Details

Autor(en) / Beteiligte

• Chollet, Bertrand
• Guinde, Julien
• Laroumagne, Sophie
• Dutau, Hervé
• Astoul, Philippe

Titel

Does the LENT score risk‐stratify patients with malignant pleural mesothelioma? An observational study

Ist Teil von

• Thoracic cancer, 2021-06, Vol.12 (11), p.1752-1756

Ort / Verlag

Melbourne: John Wiley & Sons Australia, Ltd

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Malignant pleural mesothelioma (MPM) is a rare, highly aggressive and deadly disease with a poor patient life expectancy. A few years ago, the main challenge was the histological diagnosis of this disease; at present, the search for the best therapeutic strategy is now a priority. However, an optimal therapeutic strategy is not yet clear, despite growing efforts in the treatment armamentarium and research, and at the era of tailored and individualized treatment, tools to predict patient survival are needed for therapeutic decision‐making. Among them, the LENT scoring system was developed to predict prognosis in patients with malignant pleural effusion. The aim of this study was to assess the performance of the LENT score in predicting prognosis in patients with MPM. Methods A retrospective observational study was conducted by analyzing the prospective collected databases of patients undergoing medical thoracoscopy in a single center with a final diagnosis of MPM confirmed by the MESOPATH National Reference Center. Results A total of 41 patients with MPM were studied. All patients underwent platinum‐based chemotherapy combined with pemetrexed ± bevacizumab. No high‐risk category patients were found using the LENT scoring system in this cohort. The median (range) LENT score at the time of medical thoracoscopy was 0 (0–3) and the median survival was 15.5 (2–54) months for the entire cohort. The median survival of low‐risk and moderate‐risk category patients was 21.4 months (2–54, 32 patients) and 6.7 months (2–19, nine patients), respectively. A total of 27 patients with MPM of epithelial subgroup had a median LENT score of 1 (0–2) with a 26 (2–54) months median survival. The median LENT score and median survival of nonepithelial mesothelioma patients (biphasic MPM subgroup, eight patients; sarcomatoid MPM subgroup, six patients) were 0 (0–3) and 11 (2–52) months, respectively. Conclusions Applied to a homogenous cohort of MPM patients, the LENT score underestimated prognosis and was not useful per se for the management of this disease, as evidenced in the epithelial mesothelioma subgroup of patients in our study. The therapeutic approach for mesothelioma is usually based on patient characteristics and clinical stage of the disease. The LENT scoring system has been proposed for the management of malignant pleural effusion but without focus on malignant pleural mesothelioma patients. We aimed to assess the accuracy of this score for mesothelioma patients. In this study, the LENT score underestimated prognosis and was not useful for the management of this disease, in particular for the patients in the epithelial mesothelioma subgroup.