Non-Hodgkin’s lymphoma of the testis: A retrospective study of 84 patients treated in the French anticancer centres

Abstract

Primary non-Hodgkin's lymphoma of the testicle is rare. We analysed cases treated in French anticancer centres from 1969 to 1995. All cases were reviewed and classified according to the R.E.A.L. Classification. Eighty-four cases were included in this study. The median age was 67 years (17-85). Disease was classified as stages I in 42 cases, stages II in 19 and stages III-IV in 23. Diffuse large B-cell lymphoma was diagnosed in 75% of cases. Treatment included orchidectomy and radiotherapy and/or chemotherapy. A complete response was obtained in 72.6% of the patient population and in 100%, 68% and 33% of stage I, II and III-IV disease respectively. Recurrence occurred in 32 cases and the most frequent site was the central nervous system: six of these patients presented stage I disease. Median overall survival was 32 months for the entire population, 52 months for stage I, 32 months for stage II, and 12 months for stage III-IV cases (P < 0.0001). Among patients presenting stage I disease, no difference was found between those treated with combined surgery and chemotherapy or surgery followed or not followed by radiotherapy. This study confirms that non-Hodgkin's lymphoma of the testicle carries a poor prognosis. Systemic adjuvant chemotherapy should be discussed because of the high recurrence rate. Inclusion of these cases in large co-operative prospective studies is recommended.

Testicular lymphoma A Retrospective, Population-based, Clinical and Immunohistochemical Study

“…The choice of further treatment is still a matter of debate, owing to the rare incidence of the disease and the absence of prospective, randomized studies. Systemic, doxorubicin-based chemotherapy has been widely used also in patients with localized disease, since early retrospective reports indicated an improved outcome by adding chemotherapy to surgery9/RT (2 Á/4), but in two recently published, retrospective studies no such benefit was noted (17,18). However, in a very large, retrospective, multicentre study (19), Zucca et al reported a survival benefit for patients treated with anthracycline-containing chemotherapy, regardless of disease stage, and a better outcome for patients who had received at least six cycles of chemotherapy.…”

A rare case of non-Hodgkins lymphoma of testis: case study and review of literature

“…If treated with orchidectomy alone, the majority of these patients relapse within the first two years at various extranodal sites, and hence the use of adjuvant systemic chemotherapy, radiotherapy and also prophylactic intrathecal chemotherapy has been emphasized. 10,20 In a series of 16 patients, the median survival exceeded 57 months for those with stage IE disease, whereas it was six months for patients with advanced disease. No patient with disease that had spread to or beyond the para-aortic lymph nodes survived beyond 19 months.…”

“…18 CNS relapses have been reported in 14% of stage I cases and 10.5% of stage II cases. 10 In a series of 22 patients, the CNS or the contralateral testis were involved in all the patients who failed to respond to primary therapy and in 50% of those who relapsed from complete remission. 16 Thus, lumbar puncture is warranted as one of the initial procedures at the time of diagnosis.…”

“…1,4,6,9 TNHL has a predilection for dissemination to non-contiguous extranodal sites such as the CNS, Waldeyer's ring, skin and lungs. 1,4,10,12 Martenson et al reported a 10% incidence of CNS involvement in the initial failure and 20% in subsequent relapses. 18 CNS relapses have been reported in 14% of stage I cases and 10.5% of stage II cases.…”

“…10 For stages IE and IIE, there is universal agreement on orchidectomy as the initial treatment. If treated with orchidectomy alone, the majority of these patients relapse within the first two years at various extranodal sites, and hence the use of adjuvant systemic chemotherapy, radiotherapy and also prophylactic intrathecal chemotherapy has been emphasized.…”