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Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the international extranodal lymphoma study group

Identifieur interne : 00B093 ( Main/Exploration ); précédent : 00B092; suivant : 00B094

Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the international extranodal lymphoma study group

Auteurs : E. Zucca [Australie, Canada, France, Italie, Pérou, Roumanie, Espagne, Suisse, États-Unis, Royaume-Uni] ; A. Conconi ; T. I. Mughal ; A. H. Sarris ; J. F. Seymour ; U. Vitolo ; R. Klasa ; M. Ozsahin ; G. M. Mead ; M. A. Gianni ; S. Cortelazzo ; A. J. M. Ferreri ; A. Ambrosetti ; M. Martelli ; C. Thieblemont ; H. Gomez Moreno ; G. Pinotti ; G. Martinelli ; R. Mozzana ; S. Grisanti ; M. Provencio ; M. Balzarotti ; F. Laveder ; G. Oltean ; V. Called ; P. Roy ; F. Cavalli ; M. K. Gospodarowicz

Source :

RBID : Pascal:03-0109536

Descripteurs français

English descriptors

Abstract

Purpose: To determine clinical features and patterns of outcome of primary testicular diffuse large B-cell lymphomas (DLCL). Patients and Methods: A retrospective international survey of 373 patients with primary testicular DLCL. Results: Most patients presented with localized disease (stage I to II), and the median age at diagnosis was 66 years (range, 19 to 91 years). Anthracycline-based chemotherapy was administered to 255 patients (68%), and prophylactic intrathecal chemotherapy was given to 68 patients (18%); 133 patients (36%) received prophylactic scrotal radiotherapy. Median overall survival was 4.8 years, and median progression-free survival was 4 years. The survival curves showed no clear evidence of a substantial proportion of cured patients. A favorable international prognostic index score (IPI), no B-symptoms, the use of anthracyclines, and prophylactic scrotal radiotherapy were significantly associated with longer survival at multivariate analysis. However, even for patients with stage I disease and good-risk IPI, the outcome seems worse than what was reported for DLCL at other sites. At a median follow-up of 7.6 years, 195 patients (52%) had relapsed. Extranodal recurrence was reported in 140 cases. Relapses in CNS were detected in 56 patients (15%) up to 10 years after presentation. A continuous risk of recurrence in the contralateral testis was seen in patients not receiving scrotal radiotherapy. Conclusion: Testicular DLCL is characterized by a particularly high risk of extranodal relapse even in cases with localized disease at diagnosis. Anthracycline-based chemotherapy, CNS prophylaxis, and contralateral testicular irradiation seem to improve the outcome. Their efficacy is under evaluation in a prospective clinical trial.


