Performance of LENT Score in Hispanic Population with Malignant Pleural Effusion

Authors

  • Arturo Cortes-Telles Respiratory and Thoracic Surgery Department, Hospital Regional de Alta Especialidad de la Península de Yucatán, Yucatan, México
  • Fernando Formento-Ceballos Respiratory and Thoracic Surgery Department, Hospital Regional de Alta Especialidad de la Península de Yucatán, Yucatan, México
  • Gary Kosai Vargas-Mendoza Respiratory and Thoracic Surgery Department, Hospital Regional de Alta Especialidad de la Península de Yucatán, Yucatan, México

DOI:

https://doi.org/10.12974/2312-5470.2020.06.02

Keywords:

Malignant Pleural Effusion, Pleural Effusion, Survival, LENT Score.

Abstract

Background: Malignant Pleural Effusion (MPE) represents an advanced oncological disease. Overall survival ranges between 3 to 12 months depending on different factors. LENT score has emerged as the first validated instrument to predict MPE survival with significant better accuracy. There is no information regarding LENT score in Hispanic population. Therefore, the objective of this study is to analyze the performance of LENT score within a cohort of MPE patients from Mexico. Methods: A retrospective observational study including 32 patients with a confirmed MPE was conducted. Stratification was according to LENT score (low-risk, moderaterisk, high risk). Overall survival was calculated from the date of diagnosis until death and differences between groups were analyzed. Results: The median age was 61years (IQR 47-71) and 47% were women. Based on the stratification of LENT score, 6% was stratified as low-risk, 59% as moderate-risk and 34% as high-risk. Overall median survival time was 54 days (IQR 26-243), and considering the stratification, 227, 53 and 37 days for low, moderate and high-risk groups, respectively. The higher LENT score, the higher the risk of death (HR 2.26, CI 95%, 1.15-4.47, p=0.019). Pleural LDH, ECOG and NLR were the factors that provided greater accuracy to differentiate groups, (p=0.076, p=0.003 y p=0.015, respectively). Conclusion: LENT score showed a good performance to identify patients with the most adverse prognosis and the highest risk of mortality in Hispanic population. Pleural LDH, ECOG and NLR provide the most valuable information in the identification of the cases. 

References

Psallidas I, Kalomenidis I, Porcel JM, Robinson BW, Stathopoulos GT. Malignant pleural effusion: from bench to bedside. Eur Respir Rev. 2016;25(140):189-198. https://doi.org/10.1183/16000617.0019-2016

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. https://doi.org/10.1186/s12885-017-3550-8

Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ; BTS Pleural Disease Guideline Group. Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65 Suppl 2:ii32-ii40. doi:10.1136/thx.2010.136994. https://doi.org/10.1136/thx.2010.136994

Thomas JM, Musani AI. Malignant pleural effusions: a review. Clin Chest Med. 2013;34(3):459-471. https://doi.org/10.1016/j.ccm.2013.05.004

Porcel JM, Esquerda A, Vives M, Bielsa S. Etiology of pleural effusions: analysis of more than 3,000 consecutive thoracenteses. Arch Bronconeumol. 2014;50(5):161-165 https://doi.org/10.1016/j.arbr.2014.03.012

Sosa-Juárez A, García-Sancho C, Sánchez-Hernández JD, et al. Epidemiología del derrame pleural en el INER, 2011-2012. Neumol Cir Torax 2013;72(2):136-141.

Mejía-Olivares B, Valdez-López HG, Martínez-Delgado IA, et al. Etiología y prevalencia del derrame pleural en la UMAE No. 34 Monterrey, Nuevo León, México.Neumol Cir Torax 2013;72(1):20-24.

Villarreal-Vidal AD, Vargas-Mendoza G, Cortés-Télles A. Caracterización integral del derrame pleural en un hospital de referencia del sureste de México. Neumol Cir Torax. 2019; 78 (3): 277-283. https://doi.org/10.35366/nt193c

Zamboni MM, da Silva CT Jr, Baretta R, Cunha ET, Cardoso GP. Important prognostic factors for survival in patients with malignant pleural effusion. BMC Pulm Med. 2015;15:29. https://doi.org/10.1186/s12890-015-0025-z

Dixit R, Agarwal KC, Gokhroo A, et al. Diagnosis and management options in malignant pleural effusions. Lung India. 2017;34(2):160-166. https://doi.org/10.4103/0970-2113.201305

Bielsa S, Salud A, Martínez M, et al. Prognostic significance of pleural fluid data in patients with malignant effusion. Eur J Intern Med. 2008;19(5):334-339. https://doi.org/10.1016/j.ejim.2007.09.014

Clive AO, Kahan BC, Hooper CE, et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014;69(12):1098-1104. https://doi.org/10.1136/thoraxjnl-2014-205285

Williams JR. The Declaration of Helsinki and public health. Bull World Health Organ. 2008;86(8):650-52.

https://doi.org/10.2471/blt.08.050955

Abrao FC, Peixoto RD, de Abreu IR, et al. Prognostic factors in patients with malignant pleural effusion: Is it possible to predict mortality in patients with good performance status?. J Surg Oncol. 2016;113(5):570-574. doi:10.1002/jso.24168. https://doi.org/10.1002/jso.24168

Bibby AC, Dorn P, Psallidas I, et al. ERS/EACTS statement on the management of malignant pleural effusions. Eur Respir J. 2018;52(1):1800349. https://doi.org/10.1183/13993003.00349-2018

Thomas R, Fysh ETH, Smith NA, et al. Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial. JAMA. 2017;318(19):1903-1912. https://doi.org/10.1001/jama.2017.17426

Downloads

Published

2020-06-06

How to Cite

Cortes-Telles, A. ., Formento-Ceballos, F. ., & Vargas-Mendoza, G. K. . (2020). Performance of LENT Score in Hispanic Population with Malignant Pleural Effusion. Global Journal of Respiratory Care, 6, 16–21. https://doi.org/10.12974/2312-5470.2020.06.02

Issue

Section

Articles