Validation of LENT and PROMISE scores in malignant pleural effusion in an Asian population

Abstract

Background: Malignant pleural effusions (MPE) are heterogeneous with variable prognosis, LENT and PROMISE scores are developed to risk stratify MPE. Few studies have validated their performance in Asians. Objectives: To evaluate the performance of LENT and PROMISE scores in MPE in an Asian population. Methods: Histologically proven MPE patients from January 2016 to December 2018 in a tertiary hospital in Hong Kong were identified with their clinical characteristics, LENT score, PROMISE score and survival evaluated. Kaplan-Meier method was used to estimate the survival, and ROC analysis for the accuracy in predicting 3-month mortality. Results: 221 subjects were analysed, 57% female, mean age 72. Lung cancer was the most common etiology (77%), 55% of which carried EGFR mutations, 80% of the EGFR mutants were treated with tyrosine kinase inhibitors. LENT score was computed in 193 subjects with median survival of 353, 319 and 39 days in low, moderate and high risk groups. PROMISE score was computed in 194 subjects with median survival of 526, 185, 47 and 41 days in group A, B, C and D. Survival analysis showed statistically significant differences between different risk groups (p Conclusion: Both LENT and PROMISE scores are useful in risk stratifying MPE in Asians. Incorporating EGFR status into the scores in lung MPE may further improve their performance in this subgroup.