. 2011 Jun 3;18(10):2757–2763. doi: 10.1245/s10434-011-1819-8

Table 1.

Clinical risk score

Scale	Clinical score criteria^a	Criteria	Score
Nordlinger	1. Age ≥60 years 2. Extension into the serosa of the primary cancer 3. Lymphatic spread of the primary cancer 4. Interval less than 2 years from primary tumor to metastases 5. Number of metastases ≥4 6. Largest size of liver metastasis ≥5	Exclusion criteria 1. Incomplete liver tumor resection 2. Extrahepatic tumor involvement	• 0–2 risk factors “low risk” • 3–4 risk factors “intermediate risk” • 5–6 risk factors “high risk”
Fong	1. Number of liver metastases >1 2. Preoperative CEA level >200 ng/ml 3. Largest size of liver metastasis ≥5 4. Lymph node–positive primary tumor 5. Interval from primary tumor resection to diagnosis of the liver metastases <12 months	Exclusion criteria 1. Positive resection margin 2. Preoperative extrahepatic disease	• 0–2 risk factors • 3–4–5 risk factors
Nagashima	1. Serosal invasion of primary tumor 2. Positive lymph node of primary tumor 3. Number of hepatic metastases ≥2 4. Diameter of hepatic metastases ≥5 cm 5. Resectable extrahepatic metastases.	Inclusion criteria 1. Expected radical excision (including extrahepatic metastases)	• 0–1 grade 1 • 2–3 grade 2 • ≥4 grade 3
Konopke	1. Number of liver metastases ≥4 2. CEA level (ng/ml) ≥200 3. Synchronous liver metastases	Exclusion criteria 1. Recurrent liver metastases 2. Simultaneous extrahepatic tumor recurrence 3. Simultaneous local ablative therapy 4. Intraoperative dissemination of tumor cells 5. Macroscopically or microscopically incomplete resection	• 0 low risk • 1 intermediate risk • ≥2 high risk

Scale

Clinical score criteria^a

Criteria

Score

Nordlinger

1. Age ≥60 years

2. Extension into the serosa of the primary cancer

3. Lymphatic spread of the primary cancer

4. Interval less than 2 years from primary tumor to metastases

5. Number of metastases ≥4

6. Largest size of liver metastasis ≥5

Exclusion criteria

1. Incomplete liver tumor resection

2. Extrahepatic tumor involvement

• 0–2 risk factors “low risk”

• 3–4 risk factors “intermediate risk”

• 5–6 risk factors “high risk”

Fong

1. Number of liver metastases >1

2. Preoperative CEA level >200 ng/ml

3. Largest size of liver metastasis ≥5

4. Lymph node–positive primary tumor

5. Interval from primary tumor resection to diagnosis of the liver metastases <12 months

Exclusion criteria

1. Positive resection margin

2. Preoperative extrahepatic disease

• 0–2 risk factors

• 3–4–5 risk factors

Nagashima

1. Serosal invasion of primary tumor

2. Positive lymph node of primary tumor

3. Number of hepatic metastases ≥2

4. Diameter of hepatic metastases ≥5 cm

5. Resectable extrahepatic metastases.

Inclusion criteria

1. Expected radical excision (including extrahepatic metastases)

• 0–1 grade 1

• 2–3 grade 2

• ≥4 grade 3

Konopke

1. Number of liver metastases ≥4

2. CEA level (ng/ml) ≥200

3. Synchronous liver metastases

Exclusion criteria

1. Recurrent liver metastases

2. Simultaneous extrahepatic tumor recurrence

3. Simultaneous local ablative therapy

4. Intraoperative dissemination of tumor cells

5. Macroscopically or microscopically incomplete resection

• 0 low risk

• 1 intermediate risk

• ≥2 high risk

CEA carcinoembryonic antigen

^aEach criterion is assigned 1 point