Abstract
Objectives: To study the costs and utilities associated with the use of positron emission tomography-computed tomography (PET/CT) surveillance for the first remission. Methods: A systematic MEDLINE search was conducted by pairing relevant keywords to identify English language articles describing costs and utilities involved with the usage of PET/CT surveillance in patients with Diffused Large B Cell Lymphoma (DLBCL). Results: PET/CT resulted in similar medical costs along with similar clinical outcomes as compared to no surveillance (Korean won 2,499,689 vs 5,229,901, p<0.755). Additionally, in a Markov decision-analytic model with 2-year time horizon, PET/CT surveillance had a small but insignificant benefit over no surveillance in terms of qualityadjusted life years (QALYs) gained (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). This led to high ICERs per QALY gained ($164,960- $168,750). Conclusions: As surveillance for the first remission with PET/CT is providing similar clinical and utility outcomes at a significantly high cost, we do not support routine surveillance for follow-up of DLBCL and suggest its usage should be adopted more wisely in patients with DLBCL.
Highlights
Diffuse Large B-Cell Lymphoma (DLBCL) is one of the most common subtypes of Non-Hodgkin Lymphomas comprising 30-58% of all cases [1,2]
In a study comprising a cohort of 183 patients, the use of positron emission tomography-computed tomography (PET/computed tomography (CT)) led to an earlier diagnosis of relapse, suggesting that Positron Emission Tomography (PET)/CT may be a valid tool for the routine follow-up of lymphoma patients [4]
The present systematic review was conducted to see if routine surveillance imaging with PET/CT in patients achieving complete remission following primary treatment for DLBCL offers any benefits in terms of costs and utilities along with an analysis of its effects on clinical outcomes
Summary
Diffuse Large B-Cell Lymphoma (DLBCL) is one of the most common subtypes of Non-Hodgkin Lymphomas comprising 30-58% of all cases [1,2]. The present systematic review was conducted to see if routine surveillance imaging with PET/CT in patients achieving complete remission following primary treatment for DLBCL offers any benefits in terms of costs and utilities along with an analysis of its effects on clinical outcomes. To our knowledge, this is the first of its kind review that systematically collates the currently available data highlighting the utility of conducting the PET/CT surveillance post achieving the first remission in patients with DLBCL
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