ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Correlation between MASCC score and the evolution of febrile neutropenia in patients with solid tumors: a retrospective study.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- MASCC score and neutropenic complications: what is the likelihood?Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Improving Prognostic Accuracy of MASCC Score with Lactate and CRP Measurements in Febrile Neutropenic Patients.Diagnostics (Basel, Switzerland) · 2025Article
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7 authors.
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Abstract
backgroundThe MASCC (Multinational Association for Supportive Care in Cancer) score is widely used to identify low-risk febrile neutropenia (FN) patients eligible for outpatient management. However, its performance specifically in patients with solid tumors remains insufficiently validated.
methodsWe conducted a retrospective cohort study at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) between 2011 and 2022. Adult patients admitted for FN secondary to chemotherapy for solid tumors were included. Patients were classified as high-risk (MASCC < 21) or low-risk (MASCC ≥ 21). The primary outcome was the score's ability to predict an uncomplicated clinical course with a specificity of 95%. Secondary outcomes included ICU admission, mortality, duration of hospitalization, intravenous antibiotics, neutropenia, and potential days saved with outpatient treatment.
resultsAmong 329 oncologic patients, 227 (69%) were classified as low risk. The MASCC score showed a sensitivity of 83.5% (95% CI 77.8-88.2%) and a specificity of 57.3% (95% CI 47.8-66.4%) for predicting the absence of complications. ICU admission rates were significantly lower among low-risk patients (0.4% vs. 32.7%, p < 0.001), as were mortality rates (0.9% vs. 16.8%, p < 0.001). Median hospitalization duration was 4 days [IQR (interquartile range) 3-6] for low-risk patients compared to 6 days [IQR 4-10] for high-risk patients (p < 0.001). Applying outpatient eligibility criteria could have prevented 486 hospitalization days across 161 patients, with 80.7% experiencing no complications.
conclusionThe MASCC score does not accurately identify solid tumor FN patients who would evolve without complications, given its moderate specificity. However, it remains associated with a substantial reduction in hospitalization burden among low-risk patients. Clinical judgment remains essential in outpatient management decisions. Integrating additional clinical parameters may further improve risk stratification in this population.
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