Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group.

2.50
Hdl Handle:
http://hdl.handle.net/10541/78753
Title:
Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group.
Authors:
Zucca, E; Conconi, A; Mughal, Tariq I; Sarris, A H; Seymour, J F; Vitolo, U; Klasa, R; Ozsahin, M; Mead, Graham M; Gianni, M A; Cortelazzo, S; Ferreri, A J M; Ambrosetti, A; Martelli, M; Thiéblemont, C; Moreno, H Gomez; Pinotti, G; Martinelli, Giovanni; Mozzana, R; Grisanti, S; Provencio, M; Balzarotti, M; Laveder, F; Oltean, G; Callea, V; Roy, P; Cavalli, Franco; Gospodarowicz, M
Abstract:
PURPOSE: To determine clinical features and patterns of outcome of primary testicular diffuse large B-cell lymphomas (DLCL). PATIENTS AND METHODS: A retrospective international survey of 373 patients with primary testicular DLCL. RESULTS: Most patients presented with localized disease (stage I to II), and the median age at diagnosis was 66 years (range, 19 to 91 years). Anthracycline-based chemotherapy was administered to 255 patients (68%), and prophylactic intrathecal chemotherapy was given to 68 patients (18%); 133 patients (36%) received prophylactic scrotal radiotherapy. Median overall survival was 4.8 years, and median progression-free survival was 4 years. The survival curves showed no clear evidence of a substantial proportion of cured patients. A favorable international prognostic index score (IPI), no B-symptoms, the use of anthracyclines, and prophylactic scrotal radiotherapy were significantly associated with longer survival at multivariate analysis. However, even for patients with stage I disease and good-risk IPI, the outcome seems worse than what was reported for DLCL at other sites. At a median follow-up of 7.6 years, 195 patients (52%) had relapsed. Extranodal recurrence was reported in 140 cases. Relapses in CNS were detected in 56 patients (15%) up to 10 years after presentation. A continuous risk of recurrence in the contralateral testis was seen in patients not receiving scrotal radiotherapy. CONCLUSION: Testicular DLCL is characterized by a particularly high risk of extranodal relapse even in cases with localized disease at diagnosis. Anthracycline-based chemotherapy, CNS prophylaxis, and contralateral testicular irradiation seem to improve the outcome. Their efficacy is under evaluation in a prospective clinical trial.
Affiliation:
Division of Haematology/Medical Oncology, Peter MacCallum Cancer Institute, East Melbourne, Australia. ielsg@ticino.com
Citation:
Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. 2003, 21 (1):20-7 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
1-Jan-2003
URI:
http://hdl.handle.net/10541/78753
DOI:
10.1200/JCO.2003.11.141
PubMed ID:
12506165
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorZucca, E-
dc.contributor.authorConconi, A-
dc.contributor.authorMughal, Tariq I-
dc.contributor.authorSarris, A H-
dc.contributor.authorSeymour, J F-
dc.contributor.authorVitolo, U-
dc.contributor.authorKlasa, R-
dc.contributor.authorOzsahin, M-
dc.contributor.authorMead, Graham M-
dc.contributor.authorGianni, M A-
dc.contributor.authorCortelazzo, S-
dc.contributor.authorFerreri, A J M-
dc.contributor.authorAmbrosetti, A-
dc.contributor.authorMartelli, M-
dc.contributor.authorThiéblemont, C-
dc.contributor.authorMoreno, H Gomez-
dc.contributor.authorPinotti, G-
dc.contributor.authorMartinelli, Giovanni-
dc.contributor.authorMozzana, R-
dc.contributor.authorGrisanti, S-
dc.contributor.authorProvencio, M-
dc.contributor.authorBalzarotti, M-
dc.contributor.authorLaveder, F-
dc.contributor.authorOltean, G-
dc.contributor.authorCallea, V-
dc.contributor.authorRoy, P-
dc.contributor.authorCavalli, Franco-
dc.contributor.authorGospodarowicz, M-
dc.date.accessioned2009-08-26T15:06:58Z-
dc.date.available2009-08-26T15:06:58Z-
dc.date.issued2003-01-01-
dc.identifier.citationPatterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. 2003, 21 (1):20-7 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid12506165-
dc.identifier.doi10.1200/JCO.2003.11.141-
dc.identifier.urihttp://hdl.handle.net/10541/78753-
dc.description.abstractPURPOSE: To determine clinical features and patterns of outcome of primary testicular diffuse large B-cell lymphomas (DLCL). PATIENTS AND METHODS: A retrospective international survey of 373 patients with primary testicular DLCL. RESULTS: Most patients presented with localized disease (stage I to II), and the median age at diagnosis was 66 years (range, 19 to 91 years). Anthracycline-based chemotherapy was administered to 255 patients (68%), and prophylactic intrathecal chemotherapy was given to 68 patients (18%); 133 patients (36%) received prophylactic scrotal radiotherapy. Median overall survival was 4.8 years, and median progression-free survival was 4 years. The survival curves showed no clear evidence of a substantial proportion of cured patients. A favorable international prognostic index score (IPI), no B-symptoms, the use of anthracyclines, and prophylactic scrotal radiotherapy were significantly associated with longer survival at multivariate analysis. However, even for patients with stage I disease and good-risk IPI, the outcome seems worse than what was reported for DLCL at other sites. At a median follow-up of 7.6 years, 195 patients (52%) had relapsed. Extranodal recurrence was reported in 140 cases. Relapses in CNS were detected in 56 patients (15%) up to 10 years after presentation. A continuous risk of recurrence in the contralateral testis was seen in patients not receiving scrotal radiotherapy. CONCLUSION: Testicular DLCL is characterized by a particularly high risk of extranodal relapse even in cases with localized disease at diagnosis. Anthracycline-based chemotherapy, CNS prophylaxis, and contralateral testicular irradiation seem to improve the outcome. Their efficacy is under evaluation in a prospective clinical trial.en
dc.language.isoenen
dc.subjectTesticular Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAnalysis of Variance-
dc.subject.meshDisease-Free Survival-
dc.subject.meshHumans-
dc.subject.meshLymphoma, Large B-Cell, Diffuse-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPrognosis-
dc.subject.meshRecurrence-
dc.subject.meshRetrospective Studies-
dc.subject.meshSurvival Rate-
dc.subject.meshTesticular Neoplasms-
dc.subject.meshTreatment Outcome-
dc.titlePatterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group.en
dc.typeArticleen
dc.contributor.departmentDivision of Haematology/Medical Oncology, Peter MacCallum Cancer Institute, East Melbourne, Australia. ielsg@ticino.comen
dc.identifier.journalJournal of Clinical Oncologyen

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