Rapid access clinic for unexplained lymphadenopathy and suspected malignancy: prospective analysis of 1000 patients.

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ICR Authors

Chong, Yu-Shing

Authors

Kühnl, A
Cunningham, D
Hutka, M
Peckitt, C
Rozati, H
Morano, F
Chong, I
Gillbanks, A
Wotherspoon, A
Harris, M
Murray, T
Chau, I

Document Type

Journal Article

Date

2018-01-01

Date Accepted

2018-06-25

Abstract

BACKGROUND: In patients presenting with peripheral lymphadenopathy, it is critical to effectively identify those with underlying cancer who require urgent specialist care. METHODS: We analyzed a large dataset of 1000 consecutive patients with unexplained lymphadenopathy referred between 2001 and 2009 to the Royal Marsden Hospital (RMH) rapid access lymph node diagnostic clinic (LNDC). RESULTS: Cancer was diagnosed in 14% of patients. Factors predictive for malignant disease were male sex, age, supraclavicular and multiple site involvement. Cancer-associated symptoms were present for a median of 8 weeks. The median time from referral to start of cancer therapy was 53 days. Fine needle aspiration (FNA) was performed in 83% of patients with malignancies. Sensitivity and specificity of FNA were limited (50 and 87%, respectively for any malignancy; 30 and 79%, respectively for lymphoma). The vast majority of cancer patients received diagnostic biopsies on the basis of suspicious clinical and ultrasound findings; the FNA result contributed to establishing the diagnosis in only 4 cases. CONCLUSIONS: In conclusion, we demonstrate that Oncologist-led rapid access clinics are successful concepts to assess patients with unexplained lymphadenopathy. Our data suggest that a routine use of FNA should be reconsidered in this setting.

Citation

BMC hematology, 2018, 18 pp. 19 - ?

DOI

10.1186/s12878-018-0109-0

URI

https://repository.icr.ac.uk/handle/internal/3132

Rights

https://creativecommons.org/licenses/by/4.0

Source Title

Publisher

Springer Science and Business Media LLC

ISSN

2052-1839

eISSN

2052-1839

Collections

Clinical Studies
Cancer Biology

Research Team

Medicine (RMH Smith Cunningham)
Ashworth Collaborators

Notes