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Journals / Tüberküloz ve Toraks / 2021 / Cilt: 69 - Sayı: 2

Can LENT Prognostic score (LDH, ECOG performance score, blood neutrophil/ lymphocyte ratio, tumor type) change the clinical approach in malignant pleural effusion?

LENT prognostik skoru (LDH, ECOG performans skoru, kan nötrofil/lenfosit oranı, tümör tipi) malign plevral efüzyonda klinik yaklaşımı değiştirebilir mi?

Ceyda ANAR
Mine GAYAF
Filiz GÜLDAVAL
Ahmet Emin ERBAYCU
Mustafa CANBAZ
Pages
133–143
Publication Date
2022-11-06
DOI
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The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying overall survival were 69.8 %, 100%, 100% and 18.8%, respectively at the LENT score > 4 (p= 0.000).

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Objective & Hypothesis:Introduction: The aim of this study was to evaluate the predictive power of LENT (LDH in pleural fluid, Eastern Cooperative Oncology Group [ECOG] performance status, neutrophil–lymphocyte ratio in the serum, and tumor type) score which is a current prognostic score in patients with MPE and to determine its effect on survival and its status in clinical decision making.
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Key Findings & Data:Materials and Methods: A retrospective observational study was conducted reviewing the medical records of patients managed for MPE (malign pleural effusion) between 2008 and 2018.
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Conclusion & Impact:The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying overall survival were 69.8 %, 100%, 100% and 18.8%, respectively at the LENT score > 4 (p= 0.000).
🔬Design:Review & Systematic Survey
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⚙️Variables:Domain Parameters

Abstract

Introduction: The aim of this study was to evaluate the predictive power of LENT (LDH in pleural fluid, Eastern Cooperative Oncology Group [ECOG] performance status, neutrophil–lymphocyte ratio in the serum, and tumor type) score which is a current prognostic score in patients with MPE and to determine its effect on survival and its status in clinical decision making. In addition, it was aimed to compare LENT score with the conventional but subjective score ECOG. Materials and Methods: A retrospective observational study was conducted reviewing the medical records of patients managed for MPE (malign pleural effusion) between 2008 and 2018. LENT prognostic score was calculated in the patients. The ECOG score calculated for the same patients was compared in terms of mortality. Results: A total of 191 patients with malignant pleural effusion, 118 males (61.7%) and 73 females (38.2%), were included in the study. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying overall survival were 69.8 %, 100%, 100% and 18.8%, respectively at the LENT score > 4 (p= 0.000). At ECOG PS >2, the sensitivity, specificity, PPV, NPV were as the same as the LENT score >4 for identifying overall survival. In all patients, overall median survival according to the LENT score was 662/119/33 days in low/moderate/high risk groups, respectively. Cox regression analysis indicated that having a moderate LENT score (p= 0.004, OR: 2.21, CI: 1.29 -3.78%) and high LENT score (p= 0.000, OR: 4, 50 CI: 2.57-7.89%) were predictors for overall survival in all patients due to MPE. In ROC analysis, there was no difference in mortality in terms of both LENT and ECOG at 1st, 6th and 12th months. Conclusion: LENT is a better scoring system than ECOG in predicting early mortality, while both ECOG and LENT have almost the same power in predicting mortality. However, LENT is slightly more objective but more difficult to calculate because it contains laboratory findings. Thus, both scoring systems can be used to predict mortality in patients with malignant pleural effusions. Neither of them has superiority to each other.

Özet

Giriş: Bu çalışmanın amacı güncel bir prognostik skor olan LENT (plevral mayide LDH, Eastern Cooperative Oncology Group [ECOG] performans durumu, serumda nötrofil-lenfosit oranı ve tümör tipi) skorunun MPE’li hastalarda, sağkalıma etkisinin ve klinik karar vermedeki durumunun prediktif gücünü değerlendirmektir. Ayrıca LENT skorunu konvansiyonel ancak subjectif skor olan ECOG ile karşılaştırmaktır. Materyal ve Metod: 2008-2018 yılları arasında MPE (malign plevral efüzyon) için tedavi edilen hastaların tıbbi kayıtları gözden geçirilerek geriye dönük gözlemsel bir çalışma yapıldı. Hastalarda LENT prognostik skoru hesaplandı.Aynı hastalar için hesaplanan ECOG skoru mortalite açısından karşılaştırıldı. Bulgular: Çalışmaya 118 erkek (%61,7) ve 73 kadın (%38,2) olmak üzere toplam 191 malign plevral efüzyonlu hasta dahil edildi. Genel sağkalımı belirlemek için duyarlılık, özgüllük, pozitif prediktif değeri (PPV) ve negatif prediktif değeri (NPV) LENT skoru >4’te sırasıyla %69,8, % 00,%100 ve %18,8 idi (p= 0,000. ECOG PS >2’de, genel sağkalımı tanımlamak için duyarlılık, özgüllük, PPV, NPV, LENT skoru >4 ile aynıydı.Tüm hastalarda, LENT skoruna göre genel medyan sağkalım, düşük/orta/yüksek risk gruplarında sırasıyla 662/119/33 gündü. Cox regresyon analizi, LENT skorunun orta (p= 0,004, OR: 2,21, CI: 1,29-%3,78) ve yüksek düzeyde olmasının (p= 0,000, OR: 4, 50 CI: 2,57-%7,89) MPE tüm hastalarda genel sağkalımı öngörmekteydi. ROC analizinde 1., 6. ve 12. aylarda hem LENT hem de ECOG açısından mortalitede fark yoktu. Sonuç: LENT erken mortaliteyi öngörmede ECOG’dan daha iyi bir skorlama sistemi iken, her ikisi de ECOG ve LENT mortaliteyi tahmin etmede hemen hemen aynı güce sahiptir. Ancak LENT biraz daha objektiftir ancak laboratuvar bulgularını içerdiğinden hesaplanması daha zordur. Bu nedenle, her iki skorlama sistemi de malign plevral efüzyonlu hastalarda mortaliteyi tahmin etmek için kullanılabilir. Hiçbirinin birbirine üstünlüğü yoktur

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Cite This Article

ANAR, C., GAYAF, M., GÜLDAVAL, F., ERBAYCU, A. E., CANBAZ, M. (2022). Can LENT Prognostic score (LDH, ECOG performance score, blood neutrophil/ lymphocyte ratio, tumor type) change the clinical approach in malignant pleural effusion?. Tüberküloz ve Toraks, Cilt: 69 - Sayı: 2, 133–143. https://ajindex.com/articles/618291

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