Surveillance imaging during first remission in follicular lymphoma does not impact overall survival. Issue 18 (22nd June 2021)

• Record Type: Journal Article
• Authors: Goldman, Max L.; Mao, Jimmy J.; Strouse, Christopher S.; Chen, Wanqi; Rupji, Manali; Chen, Zhengjia; Maurer, Matthew J.; Calzada, Oscar; Churnetski, Michael; Flowers, Christopher R.; Cerhan, James R.; Link, Brian K.; Thompson, Carrie A.; Cohen, Jonathon B.
• Is Part Of: Cancer. Volume 127:Issue 18(2021)
• Page Start: 3390
• Page End: 3402
• Publication Date: 2021-06-22
• Subjects: computed tomography (CT) -- follicular lymphoma -- positron emission tomography‐computed tomography (PET‐CT) -- relapsed follicular lymphoma -- surveillance; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.33660
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : 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. Abstract : The 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.