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Stratifying risk of malignancy in cystic lateral neck lumps: a multivariant analysis of demographic, radiological and histological investigation factors and the development of a patient-centred risk-predictive tool for malignancy
Published online by Cambridge University Press: 23 May 2023
Abstract
Background
Management of lateral cystic neck masses with no apparent upper aerodigestive tract primary tumour in adults is controversial. Imaging modalities and fine needle aspiration cytology often struggle to distinguish the presence of malignancy.
Method
This study entailed a multicentre retrospective review of all patients with isolated lateral cystic neck masses from 2012 to 2018 in three Welsh health boards, utilising demographic data and first-line investigations (ultrasound scanning and fine needle aspiration cytology) to develop an evidence-based predictive tool for risk of malignancy.
Results
It was found that 29.1 per cent of cystic lesions were malignant on final histology. Age, male gender, non-benign ultrasound scan findings and fine needle aspiration cytology were significant risk factors on univariate analysis. The final multivariate analysis predicted a risk of malignancy ranging from 2.1 to 65.0 per cent depending on the covariate pattern. Smoking status was non-significant.
Conclusion
A rigorous, risk-stratified approach to the management of these patients should aid the clinician in minimising morbidity and optimising resources.
- Type
- Main Article
- Information
- Copyright
- Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED
Footnotes
Victoria Evans takes responsibility for the integrity of the content of the paper
Poster presentation (commended) at the British Academic Conference in Otolaryngology, 17 February 2023, Birmingham, UK.
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