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Fong Clinical Risk Score for Colorectal Cancer Recurrence
Fong Clinical Risk Score for Colorectal Cancer Recurrence
Node-positive primary tumor
Disease-free interval from primary to metastases <12 months
More than 1 hepatic tumor
Largest hepatic tumor >5 cm
Preoperative CEA >200 ng/mL
Result0 points
0-2 points: lower clinical risk of recurrence after hepatic resection for colorectal liver metastases.
- Fong score
- 0
When to use
- Estimating recurrence risk and prognosis to guide surgical planning and perioperative chemotherapy discussions before/after resection of colorectal liver metastases.
Formula
One point each for: node-positive primary; disease-free interval <12 months; >1 hepatic tumor; largest tumor >5 cm; preoperative CEA >200 ng/mL. Range 0-5.
Pearls and pitfalls
- Derived from >1000 hepatectomies at Memorial Sloan Kettering; a score of 0 does not preclude recurrence and a high score does not preclude long-term survival.
- Predates routine use of modern systemic therapy and molecular markers (e.g. RAS/BRAF status), which also influence outcome.