Value of surveillance computed tomography in the follow-up of diffuse large B-cell and follicular lymphomas.
Computed tomography (CT) as a routine follow-up has been a standard practice for patients with non-Hodgkin lymphoma although it is not recommended in most guidelines. We aimed to describe the value of surveillance CT in detection of disease relapse in patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma grade 3 (FL3) and to evaluate whether relapse detected by different methods influenced outcome. In this retrospective review of consecutive 341 patients with DLBCL or FL3 diagnosed between 2003 and 2009 in complete response (CR) or unconfirmed CR, 113 patients experienced relapses. We found that routine surveillance CT detected asymptomatic relapse in 25 patients (22.1%; group 1), including 22 of 100 patients with DLBCL and three of 13 with FL3. The first presentation of relapse of the other 88 patients (group 2) included patient-reported symptoms (60.2%), physical examination (13.3%), or abnormal laboratory data (4.4%). For 72 patients received chemotherapy after relapse, the overall survival after relapse was not different between groups 1 and 2 (p = 0.569). The results of our study suggested that routine surveillance CT only has a limited role in the early detection of relapse and the relapse detected by surveillance CT or not has no impact on survival after relapse for patients with DLBCL or FL3.
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa North Rd, Taipei, Taiwan.
Tung-Liang
TL
Lin
Ming-Chung
MC
Kuo
Lee-Yung
LY
Shih
Po
P
Dunn
Po-Nan
PN
Wang
Jin-Hou
JH
Wu
Tzung-Chih
TC
Tang
Hung
H
Chang
Yu-Shin
YS
Hung
Shu-Chen
SC
Lu
D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000208:ethnology / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000208:ethnology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000208:ethnology / Q000473:pathology; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D016879:Salvage Therapy; D016019:Survival Analysis; D013624:Taiwan; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone