Comparison of five scores to predict mortality in malignant pleural effusion

Area of Science:

• Oncology
• Pulmonology
• Biostatistics

Background:

• Malignant pleural effusion (MPE) is a common complication in cancer patients.
• Accurate prognostic assessment is crucial for guiding MPE treatment strategies.
• Several scoring systems exist to predict outcomes in MPE patients, but their comparative efficacy needs further evaluation.

Purpose of the Study:

• To compare the predictive performance of the LENT, PROMISE, RECLS, AL, and pNLR scores for mortality in lung cancer patients with MPE.
• To identify the most accurate scoring system for predicting short-term (30-day) and long-term (6-month, 1-year) mortality.

Main Methods:

• Retrospective analysis of 180 lung cancer patients diagnosed with MPE between January 2010 and December 2019.
• Evaluation of mortality at 30 days, 6 months, and 1 year.
• Comparison of scoring system performance using Area Under the ROC Curve (AUC) and Cox regression analysis.

Main Results:

• The LENT score demonstrated the highest AUC for 30-day mortality (0.83), followed by RECLS (0.71) and PROMISE (0.70).
• LENT and RECLS scores were significantly associated with 6-month and 1-year mortality, unlike other scores.
• LENT showed stronger association with 6-month mortality than PROMISE and RECLS, and with 1-year mortality than PROMISE.

Conclusions:

• The LENT score is a more accurate predictor of mortality in lung cancer patients with MPE compared to PROMISE, RECLS, AL, and pNLR.
• LENT and RECLS scores exhibit similar performance in predicting 1-year mortality.
• The LENT score is recommended for prognostic assessment in this patient population.