Validation of the LENT score in Japanese sample: The impact of EGFR-TKI

Takahashi, T; Naito, Daisuke; Wakatsuki, Yusuke; Yamamoto, Yuko; Hamakawa, Yoko; Shima, Kazuki; Chihara, Yuichi; Takahashi, Ken­ichi; Katakura, Hiromichi; Sakai, Naoki

doi:10.1183/13993003.congress-2015.pa4328

Cited by 3 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In view of these advances, the LENT score may indeed need modification for this group of patients. Similar findings have been published by investigators from Japan who reported 14 (87.5%) patients in the high-risk group based on LENT score but could use TKI's for survival longer than 6 months [25].…”

Section: Discussionsupporting

confidence: 77%

An Observational Study Evaluating the Performance of LENT Score in the Selected Population of Malignant Pleural Effusion from Lung Adenocarcinoma in Singapore

et al. 2018

View full text Add to dashboard Cite

Background: Patients with malignant pleural effusion (MPE) secondary to lung cancer have been associated with poor prognosis historically. LENT score developed to risk-stratify unselected patients with MPE predicts prognosis of < 6 months in patients with lung cancer. Objective: To assess the performance of LENT score in predicting prognosis in selected population of MPE secondary to lung adenocarcinoma alone. Methods: A retrospective observational study was conducted by reviewing the medical records of patients managed for MPE in the year 2012. Results: Seventy patients with lung adenocarcinoma presenting with MPE were studied. The median (range) LENT score at initial diagnosis was 5 (2–7), and the median survival 7.9 (0.13–40) months. Thirty-nine patients received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs). The median LENT score and median survival was 4 (2–7) and 14.4 months, respectively, in this group. Those in high-risk category by LENT in this group (n = 19) had a median survival and 6-month survival of 17.4 months and 73.6%, respectively. Thirty-one patients were treated with conventional chemotherapy. The median LENT score and median survival was 5 (2–7) and 4.1 (0.13–34.3) months, respectively, in this group. The median survival and 6-month survival rate in patients in high-risk category and moderate-risk category by LENT score was 6.2 months and 52.7%, and 11.4 months and 70.5%, respectively. Conclusion: LENT score underestimates prognosis in patients having MPE secondary to lung adenocarcinoma. This disparity particularly applies to the lung adenocarcinoma patients carrying EGFR mutation. Hence, LENT score may not be applicable to, or may need modification before applying to such patients.

show abstract

Section: Discussionsupporting

confidence: 77%

An Observational Study Evaluating the Performance of LENT Score in the Selected Population of Malignant Pleural Effusion from Lung Adenocarcinoma in Singapore

et al. 2018

View full text Add to dashboard Cite

show abstract

“…26 Other reasons for the discrepant LENT C-statistic may be attributable to younger patients in our study (65 IQR (56-71) vs 74 IQR (67-80) years), a larger proportion of patients with better functional status (ECOG 0-1) (81% vs 54%) and possibly fewer medical comorbidities as all our patients underwent pleuroscopy. 7 In terms of median survival, our study is the third Asian study validating the LENT score that reports discordant results from other studies [10][11][12]14,15 (Table S4 in Supplementary Information). Clinical use of the existing LENT model is precluded in an Asian population as it significantly underestimates survival.…”

Section: Discussionmentioning

confidence: 56%

“…7 This score was developed from a prospective multicentre cohort and has been validated in 10 studies to date. 8,[10][11][12][13][14][15][16][17][18] It is also recommended by the European Respiratory Society clinical practice guidelines in the management of malignant effusion. 19 The clinical PROMISE prognostic score was developed from a prospective, multicentre cohort predicting 3-month probability of survival in patients newly diagnosed with malignant effusion.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the clinical utility of both the LENT and clinical PROMISE scores in an Asian patient population remains unclear as the LENT score appears to predict a shorter duration of survival than what has been observed in patients with lung adenocarcinoma. 10,11 The discrepancy can be attributed to the higher prevalence of epidermal growth factor receptor (EGFR) mutations observed in Asians with lung adenocarcinoma. 20,21 Thus, a modification to the LENT score has been proposed to substitute '2' with '0' in the 'tumour' domain in patients with lung adenocarcinoma (modified-LENT).…”

