Malignant pleural effusion - agreement between LENT and PROMISE scores

<bold>Introduction:</bold> Malignant pleural effusion (MPE) is seen in 15% of cancer patients. Due to the short overall survival, accuracy in prognosis assessment is crucial. The LENT (pleural fluid lactate dehydrogenase, ECOG, neutrophil/lymphocyte ratio, tumor type) and PROMISE (cancer type, ECOG, white blood cell count, hemoglobin, previous chemotherapy/radiotherapy and C-reactive protein) scoring systems are available. The first one predicts survival at 1, 3, and 6 months; the latter estimates the risk of death at 3 months. Our aim was to analyze the agreement between these scoring systems in patients with poor prognosis. <bold>Material and Methods:</bold> We evaluated 75 patients, with an average age of 69 years (44% male and 56% female), admitted to our unit during 2023. LENT and clinical PROMISE scores were calculated and risk categories determined. The agreement between both scales was determined with Kappa. <bold>Results:</bold> Main tumor types included lung in 45% of patients, hematological in 15% and breast in 13%. Regarding LENT, 27% of patients scored 5-7 (high risk - 44 days of survival). Concerning PROMISE, 25% of patients scored 28-35, corresponding to a 3-month mortality of 50 to <75% and 6 patients scored >35, consonant with a 3-month mortality ≥ 75%. Kappa results (0.40) indicate a fair agreement between the classifications obtained by the two scales in patients with poor prognosis (classes C-D in PROMISE and class high-risk in LENT). <bold>Discussion and Conclusion:</bold> The two scores are valuable tools for customizing MPE treatment and may be used in everyday clinical practice to improve patient management and reduce associated health-care costs. They showed a fair agreement in patients with poor prognosis.