Colorectal Liver Metastases

Table 2

Scoring systems.

(a) Nordlinger prognostic system

Risk	N	No. of risk factors	2-year survival
Low	305	0–2	79%
Intermed	738	3-4	60%
High	230	5–7	43%

Risk factors are (1) age > 60 years, (2) extension of primary CRC into serosa, (3) node-positive primary CRC, (4) time interval from primary CRC to CRLM < 2 years, (5) size of largest CRLM ≥ 5 cm, (6) number of CRLM ≥ 4, (7) margin less than 1 cm [16].

(b) Fong prognostic system

Clinical risk score for tumor recurrence
	Survival
	%
Risk factors	1 yr	2 yr	3 yr	4 yr	5 yr	Median (months)
0	93	79	72	60	60	74
1	91	76	66	54	44	51
2	89	73	60	51	40	47
3	86	67	42	25	20	33
4	70	45	38	29	25	20
5	71	45	27	14	14	22

Risk factors are (1) node-positive primary CRC, (2) time interval from primary CRC to CRLM < 1 year, (3) number of CRLM > 1, (4) size of largest CRLM > 5 cm, (5) CEA > 200 ng/mL (reproduced from [9]).

(c) Schindl prognostic system

Risk	N	Prognostic score	Median survival (months)	5-year survival (%)
Good	33	0–10	36	62
Mod	172	11–25	34	20
Poor	65	>25	11	0

Prognostic score = [(4 × Dukecode) + (6 × Metcode3) + (6 × lnAlkphos) + (2 × lnCEA) − Albumin] + 22, where Dukecode indicates Dukes stage A/B (score, 0) or C (score, 1), Metcode3, 1 to 3 metastases (score, 0) or more than 3 metastases (score, 1), lnAlkphos, natural logarithmic function of the serum concentration of alkaline phosphatase (U/L), lnCEA, natural logarithmic function of the serum concentration of CEA (μg/L), and Albumin, the serum concentration of albumin (g/dL) [17].