Surveillance imaging during first remission in follicular lymphoma does not impact overall survival.
Surveillance imaging during first remission in follicular lymphoma does not impact overall survival.
复制标题
卵泡淋巴瘤首次缓解期间的监测成像不会影响整体生存率。
DOI：
10.1002/cncr.33660
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发表时间：
2021-09-15
期刊：
影响因子：
6.2
通讯作者：
Cohen JB
中科院分区：
文献类型：
--
作者：
Goldman ML;Mao JJ;Strouse CS;Chen W;Rupji M;Chen Z;Maurer MJ;Calzada O;Churnetski M;Flowers CR;Cerhan JR;Link BK;Thompson CA;Cohen JB
While 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. We retrospectively examined the effect of surveillance imaging on relapse detection and overall survival (OS) in FL patients. Patients with newly diagnosed FL with 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 (i.e. clinical concerns vs radiologic detection via surveillance imaging in an asymptomatic patient). Of 148 LEAD cohort patients, 55 (37%) relapsed, with the majority (n=35, 64%) detected clinically. In the MER cohort, 63 (54%) of 117 relapses were detected clinically. There was no significant difference in OS from the date of diagnosis between the two methods of relapse detection in the LEAD (hazard ratio [HR]=0.61 [95% CI (0.13–2.94)], p=0.54) and MER (HR=1.02 [95% CI (0.47–2.21)], p=0.96) cohorts. Similarly, there was no significant difference in OS from the date of relapse between the two methods of relapse detection in the LEAD (HR=0.47 [95% CI (0.10–2.27)], p=0.35) and MER (HR=1.02 [95% CI (0.47–2.21)], p=0.96) cohorts. 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. Method of relapse detection (asymptomatic surveillance imaging vs clinically-directed assessment) is not associated with improved outcomes for patients with relapsed follicular lymphoma. Radiographic abnormalities identified on asymptomatic surveillance studies are frequently false positive findings.
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