The Significance of LENT and PROMISE Scoring Systems in Predicting Mortality in Patients with Malignant Pericardial Effusion

Malignant pericardial effusion (MPE) is a prevalent complication in cancer patients, often resulting from direct tumor invasion, lymphatic spread, or hematogenous dissemination. Patients with malignant pericardial effusion face a grave prognosis, as their malignancy is usually more advanced. The immediate control of this patients is important for both the survival and quality of life of patients. While commonly encountered in oncology, the prognostic factors associated with MPE, similar to those of malignant pleural effusion, remain insufficiently understood. This study aims to evaluate the efficacy of the LENT and PROMISE scoring systems in predicting mortality in patients diagnosed with malignant pericardial effusion. This retrospective study analyzed data from cancer patients who underwent pericardiocentesis between January 2013 and December 2024 using clinical and laboratory data extracted from electronic medical records. The LENT score, comprising pericardial fluid LDH, ECOG performance status, neutrophil–lymphocyte ratio and tumor type, and the PROMISE score, including tumor type, ECOG status, previous chemotherapy/radiotherapy, CRP, hemoglobin levels and white blood cell count, were calculated for each patient. Mortality rates were compared with these scores, and survival analysis was performed using Kaplan–Meier and Cox regression models. A total of 63 patients were included in the study, and data analysis showed that the 3-month mortality rate was 42.9%. Both LENT and PROMISE scores were significantly higher in patients who died within one and three months. The LENT score demonstrated a strong predictive value for 3-month mortality, and the PROMISE score also showed substantial predictive power. ROC analysis revealed that both scoring systems exhibited high predictive accuracy, with an AUC of 0.829 for the LENT score and 0.866 for the PROMISE score in predicting 3-month mortality. Both LENT and PROMISE scores are effective prognostic tools for predicting short-term mortality in patients with malignant pericardial effusion and can aid in classifying patients based on their mortality risk to provide valuable insight for clinical decision-making.