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.Acontinuous 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.
| Original language | English |
|---|---|
| Pages (from-to) | 20-27 |
| Number of pages | 8 |
| Journal | Journal of Clinical Oncology |
| Volume | 21 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2003 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the international extranodal lymphoma study group. / Zucca, E.; Conconi, A.; Mughal, T. I.; Sarris, A. H.; Seymour, J. F.; Vitolo, U.; Klasa, R.; Ozsahin, M.; Mead, G. M.; Gianni, M. A.; Cortelazzo, S.; Ferreri, A. J M; Ambrosetti, A.; Martelli, M.; Thiéblemont, C.; Moreno, H. Gomez; Pinotti, G.; Martinelli, G.; Mozzana, R.; Grisanti, S.; Provencio, M.; Balzarotti, M.; Laveder, F.; Oltean, G.; Callea, V.; Roy, P.; Cavalli, F.; Gospodarowicz, M. K.
In: Journal of Clinical Oncology, Vol. 21, No. 1, 01.01.2003, p. 20-27.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the international extranodal lymphoma study group
AU - Zucca, E.
AU - Conconi, A.
AU - Mughal, T. I.
AU - Sarris, A. H.
AU - Seymour, J. F.
AU - Vitolo, U.
AU - Klasa, R.
AU - Ozsahin, M.
AU - Mead, G. M.
AU - Gianni, M. A.
AU - Cortelazzo, S.
AU - Ferreri, A. J M
AU - Ambrosetti, A.
AU - Martelli, M.
AU - Thiéblemont, C.
AU - Moreno, H. Gomez
AU - Pinotti, G.
AU - Martinelli, G.
AU - Mozzana, R.
AU - Grisanti, S.
AU - Provencio, M.
AU - Balzarotti, M.
AU - Laveder, F.
AU - Oltean, G.
AU - Callea, V.
AU - Roy, P.
AU - Cavalli, F.
AU - Gospodarowicz, M. K.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - 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.Acontinuous 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.
AB - 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.Acontinuous 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=18744370725&partnerID=8YFLogxK
U2 - 10.1200/JCO.2003.11.141
DO - 10.1200/JCO.2003.11.141
M3 - Article
C2 - 12506165
AN - SCOPUS:18744370725
VL - 21
SP - 20
EP - 27
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 1
ER -