Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Limited utility of routine surveillance imaging for classical Hodgkin lymphoma patients in first complete remission. Cancer 2014 Jul 15;120(14):2122-9

Date

04/09/2014

Pubmed ID

24711253

DOI

10.1002/cncr.28698

Scopus ID

2-s2.0-84903791210   30 Citations

Abstract

BACKGROUND: The objective of this study was to compare the outcomes of patients with classical Hodgkin lymphoma (cHL) who achieved complete remission with frontline therapy and then underwent either clinical surveillance or routine surveillance imaging.

METHODS: In total, 241 patients who were newly diagnosed with cHL between January 2000 and December 2010 at 3 participating tertiary care centers and achieved complete remission after first-line therapy were retrospectively analyzed. Of these, there were 174 patients in the routine surveillance imaging group and 67 patients in the clinical surveillance group, based on the intended mode of surveillance. In the routine surveillance imaging group, the intended plan of surveillance included computed tomography and/or positron emission tomography scans; whereas, in the clinical surveillance group, the intended plan of surveillance was clinical examination and laboratory studies, and scans were obtained only to evaluate concerning signs or symptoms. Baseline patient characteristics, prognostic features, treatment records, and outcomes were collected. The primary objective was to compare overall survival for patients in both groups. For secondary objectives, we compared the success of second-line therapy and estimated the costs of imaging for each group.

RESULTS: After 5 years of follow-up, the overall survival rate was 97% (95% confidence interval, 92%-99%) in the routine surveillance imaging group and 96% (95% confidence interval, 87%-99%) in the clinical surveillance group (P = .41). There were few relapses in each group, and all patients who relapsed in both groups achieved complete remission with second-line therapy. The charges associated with routine surveillance imaging were significantly higher than those for the clinical surveillance strategy, with no apparent clinical benefit.

CONCLUSIONS: Clinical surveillance was not inferior to routine surveillance imaging in patients with cHL who achieved complete remission with frontline therapy. Routine surveillance imaging was associated with significantly increased estimated imaging charges.

Author List

Pingali SR, Jewell SW, Havlat L, Bast MA, Thompson JR, Eastwood DC, Bartlett NL, Armitage JO, Wagner-Johnston ND, Vose JM, Fenske TS

Authors

Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin
Jonathan R. Thompson MD Assistant Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Bleomycin
Cause of Death
Dacarbazine
Direct Service Costs
Doxorubicin
Female
Follow-Up Studies
Hodgkin Disease
Humans
Induction Chemotherapy
Male
Middle Aged
Population Surveillance
Positron-Emission Tomography
Recurrence
Tomography, X-Ray Computed
United States
Vinblastine
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0