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Le document en format XML

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<name sortKey="Martelli, M" sort="Martelli, M" uniqKey="Martelli M" first="M." last="Martelli">M. Martelli</name>
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<name sortKey="Gomez Moreno, H" sort="Gomez Moreno, H" uniqKey="Gomez Moreno H" first="H." last="Gomez Moreno">H. Gomez Moreno</name>
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<name sortKey="Martinelli, G" sort="Martinelli, G" uniqKey="Martinelli G" first="G." last="Martinelli">G. Martinelli</name>
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<name sortKey="Mozzana, R" sort="Mozzana, R" uniqKey="Mozzana R" first="R." last="Mozzana">R. Mozzana</name>
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<name sortKey="Gospodarowicz, M K" sort="Gospodarowicz, M K" uniqKey="Gospodarowicz M" first="M. K." last="Gospodarowicz">M. K. Gospodarowicz</name>
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<affiliation wicri:level="3">
<inist:fA14 i1="17">
<s1>Servicio de Oncologia Medica, Clinica Puerta de Hierio</s1>
<s2>Madrid</s2>
<s3>ESP</s3>
</inist:fA14>
<country>Espagne</country>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="18">
<s1>Divisione di Oncologia Medica, Instituto Oncologico della Svizzera Italiana</s1>
<s2>Bellinzona</s2>
<s3>CHE</s3>
</inist:fA14>
<country>Suisse</country>
<wicri:noRegion>Bellinzona</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3">
<inist:fA14 i1="19">
<s1>Rare Cancer Network, Service de Radio-Oncologie, Centre Hospitalier Universitaire Vaudois</s1>
<s2>Lausanne</s2>
<s3>CHE</s3>
</inist:fA14>
<country>Suisse</country>
<placeName>
<settlement type="city">Lausanne</settlement>
<region nuts="3" type="region">Canton de Vaud</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="20">
<s1>Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center</s1>
<s2>Houston, TX</s2>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Houston, TX</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3">
<inist:fA14 i1="21">
<s1>Department of Haematology/Meical Oncology, Christie Hospital NHS Trust</s1>
<s2>Manchester</s2>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<settlement type="city">Manchester</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Manchester</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="22">
<s1>Cancer Research Campaign, Wessex Medical Oncology Unit, Southampton General Hospital</s1>
<s2>Southampton</s2>
<s3>GBR</s3>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Southampton</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Conconi, A" sort="Conconi, A" uniqKey="Conconi A" first="A." last="Conconi">A. Conconi</name>
</author>
<author>
<name sortKey="Mughal, T I" sort="Mughal, T I" uniqKey="Mughal T" first="T. I." last="Mughal">T. I. Mughal</name>
</author>
<author>
<name sortKey="Sarris, A H" sort="Sarris, A H" uniqKey="Sarris A" first="A. H." last="Sarris">A. H. Sarris</name>
</author>
<author>
<name sortKey="Seymour, J F" sort="Seymour, J F" uniqKey="Seymour J" first="J. F." last="Seymour">J. F. Seymour</name>
</author>
<author>
<name sortKey="Vitolo, U" sort="Vitolo, U" uniqKey="Vitolo U" first="U." last="Vitolo">U. Vitolo</name>
</author>
<author>
<name sortKey="Klasa, R" sort="Klasa, R" uniqKey="Klasa R" first="R." last="Klasa">R. Klasa</name>
</author>
<author>
<name sortKey="Ozsahin, M" sort="Ozsahin, M" uniqKey="Ozsahin M" first="M." last="Ozsahin">M. Ozsahin</name>
</author>
<author>
<name sortKey="Mead, G M" sort="Mead, G M" uniqKey="Mead G" first="G. M." last="Mead">G. M. Mead</name>
</author>
<author>
<name sortKey="Gianni, M A" sort="Gianni, M A" uniqKey="Gianni M" first="M. A." last="Gianni">M. A. Gianni</name>
</author>
<author>
<name sortKey="Cortelazzo, S" sort="Cortelazzo, S" uniqKey="Cortelazzo S" first="S." last="Cortelazzo">S. Cortelazzo</name>
</author>
<author>
<name sortKey="Ferreri, A J M" sort="Ferreri, A J M" uniqKey="Ferreri A" first="A. J. M." last="Ferreri">A. J. M. Ferreri</name>
</author>
<author>
<name sortKey="Ambrosetti, A" sort="Ambrosetti, A" uniqKey="Ambrosetti A" first="A." last="Ambrosetti">A. Ambrosetti</name>
</author>
<author>
<name sortKey="Martelli, M" sort="Martelli, M" uniqKey="Martelli M" first="M." last="Martelli">M. Martelli</name>
</author>
<author>
