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Manchester Score for Prognosis in Small Cell Lung Cancer

Calculators  Oncology
Manchester score for prognosis in small cell lung cancer is use to determine the lung cancer in patients.
Serum LDH > upper limit of normal
No 0
Yes 1
Serum Na < 132 mmol/L
No 0
Yes 1
Serum alkaline phosphatase > 1.5x the upper limit of normal
No 0
Yes 1
Serum bicarbonate < 24
No 0
Yes 1
Extensive stage disease
No 0
Yes 1
Karnofsky Performance Status
100 -- Normal. No complaints. No evidence of disease. 0
90 -- Able to carry on normal activity. Minor signs or symptoms of disease. 0
80 -- Normal activity with effort. Some signs or symptoms of disease. 0
70 -- Cares for self. Unable to carry on normal activity or to do active work. 0
60 -- Requires occasional assistance, but is able to care for most of his/her personal needs. 0
50 -- Requires considerable assistance and frequent medical care. 1
40 -- Disabled. Requires special care and assistance. 1
30 -- Severely disabled. Hospital admission is indicated although death not imminent. 1
20 -- Very sick. Hospital admission necessary. Active supportive treatment necessary. 1
10 -- Moribund. Fatal processes progressing rapidly. 1
Result:

Background

Measured Factor
Manchester score
Measured Factor Disease
  • Lung cancer
Measured Factor Detail
Manchester score is used to identify the survival time of patients diagnosed with lung cancer.
Speciality
Oncologist
Body System
Oncology
Measured Factor Low Impact
  • ≤1 showed 16.2% survival time in two years.
Measured Factor High Impact
  • Score of 2 - 3 indicate medium lung cancer and showed 2.5% survival in two years
  • score of ≥4 indicates severe lung cancer and showed 0% of survival rate in two years.

Result Interpretation

Ranges Ranges
  • Critical High: ≥4
  • Normal: ≤1
  • Normal Adult Male: ≤1
Result High Conditions
  • It indicates the hih risk of severe lung cancer and less survival time.
False Positive
  • Due to any nodule which is more than 4 mm in diameter.
References: 5

