Surveillance imaging during remission identifies a group of patients with more favorable aggressive NHL at time of relapse: A retrospective analysis of a uniformly-treated patient population Journal Article

  

Authors:	Liedtke, M.; Hamlin, P. A.; Moskowitz, C. H.; Zelenetz, A. D.
Article Title:	Surveillance imaging during remission identifies a group of patients with more favorable aggressive NHL at time of relapse: A retrospective analysis of a uniformly-treated patient population
Abstract:	Background: Approximately one-third of the patients with relapsed aggressive non-Hodgkin's lymphoma (NHL) are cured by second-line chemotherapy followed by high-dose consolidation. The age-adjusted international prognostic index determined at the time of relapse (sAAIPI) predicts outcome in relapsed diffuse large B-cell lymphoma, suggesting that the success of salvage therapy could be enhanced by early relapse detection. This study evaluated the role of surveillance imaging in detection of relapsed disease and its impact on outcome of salvage treatment. Patients and methods: One hundred and eight patients with relapsed aggressive NHL were treated with ICE-based second-line chemotherapy. Relapses were categorized as detected by imaging, examination, or patient-reported symptoms. Results: Twenty per cent of relapses were detected by routine imaging while 80% were identified by reported symptoms or abnormalities on exam. Patients were 4.1 times (95% CI: 1.7-10.2) more likely to have low risk disease if relapse was diagnosed by routine imaging (group 1) compared with those diagnosed by reported symptoms or physical findings (group 2). Median overall 5-year survival for group 1 versus group 2 was 54% and 43% respectively (P = 0.13). Conclusion: These results suggest that routine surveillance imaging can identify a population of patients with a more favorable outcome based on the sAAIPI. © 2006 Oxford University Press.
Keywords:	adult; cancer survival; controlled study; treatment outcome; aged; middle aged; survival analysis; retrospective studies; major clinical study; overall survival; prednisone; salvage therapy; doxorubicin; cancer combination chemotherapy; cancer staging; follow up; cancer diagnosis; neoplasm staging; carboplatin; etoposide; antineoplastic combined chemotherapy protocols; risk factors; relapse; recurrence; tomography, x-ray computed; cyclophosphamide; vincristine; autologous stem cell transplantation; medical record review; retrospective study; prediction; biopsy; ifosfamide; confidence interval; survival time; b cell lymphoma; cancer regression; correlation analysis; nonhodgkin lymphoma; karnofsky performance status; lymphoma, non-hodgkin; early diagnosis; lymphoma; positron-emission tomography; remission induction; cancer relapse; lactate dehydrogenase; symptomatology; large cell lymphoma; kaplan meier method; databases, factual; lactate dehydrogenase blood level; follow-up; log rank test; disease surveillance; periodic medical examination; surveillance imaging
Journal Title:	Annals of Oncology
Volume:	17
Issue:	6
ISSN:	0923-7534
Publisher:	Oxford University Press
Date Published:	2006-06-01
Start Page:	909
End Page:	913
Language:	English
DOI:	10.1093/annonc/mdl049
PUBMED:	16672295
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33646860107&partnerID=40&md5=625401f895eaaefd6aa648730b134374
Notes:	--- - "Cited By (since 1996): 23" - "Export Date: 4 June 2012" - "CODEN: ANONE" - "Source: Scopus"

https://synapse.mskcc.org/synapse/works/has_related_data_chk/27634