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Manchester Score for Prognosis in Small Cell Lung Cancer

Six-factor pretreatment score predicting 2-year survival in small cell lung cancer.

Manchester Score for Prognosis in Small Cell Lung Cancer
Serum LDH above the upper limit of normal
Serum sodium <132 mmol/L
Serum alkaline phosphatase >1.5x the upper limit of normal
Serum bicarbonate <24 mmol/L
Karnofsky performance status <60
Extensive-stage disease
Result0 points

Good prognostic group; reported 2-year survival ~16.2%.

Prognostic group
Good
2-year survival
~16.2%

When to use

  • Estimating 2-year survival at diagnosis of small cell lung cancer using routine pretreatment labs, performance status, and stage.

Formula

One point each for: LDH above normal, sodium <132 mmol/L, alkaline phosphatase >1.5x upper limit of normal, bicarbonate <24 mmol/L, Karnofsky performance status <60, and extensive-stage disease. Total 0-6: Good 0-1, Medium 2-3, Poor 4-6.

Pearls and pitfalls

  • Derived from Cox regression on 61 candidate pretreatment variables in 407 SCLC patients; stage and performance status remain the dominant contributors.

References

  1. Cerny T, Blair V, Anderson H, et al. Int J Cancer. 1987;39(2):146-9.