title: Symptom-oriented clinical detection versus routine imaging as a monitoring policy of relapse in patients with diffuse large B-cell lymphoma.
abstract: This study aimed at evaluating the role of routine imaging versus symptom-directed unplanned early outpatient department (OPD) visits in patients with diffuse large B-cell lymphoma (DLBCL) in complete remission (CR) by analyzing the patterns and outcomes of OPD visits for disease monitoring. Patients with DLBCL in CR after treatment in the rituximab era with any OPD monitoring visit were analyzed. A total of 856 OPD visits were recorded: 501 visits were with routine imaging, 322 were without routine imaging and 33 visits (3.9%) were unplanned early visits due to abnormal symptoms. Of the 106 analyzed patients, 15 experienced a relapse (median follow-up duration of 38.1 months). Routine imaging showed an unsatisfactory positive predictive value due to frequent false-positive visits, and a substantial number of patients with false-positive imaging underwent unnecessary biopsies or additional scans. Compared with planned OPD visits, unplanned early visits were highly related to relapse.
authors.affiliation: Department of Internal Medicine, Gachon University Gil Hospital, Gachon University School of Medicine , Incheon , Republic of Korea.
authors.forename: Junshik
authors.initials: J
authors.lastname: Hong
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyoung Hwa
authors.initials: KH
authors.lastname: Lee
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Ahn
authors.forename: Sanghui
authors.initials: S
authors.lastname: Park
authors.forename: Sun Jin
authors.initials: SJ
authors.lastname: Sym
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Cho
authors.forename: Dong Bok
authors.initials: DB
authors.lastname: Shin
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010045:Outpatients; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Lymphoma; diffuse large B-cell lymphoma; medical imaging; surveillance