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LENT Prognostic Score for Malignant Pleural Effusion

Calculators  Respiratory
LENT Prognostic Score for Malignant Pleural Effusion is beneficial in predicting the survival chances in patients with LENT prognostic score for malignant pleural effusion
Pleural fluid LDH
<1,500 0
≥1,500 1
ECOG Score
Eastern Cooperative Oncology Group (ECOG) Performance Status
0 (asymptomatic) 0
1 (symptomatic but ambulatory) 1
2 (symptomatic, in bed <50% of day) 2
3–4 (symptomatic, in bed >50% of day or bedbound) 3
Serum neutrophil-to-lymphocyte ratio From CBC
<9 0
≥9 1
Tumor type
Mesothelioma or hematologic malignancy 0
Breast or gynecologic cancer or RCC 1
Lung or any other cancer 2
Result:

Background

Measured Factor
Median survival
Measured Factor Disease
  • Malignant pleural effusion
Measured Factor Detail
LENT Prognostic Score estimates the median survival in patients with malignant pleural effusion. It provides important prognostic information which may aid in selecting individual based targeted therapy.
Speciality
Pulmonologist
Body System
Respiratory
Measured Factor Low Impact
  • A score of 0 designates the low risk with median survival of 319 days.
Measured Factor High Impact
  • A maximum score of 7 indicates towards the high risk with median survial of only 44 days.

Result Interpretation

Ranges Ranges
  • Critical High: 5-7
Result High Conditions
  • Mortality
Test Limitations
LENT score underestimates prognosis in patients having MPE secondary to lung adenocarcinoma
References: 2

Studies

Study Validation 1
The aim of this study was to validate LENT prognostic score in predicting the survival in patients with malignant pleural effusion (MPE). Total 203 patients with MPE were recruited in the study. Overall survival in patients was the primary outcome in the study. Patients were scrutinized into three risk groups based on their LENT score: low-risk, moderate-risk and high-risk groups. The median survival days of three groups were 319 days 130 days 44 days respectively. LENT score was able to predict survival at 1 month, 3 month and 6 months in patients. This study concluded that LENT score is clinical effective and validated tool which predicts survival with significantly better accuracy than other scores,
References: 3
Study Validation 2
This multicentre, prospective, observational trial was conducted with aim to validate the LENT score in 75 patients with malignant pleural effusions (MPE). Data from previously conducted trials TIME1 & 2 was collected and this data included information regarding type of primary cancer, LDH, performance status and full blood count which were the main outcomes of the study. Survival rates from database were revalidated using LENT score. Kaplan Meier curves and a Cox regression model were used to assess the LENT risk category. Mortality rates at time points of interest were calculated. This study concluded that LENT score is promising method for predicting good survival in patients with MPE for those with a low risk
References: 4
Study Additional 1
The aim of this retrospective observational study was to evaluate the performance of LENT score for predicting the survival in patients with malignant pleural effusion (MPE). Patients were categorized according the LENT score given and three risk categories were made: low, moderate and high risk. The median survival and 6-month survival rate in patients at high-risk  and moderate-risk  by LENT score was 6.2 months and 52.7%, and 11.4 months and 70.5%, respectively. This study showed that LENT score underestimates prognosis in patients having MPE  thus improvement in LENT scores are needed to make it fully developed model
References: 2
Study Additional 2
The purpose of this retrospective study was to investigate the clinical impact of neutrophil-to-lymphocyte ratio in the serum (sNLR) as a prognostic factor in malignant pleural effusion (MPE) and to validate new scoring method that take into account NLRs in the serum (sNLR) and MPE (smNLR score) in lung cancer patients. 158 patients were recruited in the study having malignant cells in the pleural fluid or tissue. Patients were divided into three smNLR score groups: sNLR, mNLR and both smNLR group. Age, Eastern Cooperative Oncology Group performance status (ECOG PS), histology, M stage, hemoglobin level, albumin level, and calcium level were outcome prognostic factors. Results showed that new smNLR score is valuable and inexpensive prognostic factor in lung cancer patients with MPE
References: 5
Study Additional 3
The purpose of retrospective study was to assess the role of LENT score among different patient, tumor, and treatment related factors that may affect survival of palliative care cancer patients.  48 patients with MPE were included in study with 70.8% male and 29.2% female. The assessment parameters included patient, tumor, and treatment related factors that may affect survival. Primary outcomes were measurement of overall survival and survival time. LENT prognostic score was calculated and patients were categorized into low, intermediate and high risk groups based on their LENT score. This study showed that there was no significant effect of assessment parameter was seen on survival rate. ECOG performance status, bilateral effusion and lung primary were responsible for poor ST and OS respectively. larger studies are warranted to conclude the prognostic effect of LENT score on survival of patients
References: 6

References

  1. Clive AO, Kahan BC, Hooper CE, Bhatnagar R1, Morley AJ3, Zahan-Evans N, et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014;69(12):1098-104.
  2. Abisheganaden J, Verma A, Dagaonkar RS, Light RW. An Observational Study Evaluating the Performance of LENT Score in the Selected Population of Malignant Pleural Effusion from Lung Adenocarcinoma in Singapore. Respiration. 2018;:1-6.
  3. Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014;69(12):1098-104.
  4. Psallidas I, Kannelakis N, Yousuf A, Corcoran J, Hallifax R, Wrightson J, et al. "Lent score validation on patients with malignant pleural effusion." (2016): PA3385.951.
  5. Lee YS, Nam HS, Lim JH, et al. Prognostic impact of a new score using neutrophil-to-lymphocyte ratios in the serum and malignant pleural effusion in lung cancer patients. BMC Cancer. 2017;17(1):557.
  6. Jeba J, Cherian RM, Thangakunam B, George R, Visalakshi J. Prognostic Factors of Malignant Pleural Effusion among Palliative Care Outpatients: A Retrospective Study. Indian J Palliat Care. 2018;24(2):184-188.