[Non-Hodgkin's primitive lymphoma of the testis: long-term prognosis associated with treatment combining systemic and intrathecal chemotherapy].
OBJECTIVE
To evaluate the long-term prognosis of a retrospective series of primitive malignant non-Hodgkin's lymphoma (MNHL) of the testicle treated by orchidectomy and combined systemic and intrathecal chemotherapy.


METHODS
From 1992 to 2006, eight consecutive patients were treated for a primitive MNHL of the testicle (stages : IA [n=1], IEA [n=5], IIEA [n=1], IVEA [n=1]) and retrospectively analyzed. All of these tumors were highly malignant. The average age of the patients at the time of diagnosis was 64 years old (46-78). All the patients benefited from an enlarged orchidectomy and received a combination of systemic and intrathecal CHOP and VACP chemotherapy. Six patients finished with some locoregional radiotherapy and three had cerebral radiotherapy.


RESULTS
Patients were treated over an average period of 90.5 months (12 to 168 months). Five patients (62.5%) responded successfully, one patient had a cerebral relapse stabilized by a second course of chemotherapy. Three patients died, one from septic shock during chemotherapy (IVEA stage), another from mesenteric infarction (IAE stage) and the third from acute coronary thrombosis while in complete remission.


CONCLUSIONS
In spite of a reputedly bleak prognosis, primitive MNHL of the testicle treated with a combination of systemic and intrathecal chemotherapy would seem to be associated with a good specific long-term survival. Unfortunately, the rate of mortality linked to chemotherapy is significant (close to 12.5% in our series) and would not appear to entirely protect against cerebral recurrence.
Sénéchal
C
C
Service d'urologie et transplantation rénale, CHU Hôpital-Sud, Amiens, France. cedricsenechal@yahoo.fr
Saint
F
F
Petit
T
T
Petit
J
J
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone