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, EConconi, 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
Affiliation
Division of Haematology/Medical Oncology, Peter MacCallum Cancer Institute, East Melbourne, Australia. ielsg@ticino.comIssue Date
2003-01-01
Metadata
Show full item recordAbstract
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.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 OncologyDOI
10.1200/JCO.2003.11.141PubMed ID
12506165Type
ArticleLanguage
enISSN
0732-183Xae974a485f413a2113503eed53cd6c53
10.1200/JCO.2003.11.141