Section: Introductionmentioning

confidence: 99%

“…The LENT prognostication score is applied to patients with newly diagnosed malignant effusion to estimate median survival based on pleural fluid L actate dehydrogenase (LDH), E astern Cooperative Oncology Group (ECOG) functional status, serum N eutrophil‐to‐lymphocyte ratio and primary T umour type based on histopathology 7 . This score was developed from a prospective multicentre cohort and has been validated in 10 studies to date 8,10–18 . It is also recommended by the European Respiratory Society clinical practice guidelines in the management of malignant effusion 19 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Malignant pleural effusion survival prognostication in an Asian population

et al. 2020

View full text Add to dashboard Cite

Background and objective: LENT and PROMISE scores prognosticate survival in patients with MPE. Prognostication guides the selection of interventions and management. However, the predictive value of these scores and their refinements (modified-LENT) in Asians remain unclear. We aim to evaluate the performance of LENT, modified-LENT and clinical PROMISE scores; identify predictors of survival; and develop an alternative prognostication tool should current scores lack accuracy. Methods: Retrospective medical record review of an Asian pleuroscopy database from 2011 to 2018 of patients with MPE was conducted. The prognostic capability of current available scores were evaluated using C-statistics. Demographic and clinical variables as predictors of survival were assessed, and an alternative model was developed using logistic regression. Results: In 130 patients, the C-statistics for modified-LENT was not significantly different from LENT (0.59 (95% CI: 0.52-0.67) vs 0.56 (95% CI: 0.49-0.63); P = 0.403). In 57 patients, the PROMISE C-statistics was 0.72 (95% CI: 0.53-0.91). In our alternative prognostication model (n = 147), Sex, Eastern Cooperative Oncology Group status, Leukocyte count, EGFR mutation, Chemotherapy and primary Tumour type (SELECT) were predictors of 90-day mortality (C-statistic = 0.87 (95% CI: 0.79-0.95)). SELECT sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios using a predicted probability of 90-day mortality cutoff point of 10% were 0.91, 0.68, 0.34, 0.98, 2.83 and 0.13, respectively. Conclusion: The LENT, modified-LENT and PROMISE scores have poor accuracy of survival prognostication in Asian patients with MPE undergoing pleuroscopy. The proposed SELECT prognostication model is accurate at identifying patients with high probability of survival at 90 days.

show abstract

LENT score in prognostic assessment of malignant pleural effusion – the impact of target therapy

Sousa¹,

Pneumologia²,

Caldeira³

et al. 2021

gecp

View full text Add to dashboard Cite

Introduction: Malignant pleural effusion (MPE) is a common manifestation in patients with advanced lung cancer. The LENT score was developed as a risk stratification system to predict the survival of these patients. However, following the discovery of molecular markers and a new era of personalized therapy, prognostic estimation became a challenging exercise. The aim of this study was to evaluate the performance of LENT score in predicting MPE survival in EGFR and ALK mutated lung adenocarcinoma. Methods: A retrospective single-center study of patients with MPE from lung adenocarcinoma followed between January 2008 to December 2018. Results: Forty-two patients were included in the study (mean age 76.4 ± 12.6 years, 52% female). Of these patients, 29% exhibited EGFR gene mutation or ALK gene translocation and received tyrosine kinase inhibitor therapy (TKI), in contrast to 71% of patients without identification of mutational factors and receiving conventional chemotherapy. Based on LENT score, in the sub-group treated with conventional chemotherapy, 67% had a moderate-risk category and 33% a high-risk category, with a median overall survival (OS) of 109 (31-406) and 36 (11-77) days, respectively. In the sub-group treated with targeted therapy, 75% were in a moderate-risk category and 25% in a high-risk category with a median OS of 1033 (245-1710) and 238 (27-not available) days, respectively. Patients receiving targeted therapy had a longer survival than patients receiving conventional chemotherapy in all LENT score risk categories (p<0.05). Conclusions: OS in patients with MPE due to lung adenocarcinoma was similar to that predicted by the LENT score, except for patients with EGFR mutation or ALK translocation. In this subgroup, the LENT score seems to underestimate the prognosis. Although this study has limitations regarding sample size, it does reveal, in the present time, some inaccuracy of the LENT score, demonstrating that it needs to be reviewed and revalidated in view of recent therapeutic advances.

show abstract

Validation of the LENT score in Japanese sample: The impact of EGFR-TKI

Cited by 3 publications

References 0 publications

An Observational Study Evaluating the Performance of LENT Score in the Selected Population of Malignant Pleural Effusion from Lung Adenocarcinoma in Singapore

An Observational Study Evaluating the Performance of LENT Score in the Selected Population of Malignant Pleural Effusion from Lung Adenocarcinoma in Singapore

Malignant pleural effusion survival prognostication in an Asian population

LENT score in prognostic assessment of malignant pleural effusion – the impact of target therapy

Contact Info

Product

Resources

About