학술논문

Surveillance imaging during first remission in follicular lymphoma does not impact overall survival
Document Type
article
Source
Cancer. 127(18)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Clinical Sciences
Oncology and Carcinogenesis
Lymphoma
Hematology
Genetics
Clinical Research
Rare Diseases
Cancer
4.2 Evaluation of markers and technologies
Detection
screening and diagnosis
4.1 Discovery and preclinical testing of markers and technologies
Good Health and Well Being
Diagnostic Imaging
Humans
Lymphoma
Follicular
Neoplasm Recurrence
Local
Positron-Emission Tomography
Remission Induction
Retrospective Studies
computed tomography
follicular lymphoma
positron emission tomography-computed tomography
relapsed follicular lymphoma
surveillance
Public Health and Health Services
Oncology & Carcinogenesis
Oncology and carcinogenesis
Public health
Language
Abstract
BackgroundAlthough many patients with follicular lymphoma (FL) undergo routine radiographic surveillance during their first remission, no consensus exists on the modality, duration, frequency, or need for routine imaging studies. The authors retrospectively examined the effect of surveillance imaging on relapse detection and overall survival (OS) in patients with FL.MethodsPatients with newly diagnosed FL who had a response to induction therapy were identified from the Lymphoid Malignancies Enterprise Architecture Database (LEAD) at Emory University and from the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic. Patients were evaluated for both relapse and method of relapse detection (ie, clinical concerns vs radiologic detection through surveillance imaging in an asymptomatic patient).ResultsOf 148 patients in the LEAD cohort, 55 (37%) relapsed, and the majority (n = 35; 64%) of relapses were detected clinically. In the MER cohort, 63 of 177 relapses (54%) were detected clinically. There was no significant difference in OS from the date of diagnosis between the 2 methods of relapse detection in the LEAD (hazard ratio [HR], 0.61; 95% CI, 0.13-2.94; P = .54) and MER (HR, 1.02; 95% CI, 0.47-2.21; P = .96) cohorts. Similarly, there was no significant difference in OS from the date of relapse between the 2 methods of relapse detection in the LEAD (HR, 0.47; 95% CI, 0.10-2.27; P = .35) and MER (HR, 1.02; 95% CI, 0.47-2.21; P = .96) cohorts.ConclusionsThese findings suggest a limited role for routine surveillance imaging in patients with FL who complete front-line therapy. Future studies should evaluate which patients may benefit from a more aggressive surveillance approach and should explore novel methods of relapse detection.