Follow-up care for survivors of lymphoma who have received curative-intent treatment.
OBJECTIVE
This evidence summary set out to assess the available evidence about the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment.


METHODS
The medline and embase databases and the Cochrane Database of Systematic Reviews were searched for evidence published between 2000 and August 2015 relating to lymphoma survivorship follow-up. The evidence summary was developed by a Working Group at the request of the Cancer Care Ontario Survivorship and Cancer Imaging programs because of the absence of evidence-based practice documents in Ontario for the follow-up and surveillance of asymptomatic patients with lymphoma in complete remission.


RESULTS
Eleven retrospective studies met the inclusion criteria. The proportion of relapses initially detected by clinical manifestations ranged from 13% to 78%; for relapses initially detected by imaging, the proportion ranged from 8% to 46%. Median time for relapse detection ranged from 8.6 to 19 months for patients initially suspected because of imaging and from 8.6 to 33 months for those initially suspected because of clinical manifestations. Only one study reported significantly earlier relapse detection for patients initially suspected because of clinical manifestations (mean: 4.5 months vs. 6.0 months,p= 0.042). No benefit in terms of overall survival was observed for patients depending on whether their relapse was initially detected because of clinical manifestations or surveillance imaging.


CONCLUSIONS
Findings in the present study support the importance of improving awareness on the part of survivors and clinicians about the symptoms that might be associated with recurrence. The evidence does not support routine imaging for improving outcomes in this patient population.
Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton.
J
J
Sussman
Cancer Care Ontario, Program in Evidence-Based Care, McMaster University, Hamilton.
N P
NP
Varela
Odette Cancer Centre, Sunny-brook Health Sciences Centre, Toronto.
M
M
Cheung
Division of Hematology/Oncology, St. Michael's Hospital, Toronto.
L
L
Hicks
Provincial Primary Care and Cancer Network, Hamilton Niagara Haldimand Brant, Grimsby.
D
D
Kraftcheck
Department of Diagnostic Imaging and Nuclear Medicine, Oakville Trafalgar Memorial Hospital, Oakville.
J
J
Mandel
Division of Malignant Hematology, Juravinski Cancer Centre, Hamilton.
G
G
Fraser
Sunnybrook Health Sciences Centre, Toronto and.
L
L
Jimenez-Juan
Sunnybrook Health Sciences Centre, Toronto and.
A
A
Boudreau
Cancer Care Ontario Patient and Family Advisor, Toronto, ON.
S
S
Sajkowski
Cancer Care Ontario Patient and Family Advisor, Toronto, ON.
R
R
McQuillan
Hodgkin lymphoma; Lymphoma; follow-up; non-Hodgkin lymphoma; relapse