TY - JOUR
T1 - Surveillance imaging during first remission in follicular lymphoma does not impact overall survival
AU - Goldman, Max L.
AU - Mao, Jimmy J.
AU - Strouse, Christopher S.
AU - Chen, Wanqi
AU - Rupji, Manali
AU - Chen, Zhengjia
AU - Maurer, Matthew J.
AU - Calzada, Oscar
AU - Churnetski, Michael
AU - Flowers, Christopher R.
AU - Cerhan, James R.
AU - Link, Brian K.
AU - Thompson, Carrie A.
AU - Cohen, Jonathon B.
N1 - Publisher Copyright:
© 2021 American Cancer Society.
PY - 2021/9/15
Y1 - 2021/9/15
N2 - 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.
AB - 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.
KW - computed tomography (CT)
KW - follicular lymphoma
KW - positron emission tomography-computed tomography (PET-CT)
KW - relapsed follicular lymphoma
KW - surveillance
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U2 - 10.1002/cncr.33660
DO - 10.1002/cncr.33660
M3 - Article
C2 - 34157780
AN - SCOPUS:85108277983
SN - 0008-543X
VL - 127
SP - 3390
EP - 3402
JO - Cancer
JF - Cancer
IS - 18
ER -