Limited Utility of Surveillance Imaging for Detecting Disease Relapse in Patients With Non-Hodgkin Lymphoma in First Complete Remission

Truong, Quoc Van; Shah, Nilay; Knestrick, Mark; Curley, Brendan F.; Hu, Yanqing; Craig, Michael; Hamadani, Mehdi

doi:10.1016/j.clml.2013.08.009

Cited by 28 publications

(27 citation statements)

References 33 publications

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“…The study reported by Hong et al 10 assessed the role of routine imaging compared with symptom-directed unplanned early outpatient department visits in patients with dlbcl and reported that, compared with planned visits with or without clinical symptoms or signs, early visits because of symptoms or signs have a strong association with the detection of relapse (33% vs. 0.5%, p < 0.001). Similarly, the study reported by Truong et al 12 found that, for most relapses in aggressive nhl, patient-reported symptoms led to detection (86% vs. 14%, p < 0.0001).…”

Section: Detection Of Relapsementioning

confidence: 94%

“…Two studies involving patients with nhl in complete remission detected a statistically significant difference in the number of relapses initially suspected by clinical manifestations (patient-reported symptoms or physical examination) compared with relapses initially suspected by imaging before clinical manifestation 10,12 . The study reported by Hong et al 10 assessed the role of routine imaging compared with symptom-directed unplanned early outpatient department visits in patients with dlbcl and reported that, compared with planned visits with or without clinical symptoms or signs, early visits because of symptoms or signs have a strong association with the detection of relapse (33% vs. 0.5%, p < 0.001).…”

Section: Detection Of Relapsementioning

confidence: 99%

“…The sample size of the included studies ranged from a low of 109 to a high of 1221 in a population-based study comparing the survival rate of patients with lymphoma undergoing different clinical follow-up policies 4,13 . In most of the studies, patients had nhl 5,7,8,10,[12][13][14] ; three studies focused on the follow-up of patients with Hodgkin lymphoma 4,9,11 , and one study reported on patients with both types of lymphoma 6 . The number of relapses ranged from a low of 15 to a high of 163 in patients with nhl 10,12 , and from a low of 11 to a high of 42 in patients with Hodgkin lymphoma 6,11 .…”

Section: Literature Searchmentioning

confidence: 99%

“…Nine studies reported on the followup care of asymptomatic survivors of lymphoma who had received curative-intent treatment [4][5][6][7][8][9][10][11][12] . Two studies involving patients with nhl in complete remission detected a statistically significant difference in the number of relapses initially suspected by clinical manifestations (patient-reported symptoms or physical examination) compared with relapses initially suspected by imaging before clinical manifestation 10,12 .…”

Section: Detection Of Relapsementioning

confidence: 99%

“…Overall Survival: Seven studies reported on overall survival outcomes 5,8,[10][11][12][13][14] . Six of the studies reported comparable survival rates for patients with relapse initially detected by clinical manifestations and initially detected by surveillance imaging 5,8,[11][12][13][14] .…”

Section: Detection Of Relapsementioning

confidence: 99%

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Follow-Up Care for Survivors of Lymphoma Who Have Received Curative-Intent Treatment

et al. 2016

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Objective This evidence summary set out to assess the available evidence about the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment. MethodsThe medline and embase databases and the Cochrane Database of Systematic Reviews were searched for evidence published between 2000 and August 2015 relating to lymphoma survivorship follow-up. The evidence summary was developed by a Working Group at the request of the Cancer Care Ontario Survivorship and Cancer Imaging programs because of the absence of evidence-based practice documents in Ontario for the follow-up and surveillance of asymptomatic patients with lymphoma in complete remission.Results Eleven retrospective studies met the inclusion criteria. The proportion of relapses initially detected by clinical manifestations ranged from 13% to 78%; for relapses initially detected by imaging, the proportion ranged from 8% to 46%. Median time for relapse detection ranged from 8.6 to 19 months for patients initially suspected because of imaging and from 8.6 to 33 months for those initially suspected because of clinical manifestations. Only one study reported significantly earlier relapse detection for patients initially suspected because of clinical manifestations (mean: 4.5 months vs. 6.0 months, p = 0.042). No benefit in terms of overall survival was observed for patients depending on whether their relapse was initially detected because of clinical manifestations or surveillance imaging. SummaryFindings in the present study support the importance of improving awareness on the part of survivors and clinicians about the symptoms that might be associated with recurrence. The evidence does not support routine imaging for improving outcomes in this patient population.

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Section: Detection Of Relapsementioning

confidence: 94%

Section: Detection Of Relapsementioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Detection Of Relapsementioning

confidence: 99%

Section: Detection Of Relapsementioning

confidence: 99%

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Follow-Up Care for Survivors of Lymphoma Who Have Received Curative-Intent Treatment

et al. 2016

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Diffuse large B‐cell lymphoma

Veltri¹,

Savani²,

Kharfan‐Dabaja³

et al. 2015

Clinical Guide to Transplantation in Lymphoma

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Surveillance imaging during first remission in follicular lymphoma does not impact overall survival

Goldman

Mao

Strouse

et al. 2021

Cancer

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Background Although 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. Methods Patients 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). Results Of 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. Conclusions These 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.

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Limited Utility of Surveillance Imaging for Detecting Disease Relapse in Patients With Non-Hodgkin Lymphoma in First Complete Remission

Cited by 28 publications

References 33 publications

Follow-Up Care for Survivors of Lymphoma Who Have Received Curative-Intent Treatment

Follow-Up Care for Survivors of Lymphoma Who Have Received Curative-Intent Treatment

Diffuse large B‐cell lymphoma

Surveillance imaging during first remission in follicular lymphoma does not impact overall survival

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