Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the international extranodal lymphoma study group

E. Zucca, A. Conconi, T. I. Mughal, A. H. Sarris, J. F. Seymour, U. Vitolo, R. Klasa, M. Ozsahin, G. M. Mead, M. A. Gianni, S. Cortelazzo, A. J M Ferreri, A. Ambrosetti, M. Martelli, C. Thiéblemont, H. Gomez Moreno, G. Pinotti, G. Martinelli, R. Mozzana, S. GrisantiM. Provencio, M. Balzarotti, F. Laveder, G. Oltean, V. Callea, P. Roy, F. Cavalli, M. K. Gospodarowicz

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)20-27
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 1 2003

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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