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

Bo Chen,Na Ma,Jian-Bing Guo,Li Lai,Shi Qiu,Tian-Hai Lin,Ze-Yu Chen,Liang-Ren Liu,Qiang Wei,Yin Huang,Yue Gou,De-Hong Cao,Lu Yang

doi:10.1186/s12885-020-6711-0

Bo Chen, Na Ma + Show 11 more

Open Access

https://doi.org/10.1186/s12885-020-6711-0

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Abstract

BackgroundTo 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.MethodsFrom 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.ResultsAll 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.ConclusionThis 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.

Highlights

Primary testicular lymphoma (PTL) is a rare entity with an annual incidence of 0.26 cases per 100,000 personyears and the most common malignant testicular neoplasms in male over 60 years old, which accounts for about 1–9% in testicular tumors and 1–2% of all nonHodgkin’s lymphomas [1,2,3]
Patients were identified by searching database of West China Hospital of Sichuan University for cases of testicular lymphoma occurring from December 2008 to July 2018. 28 patients with primary primary testicular lymphoma (PTL) were included in this study
Twenty-eight male patients diagnosed with PTL with a median age of 65.5 years (IQR 56.5–72.8 years) met the eligibility criteria for our study

Summary

Introduction

Primary testicular lymphoma (PTL) is a rare entity with an annual incidence of 0.26 cases per 100,000 personyears and the most common malignant testicular neoplasms in male over 60 years old, which accounts for about 1–9% in testicular tumors and 1–2% of all nonHodgkin’s lymphomas [1,2,3]. Chen et al BMC Cancer (2020) 20:220 testicular lymphoma is usually confirmed through orchiectomy or testis biopsy. The most common clinical symptom of PTL is a unilateral painless testicular swelling developing more than weeks to months, even several years. A minority of patients appear a testicular swelling with sharp pain. Bilateral testicular swelling is seen in around 35% of patients [3, 7, 8]. 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

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