title: Consideration of aggressive therapeutic strategies for primary testicular lymphoma.
abstract: To evaluate the clinical features and treatment of primary testicular lymphoma, 45 cases were retrospectively evaluated. The median age of the patients was 59 years (range, 40-81) and most patients (76%) presented with Stages I-II. All patients underwent an orchiectomy, after which various treatments were given, chemotherapy alone in 37 patients (60%) and chemotherapy with involved field radiotherapy (IFRT) in 15 patients (33%). Prophylactic intrathecal chemotherapy was given to six patients; cranial irradiation was given in two patients. Eleven patients (24%) received prophylactic irradiation or surgery on the contralateral testis. In 40 patients able to be evaluated, complete response (CR) rate was 78%; 11 of 31 CR patients (36%) had relapsed. Relapse or disease progression was observed in 21 patients. The most frequent site (44%) was in the CNS. The median progression free survival and overall survival were 16 and 34 months, respectively. Ten patients who received prophylactic radiation to the contralateral testis had no relapse in this site. In six patients who received prophylactic intrathecal chemotherapy, there was no leptomeningeal progression, but brain parenchymal relapse occurred in two patients. In multivariate analysis, Stage I (P = 0.02) and additional IFRT after orchiectomy (P = 0.01) were found to be good prognostic factors. In conclusion, orchiectomy followed by intensive chemotherapy and IFRT including prophylaxis to the CNS and contralateral testis, should be considered as initial treatment in primary testicular lymphoma.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University College of Medicine, 17 Haengdang-dong, Sungdong-gu, Seoul 133-791, Korea.
authors.forename: Byeong-Bae
authors.initials: BB
authors.lastname: Park
authors.forename: Jong Gwang
authors.initials: JG
authors.lastname: Kim
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Seung Sook
authors.initials: SS
authors.lastname: Lee
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Hyuck Chan
authors.initials: HC
authors.lastname: Kwon
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
authors.forename: Suk Joong
authors.initials: SJ
authors.lastname: Oh
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Baek Yeol
authors.initials: BY
authors.lastname: Ryoo
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016543:Central Nervous System Neoplasms / Q000556:secondary; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome