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Hodgkin's lymphoma in remission after first-line therapy: which patients need FDG-PET/CT for follow-up?

Petrausch, U. ; Samaras, P. ; Veit-Haibach, P. ; Tschopp, A. ; Soyka, J. D. ; Knuth, A. ; Hany, T. F. ; Mischo, A. ; Renner, C. ; Schaefer, N. G.

In: Annals of Oncology, 2010, vol. 21, no. 5, p. 1053-1057

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    Title
    • Hodgkin's lymphoma in remission after first-line therapy: which patients need FDG-PET/CT for follow-up?
    Author
    • Petrausch, U.. Department of Oncology
    • Samaras, P.. Department of Oncology
    • Veit-Haibach, P.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich
    • Tschopp, A.. Institute of Social and Preventive Medicine, Biostatistics Unit, University of Zurich, Zurich, Switzerland
    • Soyka, J. D.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich
    • Knuth, A.. Department of Oncology
    • Hany, T. F.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich
    • Mischo, A.. Department of Oncology
    • Renner, C.. Department of Oncology
    • Schaefer, N. G.. Department of Oncology
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Annals of Oncology, 2010, vol. 21, no. 5, p. 1053-1057. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:304495
    Summary
    Background: The purpose of the study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) during follow-up of patients with Hodgkin's lymphoma. Patients and methods: Patients in complete remission or an unconfirmed complete remission after first-line therapy who received FDG-PET/CT during their follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in case of recurrence. Results: Overall, 134 patients were analyzed. Forty-two (31.3%) patients had a recurrence. The positive predictive value of FDG-PET/CT was 0.98. Single-factor analysis identified morphological residual mass [P = 0.0005, hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.7-6.6] and symptoms (P < 0.0001, HR 4.9, 95% CI 2.4-9.9) as significant risk factors for relapse. By multivariate analysis, morphological residual mass was the only significant risk factor for early follow-up (<24 months) (P = 0.0019, HR 7.6, 95% CI 2.1-27.3). Advanced stage (P = 0.0426, HR 3.6, 95% CI 1.1-12.3) and the presence of symptoms (P = 0.0009, HR = 14.6, 95% CI 3.0-69.7) were found to be significant risk factors for later follow-up (>24 months). Conclusions: Asymptomatic patients without morphological residues and an early stage of disease do not need a routine FDG-PET/CT for follow-up. Asymptomatic patients with morphological residues should receive routine follow-up FDG-PET/CT for the first 24 months. Only patients with advanced initial stage do need a routine follow-up FDG-PET/CT beyond 24 months