manchester score manchester score manchester score is an indicator of prognosis in small cell lung cancer. it is calculated from a number of physical and biochemical markers. a patient with small cell lung cancer scores one point for each of the following: - serum lactate dehydrogenase exceeds the upper limit of the reference range. serum sodium concentration less than 132 mmol/l. serum alkaline phosphatase over one-and-a-half times the upper limit of the reference range. serum bicarbonate less than 24. karnofsky performance status less than 60. extensive stage disease. prognosis prognosis of small cell lung cancer according to manchester score manchester scoreprognostic grouptwo year survival (%) 0-1 good 16.2 2-3 medium 2.5 4 or more poor 0