Comparison of five scores to predict mortality in malignant pleural effusion.

Abstract

Malignant pleural effusion (MPE) is a complication of malignancy. Treatment of MPE is based on predicted outcome. The aim of this study was to compare the performance characteristics of LENT, PROMISE, RECLS, AL and pNLR scores for prediction of mortality in lung cancer patients who have MPE. Patients who were diagnosed with MPE that was associated with underlying lung cancer between January 2010 and December 2019 were included and analyzed retrospectively in a single center. Outcomes considered were 30-day, 6 months, and 1-year mortality. A total of 180 patients were examined. For 30-day mortality, the areas under the ROC curves (AUC) (95% CI) were: LENT 0.83 (0.76-0.87), RECLS 0.71 (0.63-0.77), and PROMISE 0.70 (0.17-0.38). For 6-month and 1-year mortality the order of these AUCs was similar. Cox regression showed that none of the scores were significantly associated with 30-day mortality, but LENT and RECLS were significantly associated with 6-month and 1-year mortality. Comparison of - 2log likelihood ratios showed that LENT score was more, strongly associated with 6-month mortality than PROMISE (p = 0.001) or RECLS (p = 0.02). LENT score was also more strongly associated with 1-year mortality than PROMISE (p = 0.001) but there was no difference between LENT and RECLS score (p = 0.64). We observed that the LENT score was more predictive than the other scores in mortality in patients who have lung cancer and MPE. The LENT and RECLS scores have similar performance characteristics for prediction of 1-year mortality in these patients.