Primary testicular lymphoma—A single center experience and review of literature

Abstract

ObjectiveThe purpose of this study is to evaluate the clinical characteristics, pathology, treatment outcomes, and survival of primary testicular lymphoma (PTL) patients treated at our hospital after 1990. Related literature was reviewed. Materials and methodsWe retrospectively enrolled patients diagnosed with PTL between January 1990 and September 2013 in our institute. Clinical features, pathology, and overall survival were analyzed. Results24 patients were enrolled. They had a mean age at diagnosis of 65.0 years (range 10–84 y), mean follow-up duration 57.0 months (range 3–182 mo), and median overall survival of 38 months (range 4.0–184.7 mo). The most common pathology subtype was diffuse large B-cell lymphoma (n = 21, 87.5%). Fourteen patients (58.3%) achieved complete remission of disease and five patients (20.8%) achieved partial remission after treatment. Three patients had a relapse of disease after complete remission: one in the brain parenchyma, one in the pelvis soft tissue and omentum, and one in the left pyriform muscle. Three patients had metastasis after partial remission of disease: two in the brain parenchyma and one in the cauda equina. By univariate analysis, the factors significantly associated with superior overall survival were primary tumor diameter < 7.5 cm, serum lactate dehydrogenase ≤ 250 U/L, Ann-Arbor Stage IE/II, and International Prognostic Index (IPI) ≤ 1 (p < 0.05). Rituximab-containing treatment did not show overall survival benefits in our series. By multivariate analysis, IPI ≤ 1 showed statistical significance (p = 0.019), suggesting a potential prognostic value of IPI in evaluating PTL patients. ConclusionsThe overall survival of PTL patients is poor, especially those with extensive disease (Stage III/IV). The IPI have a prognostic role in PTL. The use of rituximab in the treatment regimen of PTL does not seem to improve survival in our series.