Follow up policy after treatment for Hodgkin's disease: too many clinic visits and routine tests? A review of hospital records.
AffiliationDepartment of Medical Oncology, Christie Hospital NHS Trust, Manchester.
MetadataShow full item record
AbstractOBJECTIVE: To examine the effectiveness of routine clinic review in detecting relapse after treatment for Hodgkin's disease. DESIGN: Review of hospital records. SETTING: Regional centre for cancer treatment and research. SUBJECTS: 210 patients with Hodgkin's disease recruited to a chemotherapy trial protocol between 1984 and the end of 1990 who had achieved a complete or partial remission after treatment. MAIN OUTCOME MEASURES: The number of clinic visits made by patients over the period of observation, the number of relapses occurring during that time, and the route by which relapse was detected. RESULTS: The 210 patients generated 2512 outpatient reviews, and 37 relapses were detected. Thirty relapses (81%) were diagnosed in patients who described symptoms, which in 15 cases had resulted in an earlier appointment being arranged. In only four cases (11%; 95% confidence interval 4% to 25%) was relapse detected as a result of routine physical examination on investigation of a patient who did not have symptoms. CONCLUSIONS: Relapse of Hodgkin's disease after treatment is usually detected as a result of the investigation of symptoms rather than by routine screening of asymptomatic patients. It is therefore proposed that the frequency of routine follow up visits should be reduced and greater emphasis placed on patient education. This should underline the importance of symptoms and encourage patients to arrange an earlier appointment if these develop.
CitationFollow up policy after treatment for Hodgkin's disease: too many clinic visits and routine tests? A review of hospital records. 1997, 314 (7077):343-6 BMJ
- Detection of relapse in non-Hodgkin's lymphoma: role of routine follow-up studies.
- Authors: Elis A, Blickstein D, Klein O, Eliav-Ronen R, Manor Y, Lishner M
- Issue date: 2002 Jan
- Long-term outcome of treatment for Ann Arbor Stage I Hodgkin's disease: prognostic factors for survival and freedom from progression.
- Authors: Vlachaki MT, Hagemeister FB, Fuller LM, Besa PC, Hess MA, Brown B, Cabanillas F, Cox JD
- Issue date: 1997 Jun 1
- Relapse and late complications in early-stage Hodgkin's disease patients with mediastinal involvement treated with radiotherapy alone or plus one cycle of ABVD.
- Authors: Enrici RM, Anselmo AP, Donato V, Falchetto Osti M, Santoro M, Tombolini V, Mandelli F
- Issue date: 1999 Oct
- Does bulky disease at diagnosis influence outcome in childhood Hodgkin's disease and require higher radiation doses? Results from the German-Austrian Pediatric Multicenter Trial DAL-HD-90.
- Authors: Dieckmann K, Pötter R, Hofmann J, Heinzl H, Wagner W, Schellong G, Pediatric Cooperative Hodgkin Disease Study Group of the GPOH.
- Issue date: 2003 Jul 1
- Treatment of relapsed aggressive lymphomas: regimens with and without high-dose therapy and stem cell rescue.
- Authors: Hagemeister FB
- Issue date: 2002 May