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DELTA-P score for LEMS tumour association

Predicts small-cell lung cancer risk in patients with Lambert-Eaton myasthenic syndrome.

DELTA-P score for LEMS tumour association
Age at LEMS onset >=50 years
Current or former smoker at diagnosis
Weight loss >=5% of body weight
Bulbar involvement (dysarthria, dysphagia)
Erectile dysfunction (in men)
Karnofsky performance status <70
Result0 points

Low risk of small-cell lung cancer (estimated risk 0-2.6 %).

Estimated SCLC risk
0-2.6 %

When to use

  • Stratifying small-cell lung cancer risk and guiding the intensity of tumour screening in patients newly diagnosed with Lambert-Eaton myasthenic syndrome.

Formula

One point each for: age at onset >=50y, current/former smoking, weight loss >=5%, bulbar involvement, erectile dysfunction, Karnofsky performance status <70. Range 0-6.

Pearls and pitfalls

  • Score 0-1: screening can be discontinued after two adequate, negative screens 6 months apart (chance of SCLC then <1 per 1,000).
  • Score 2: repeat screening every 6 months for at least 2 years.
  • Score >=3 warrants an early repeat malignancy screen at 3 months, then every 6 months for at least 2 years.

References

  1. Titulaer MJ, et al. J Clin Oncol. 2011;29(7):902-8.