Adult primary testicular lymphoma: clinical features and survival in a series of patients treated at a high-volume institution in China

Abstract

Background: To retrospectively investigate the clinical characteristics, initial treatment, relapse, therapy outcome, and prognosis of Chinese patients with primary testicular lymphoma (PTL) through analysis of the cases of our institute. Methods: From December 2008 to July 2018, all patients with PTL were included in this study. Kaplan-Meier method was used to estimate PFS and OS. The Cox proportional hazards model was used to compare the survival times for groups of patients differing in terms of clinical and laboratory parameters. Results: All 28 PTL patients (24 DLBCL, three NK/T lymphomas, and one Burkkit's lymphoma) with a median age of 65.5 years were included in this study. Six patients were observed recurrence among all the 22 individuals evaluated. Following orchiectomy and systemic chemotherapy, with or without intrathecal prophylaxis, complete response was achieved in 15 (68%) patients. For DLBCL patients, the median progression-free survival (PFS) was 44.63 months (95% CI 17.71-71.56 months), and the median overall survival (OS) was 77.02 months (95% CI, 57.35-96.69 months). For all the DLBCL patients, the 5-year PFS and 5-year OS were 35.4% (95%CI, 14.8-56.0%) and 53.4% (95%CI, 30.1-76.7%). Without further chemotherapy following orchiectomy (HR = 3.4, P = 0.03) were associated with inferior PFS of DLBCL patients. Advanced Ann Arbor stage (HR =5.9, P = 0.009) and high (international prognostic index, IPI) score: 3-5 (HR =3.9, P = 0.04) were correlated with shorter OS of DLBCL patients. Conclusion: This study confirms that PTL is an aggressive malignant with a poor prognosis. Limited Ann Arbor stage, further chemotherapy following orchiectomy, and low IPI score (less than 2) are correlated with superior survival for DLBCL patients.

Testicular Tumors: A 15-Year Archive Review and Histopathological Evaluation

“…The most common type is diffuse large B-cell lymphoma with a rate of 80-90%. [15] Diffuse large B cell lymphoma was observed in 4 (6.2%) of our cases. Three of these cases were over 60 years old.…”

A case at crossroads—urological presentation, cardiac complication and haematological diagnosis: should imaging be pursued prior to orchidectomy at all costs?

“…The urology team considered whether preoperative imaging and tissue biopsy would have altered this patient’s outcome; however, orchidectomy is the first-line management of patients with DLBCL presenting with primary or secondary testicular lesions [ 11 ]. Therefore, a tissue biopsy would not have influenced the decision to operate prior to imaging.…”

Testicular non-Hodgkin’s lymphoma – a rare tumor

“…Testicular lymphoma is a rare disease with an annual incidence of 0.26 cases per 100,000 and the most common testicular malignancy in elderly males above the age of 60 years. 1,2 This accounts for about 1% to 2% of all non-Hodgkin lymphomas (NHLs) and approximately 5% of all testicular neoplasms. 2 The most common histological subtype of PTL is diffuse large B-cell lymphoma (DLBCL).…”

“…Primary testicular lymphoma (PTL) is a rare disease with an annual incidence of 0.26 cases per 100,000. 1 It is the most common testicular malignancy in elderly males above the age of 60 years, with the most common histological subtype being diffuse large B-cell lymphoma (DLBCL). 2,3 Clinical suspicion of a testicular neoplasm can be supported by imaging studies and estimation of serum tumor marker levels.…”