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Scientific Oral Presentations

Pediatric Otolaryngology

Session: Scientific Oral Presentations 2 - Pediatric Otolaryngology

Impact of Sociodemographic Factors on Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy

Sunday, September 29, 2024
8:54 AM – 9:00 AM EDT
Location: MBCC, 225
Disclosure(s):
Alyssa M. Civantos, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Samuel H. Salib, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Inderpreet Kaur Khalsa, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: While excisional biopsy is the historical gold standard for pediatric persistent asymptomatic cervical lymphadenopathy (PACL), studies demonstrate safe monitoring through serial clinical follow-up and ultrasound. Our objective was to present our management of PACL patients and assess the impact of sociodemographic factors.

Methods: A retrospective cohort study of pediatric patients presenting to a tertiary academic center with PACL between 2011-2023 was conducted. Sociodemographic characteristics, clinical presentation, workup, and diagnoses were collected. Residential addresses were geocoded to census tracts and assigned 2020 CDC Social Vulnerability Index (SVI) rankings, a multidimensional measure of socio-demographic disparity. Multivariable analyses were performed.

Results: In our population of 287 patients, median age was 5 years (IQR 3-10); 55% were male; 35% self-identified as Hispanic/Latinx, and mean SVI was 0.423 (0.0019-0.9722). 23% of patients underwent repeat serial ultrasound with a median interval of 4.5 months. 16% underwent surgical biopsy; 15% were diagnosed with lymphoma on pathology (2.4% of the total). Seven of the biopsies occurred after a second ultrasound. Multivariable logistic regression revealed that presence of nodes characterized as firm, immobile, painful, and of larger size were associated with surgical biopsy, and Hispanic/Latinx patients were twice as likely to undergo surgical biopsy.

Conclusions: Through serial clinical exams and ultrasound, patients with PACL can forgo invasive surgical biopsy under general anesthesia. Our study found that Hispanic/Latinx patients were twice as likely to undergo biopsy, without being more likely to have malignant pathology. Strategies are needed to better support PACL management decision-making in vulnerable populations.

    Presenting Author(s)

  • Alyssa M. Civantos, MD

    Resident Physician
    University of California - San Francisco
    San Francisco, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Samuel H. Salib, BS

    Medical Student
    California Northstate University
    Tustin, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Inderpreet Kaur Khalsa, MS

    Medical Student
    School of Medicine, University of California–San Francisco, San Francisco, California, USA
    Turlock, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Kristina W. Rosbe, MD

    Professor of Otolaryngology
    UCSF Benioff Children's Hospitals
    San Francisco, CA, United States

    Disclosure information not submitted.