimed to evaluate the strength and validity of the evidence for reported associations between multiple factors and colorectal cancer (CRC) survival.

methodsWe searched PubMed, Embase, Cochrane Database of Systematic Reviews from inception to 20 June 2024 for systematic reviews and meta-analyses of observational studies on factors and CRC prognosis. The quality of the methodology was evaluated using A Measurement Tool to Assess systematic Reviews 2 (AMSTAR-2).

results90 meta-analyses investigated 191 associations (123 main evidence and 68 supplementary evidence) with CRC overall survival (OS). Factors were categorized into: demographic characteristic, perioperative condition, pathology of neoplasia, clinical laboratory indicators, comorbidities, behavior patterns and others. Totally, 6 associations were recommended as strong evidence (class I). While the presence of chemotherapy-induced neutropenia (CIN) (hazard ratio [HR] = 0.40, 95% confidence interval [CI] 0.32-0.51) denoted a better OS outcome, the existence of log odds of positive lymph nodes (LODDS) (HR = 3.49, 95% CI 2.88-4.23), liver cirrhosis (HR = 3.10, 95% CI 2.68-3.59) and the increment of metastatic lymph node ratio (mLNR) (HR = 1.62, 95% CI 1.39-1.88), pretreatment neutrophils-lymphocytes ratio (NLR) (HR = 2.17, 95% CI 1.83-2.58) and pretreatment lymph node ratio (LNR) (HR = 3.13, 95% CI 2.36-4.15) were considered as poor predictors of OS. Notably, 2 strong evidence was also found in supplementary evidence including extranodal tumor deposits (ENTDs) (HR = 1.72, 95% CI 1.46-2.04) and absolute monocyte count (AMC) (HR = 1.83, 95% CI 1.47-2.29).

conclusionBeyond high-risk pathological signs of lymph node status and ENTDs, optimizable and cost-effective laboratory indicators, such as CIN, NLR, LNR and AMC, may effectively predict the prognosis of CRC. Furthermore, our study provides valuable insights for stratified CRC patient management, reinforcing the development of evidence-based prognostic survival strategies and recommendations.

trial registrationThis protocol was registered with PROSPERO under CRD42024560003.

Indexed as

Colorectal NeoplasmsHumansPrognosisPublication BiasRisk FactorsSurvival AnalysisColorectal cancerOverall survivalProtective factorRisk factorUmbrella review

Identifiers

PMID41163008
PMCPMC12570487

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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 Socratic graph.