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

Details

Serval ID
serval:BIB_F4E02920A4C2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
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.
Journal
Journal of Clinical Oncology
Author(s)
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., Ambrosetti A., Martelli M., Thiéblemont C., Moreno H.G., 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.
ISSN
0732-183X
Publication state
Published
Issued date
2003
Peer-reviewed
Oui
Volume
21
Number
1
Pages
20-27
Language
english
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.
Keywords
Adult, Aged, Aged, 80 and over, Analysis of Variance, Disease-Free Survival, Humans, Lymphoma, Large B-Cell, Diffuse/diagnosis, Lymphoma, Large B-Cell, Diffuse/mortality, Male, Middle Aged, Prognosis, Recurrence, Retrospective Studies, Survival Rate, Testicular Neoplasms/diagnosis, Testicular Neoplasms/mortality, Treatment Outcome
Pubmed
Web of science
Create date
24/01/2008 17:16
Last modification date
20/08/2019 16:21
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