Studies

Study Validation 1
The aim of this study was to validate the Manchester score to estimate prognosis of small-cell lung cancer (SCLC) patients. Study was conducted from January 2000 to December 2010 in 92 SCLC patients. Data from patients was collected through patients’ medical records, and blood results evaluated at the time of diagnosis. Univariate and multiple cox regression analyses of overall survival was analyzed to measure the prognostic value of laboratory factors for SCLC and correlation between OS and Manchester score was investigated. Staging number of metastatic sites, liver metastasis, bone metastasis, adrenal gland metastasis and response to initial therapy were observed parameters in the study. Lab tests were also performed in predicting the OS. Patients were scrutinized in good, intermediate and poor prognosis groups according to Manchester score. Median OS of three 12.9, 6.6 and 5.8 months, respectively (p = 0.008). This study concluded that Manchester score was effective tool in prediction of Overall survival in SCLC patients.
References: 6
Study Validation 2
The purpose of this randomized study was to assess the various prognostic factors to predict long-term (3-year) survival in patients with small cell carcinoma of the lung (SCLC). A total 300 patients with SCLC were recruited in this clinical trial. All patients were administered with two different chemotherapeutic regimens containing cyclophosphamide, adriamycin and vincristine (CAV), cisplatin and etoposide (PE).  Patients were assigned scores and categorized to three different prognostic groups: low (0-1), intermediate (1-2) and severe (2-3).Various prognostic factors measured were white blood cell count, lactate dehydrogenase, performance status and serum sodium levels. From these factors, performance status (P = 0.029) and white blood cell count (P = 0.044) had a significant influence on the probability of 3-year disease-free survival. The median survival time of three groups was found to be 16, 9.4 and 6.6 months respectively.  This study concludes that this sub-classification will aid in development of new diagnostic criteria and in designing of new clinical studies in patients with SCLC
References: 7
Study Additional 1
The objective of the retrospective study was to validate the different prognostic tools for prediction of patient’s survival in small-cell lung cancer (SCLC). A total of SCLC patients who were treated with chemotherapy, radiotherapy or surgery. Clinical or blood parameters were performed in order to analyze whether these blood parameters were predictive of patients overall survival. Univariate and multiple regression analyses of survival were performed using three different models: Royal Marsden Model (index 1), London Group (index 2) and Manchester Score (index 3). Disease extent, creatine kinase, neutrophilia, LDH, hypoalbuminemia, hyperglycemia and bicarbonate were evaluated in patients using lab methods. Results showed that Index 1 identified two prognostic group (PG) with 0% and 16.6% two-year survival (P < 0.001); index 2 detected three PG with 0%, 5% and 15.7% two-year survival (P < 0.001) and index 3 detected three PG with 0%, 2.5% and 16.2% two-year survivals, respectively (P < 0.001). This study concluded the validation of three predictive methods to estimate the patient’s survival in SCLC
References: 8
Study Additional 2
The current review focused to determine an algorithm based on the data available for lung cancer patients. This Review explained a study by Jennens RR,et.al  in which 20 patients with small cell lung cancer were recruited. Administration of chemotherapy was the evaluating criteria as a prognostic factor in SCLC. Manchester score [0-4 ] was calculated using various parameters seen in SCLC patients. 5 patients received chemotherapy and from them 2 patients were free of tumour recurrence 7 months later while patients who didn’t receive chemotherapy died within 40 days. The above study concluded that the Manchester score is a effective tool for decision making for administering chemotherapy in patients with SCLC
References: 9
Study Additional 3
This study was aimed to design the new treatment approaches in patients with small-cell lung cancer (SCLC). A total 407 patients with SCLC were recruited and 61 pretreatment measures were evaluated.. Cox multiple regression analysis was utilized to assess their prognostic value. All patients received short-term intensive regimen of chemotherapeutic agents.  Lactate dehydrogenase tumour stage, serum sodium levels, Karnofsky performance score, alkaline phosphatase were some of the parameters assessed in patients which provided prognostic value of the disease. Manchester score was used to categorize the patients into three prognostic groups. This study concluded that this score is clinically effective which could help in designing of novel treatment approaches for SCLC patients
References: 10

References

  1. Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N. Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients. Int J Cancer. 1987;39(2):146-9.
  2. Kawahara M, Fukuoka M, Saijo N, et al. Prognostic factors and prognostic staging system for small cell lung cancer. Jpn J Clin Oncol. 1997;27(3):158-65.
  3. Maestu I, Pastor M, Gómez-codina J, et al. Pretreatment prognostic factors for survival in small-cell lung cancer: a new prognostic index and validation of three known prognostic indices on 341 patients. Ann Oncol. 1997;8(6):547-53.
  4. Zarogoulidis P, Pataka A, Terzi E, et al. Intensive care unit and lung cancer: when should we intubate?. J Thorac Dis. 2013;5 Suppl 4:S407-12.
  5. Blandin knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C. Progress and prospects of early detection in lung cancer. Open Biol. 2017;7(9).
  6. Rothschild SI, Hagmann R, Zippelius A. 92P: Validation of prognostic scores in small cell lung cancer. J Thorac Oncol. 2016;11(4 Suppl):S96-7.
  7. Kawahara M, Fukuoka M, Saijo N, Nishiwaki Y, Ikegami H, Tamura T, Shimoyama M, Suemasu K, Furuse K. Prognostic factors and prognostic staging system for small cell lung cancer. Japanese journal of clinical oncology. 1997 Jun 1;27(3):158-65.
  8. Maestu I, Pastor M, Gómez-codina J, et al. Pretreatment prognostic factors for survival in small-cell lung cancer: a new prognostic index and validation of three known prognostic indices on 341 patients. Ann Oncol. 1997;8(6):547-53.
  9. Zarogoulidis P, Pataka A, Terzi E, et al. Intensive care unit and lung cancer: when should we intubate?. J Thorac Dis. 2013;5 Suppl 4:S407.
  10. Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N. Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients. Int J Cancer. 1987;39(2):146-9.