Predictive factors for malignancy in patients with persistent cervical lymphadenopathy

Area of Science:

• Oncology
• Otolaryngology
• Pathology

Background:

• Persistent cervical lymphadenopathy is a common clinical presentation.
• Distinguishing benign from malignant causes is crucial for timely and appropriate management.
• Predictive clinical factors can aid in risk stratification and diagnostic decision-making.

Purpose of the Study:

• To identify clinical factors that predict malignancy in patients with persistent cervical lymphadenopathy.
• To compare predictive factors between pediatric and adult patient groups.

Main Methods:

• Retrospective study of 575 patients with persistent cervical lymphadenopathy who underwent surgical excision.
• Patients were stratified into two age groups: ≤18 years (Group 1) and >18 years (Group 2).
• Multiple logistic regression and univariate analyses were employed to assess associations between clinical factors and malignancy.

Main Results:

• In children (Group 1), male gender, increased age, left-sided lesions, and larger lymph node size were associated with malignancy.
• In adults (Group 2), male gender, increased age, disease duration, and presence of B symptoms were significant predictors of malignancy.
• Increasing age and male gender were consistent predictors across both groups. Sensitivity and specificity of predictive models were 84%/61.5% for Group 1 and 77.9%/67.9% for Group 2.

Conclusions:

• Clinical factors such as male gender, increased age, lymph node size, and location can help predict malignancy in cervical lymphadenopathy.
• Specific predictors differ between pediatric and adult populations, highlighting the need for age-specific assessment.
• The findings support the use of clinical evaluation to guide further diagnostic workup for persistent cervical lymphadenopathy.