Search

The research aimed to identify previously published CpG-methylation-based prognostic biomarkers and prediction models for colorectal cancer (CRC) prognosis and validate them in a large external cohort. A systematic search was conducted, analyzing 298 unique CpGs and 12 CpG-based prognostic models from 28 studies. After adjustment for clinical variables, 48 CpGs and five prognostic models were confirmed to be associated with survival. However, the discrimination ability of the models was insufficient, with area under the receiver operating characteristic curves ranging from 0.53 to 0.62. Calibration accuracy was mostly poor, and no significant added prognostic value beyond traditional clinical variables was observed. All prognostic models were rated at high risk of bias. While a fraction of CpGs showed potential clinical utility and generalizability, the CpG-based prognostic models performed poorly and lacked clinical relevance. [Display omitted] • A systematic review retrieved 298 CpG-methylation biomarkers and 12 CpG-based prediction models for colorectal cancer (CRC) prognosis. • Our external validation confirmed the prognostic value of 48 CpG-biomarkers and 5 prediction models. • Our analysis finds inadequate external model performance and a high risk of bias of published CpG-based prognostic models. [ABSTRACT FROM AUTHOR]