P82 Evaluation of the LENT and PROMISE score for malignant pleural mesothelioma by histological subtype

• Published in: Thorax Vol. 74; no. Suppl 2; p. A133
• Main Authors: Banka, R, Ferris, R, Hung, A, Gkogkou, P, Mishra, E
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.12.2019
• Subjects: Lung cancer; Medical prognosis; Mesothelioma; Mortality
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax-2019-BTSabstracts2019.225

IntroductionThe LENT and PROMISE scores are prognostic scores developed to predict prognosis in patients with malignant pleural effusions (MPE) including mesothelioma. Previous work has demonstrated that the LENT score underestimates survival in subtypes of patients with lung adenocarcinoma.AimTo evaluate the LENT and clinical PROMISE score in a cohort of patients presenting with MPE secondary to mesothelioma (MPM) by histological subtype.MethodsRecords were retrospectively reviewed from January 1, 2011- December 31, 2018 and January 1, 2013 – December 31, 2018 for patients with non-epithelioid and epithelioid mesothelioma respectively who presented with MPE. Patients who were alive at the time of data analysis were included for PROMISE score analysis only. Only patients with complete data available to calculate LENT/PROMISE score were included in analysis.Results142 patients were diagnosed with MPE and MPM. Complete data was available to analyse LENT and PROMISE score in 99 and 136 patients respectively. The overall median survival (n=122) was 315 days (IQR 167–538). The median survival was significantly different for different histological subtypes: sarcomatoid, (n=27) 191 days (IQR 120–349); biphasic (n=21) 282 days (IQR 135–473); and epithelioid (n=70) 481 days (IQR 236–620)(p=0.008). Most patients with sarcomatoid MPE had a low risk LENT score despite poor survival (table 1). The PROMISE score did not differentiate between patients with MPM, with 121/136 (89%) scoring 0–20 (3 month mortality <25%) (table 1).ConclusionIn our sample, patients divided into significantly different survival groups based on histology. The LENT score misclassified sarcomatoid MPM patients as being in a low mortality group. The PROMISE score failed to differentiate between patients with MPM.ReferencesClive, et al. Thorax 2014;69(12):1098–1104.Psallidas, et al. Lancet Oncol 2018;19(7):930–939.Abisheganaden J, et al. Respiration 2018;96(4):308–313.Abstract P82 Table 1Survival in patients divided by histological subtype based on LENT and PROMISE score LENT SCORE Total N= 96/99 Median survival in days (IQR) Epithelioid Low 39 537 (370–718) Moderate 16 206 (32–278) Biphasic Low 17 304 (135–479) Moderate 2 170 (112–227) Sarcomatoid Low 17 191 (125–318) Moderate 5 75 (46–141) PROMISE SCORE N= 132/136 3 month mortality (%) Epithelioid N=88 0–20 78 1 (1) 21–27 8 4 (50) 28–35 2 2 (100) Biphasic N=22 0–20 20 2 (10) 21–27 1 1 (100) 28–35 1 1 (100) Sarcomatoid N=22 0–20 20 4 (20) 21–27 2 1 (50) 28–35 0 -