<name sortKey="Thieblemont, C" sort="Thieblemont, C" uniqKey="Thieblemont C" first="C." last="Thieblemont">C. Thieblemont</name>
</author>
<author>
<name sortKey="Gomez Moreno, H" sort="Gomez Moreno, H" uniqKey="Gomez Moreno H" first="H." last="Gomez Moreno">H. Gomez Moreno</name>
</author>
<author>
<name sortKey="Pinotti, G" sort="Pinotti, G" uniqKey="Pinotti G" first="G." last="Pinotti">G. Pinotti</name>
</author>
<author>
<name sortKey="Martinelli, G" sort="Martinelli, G" uniqKey="Martinelli G" first="G." last="Martinelli">G. Martinelli</name>
</author>
<author>
<name sortKey="Mozzana, R" sort="Mozzana, R" uniqKey="Mozzana R" first="R." last="Mozzana">R. Mozzana</name>
</author>
<author>
<name sortKey="Grisanti, S" sort="Grisanti, S" uniqKey="Grisanti S" first="S." last="Grisanti">S. Grisanti</name>
</author>
<author>
<name sortKey="Provencio, M" sort="Provencio, M" uniqKey="Provencio M" first="M." last="Provencio">M. Provencio</name>
</author>
<author>
<name sortKey="Balzarotti, M" sort="Balzarotti, M" uniqKey="Balzarotti M" first="M." last="Balzarotti">M. Balzarotti</name>
</author>
<author>
<name sortKey="Laveder, F" sort="Laveder, F" uniqKey="Laveder F" first="F." last="Laveder">F. Laveder</name>
</author>
<author>
<name sortKey="Oltean, G" sort="Oltean, G" uniqKey="Oltean G" first="G." last="Oltean">G. Oltean</name>
</author>
<author>
<name sortKey="Called, V" sort="Called, V" uniqKey="Called V" first="V." last="Called">V. Called</name>
</author>
<author>
<name sortKey="Roy, P" sort="Roy, P" uniqKey="Roy P" first="P." last="Roy">P. Roy</name>
</author>
<author>
<name sortKey="Cavalli, F" sort="Cavalli, F" uniqKey="Cavalli F" first="F." last="Cavalli">F. Cavalli</name>
</author>
<author>
<name sortKey="Gospodarowicz, M K" sort="Gospodarowicz, M K" uniqKey="Gospodarowicz M" first="M. K." last="Gospodarowicz">M. K. Gospodarowicz</name>
</author>
</analytic>
<series>
<title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
<imprint>
<date when="2003">2003</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Anthracyclins</term>
<term>Antineoplastic agent</term>
<term>B-Lymphocyte</term>
<term>Chemotherapy</term>
<term>Combined treatment</term>
<term>Human</term>
<term>Intravenous administration</term>
<term>Large cell lymphoma</term>
<term>Prognosis</term>
<term>Radiotherapy</term>
<term>Testicle</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Lymphome grande cellule</term>
<term>Testicule</term>
<term>Lymphocyte B</term>
<term>Anthracyclines</term>
<term>Anticancéreux</term>
<term>Chimiothérapie</term>
<term>Radiothérapie</term>
<term>Traitement associé</term>
<term>Voie intraveineuse</term>
<term>Pronostic</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Purpose: To determine clinical features and patterns of outcome of primary testicular diffuse large B-cell lymphomas (DLCL). Patients and Methods: A retrospective international survey of 373 patients with primary testicular DLCL. Results: Most patients presented with localized disease (stage I to II), and the median age at diagnosis was 66 years (range, 19 to 91 years). Anthracycline-based chemotherapy was administered to 255 patients (68%), and prophylactic intrathecal chemotherapy was given to 68 patients (18%); 133 patients (36%) received prophylactic scrotal radiotherapy. Median overall survival was 4.8 years, and median progression-free survival was 4 years. The survival curves showed no clear evidence of a substantial proportion of cured patients. A favorable international prognostic index score (IPI), no B-symptoms, the use of anthracyclines, and prophylactic scrotal radiotherapy were significantly associated with longer survival at multivariate analysis. However, even for patients with stage I disease and good-risk IPI, the outcome seems worse than what was reported for DLCL at other sites. At a median follow-up of 7.6 years, 195 patients (52%) had relapsed. Extranodal recurrence was reported in 140 cases. Relapses in CNS were detected in 56 patients (15%) up to 10 years after presentation. A continuous risk of recurrence in the contralateral testis was seen in patients not receiving scrotal radiotherapy. Conclusion: Testicular DLCL is characterized by a particularly high risk of extranodal relapse even in cases with localized disease at diagnosis. Anthracycline-based chemotherapy, CNS prophylaxis, and contralateral testicular irradiation seem to improve the outcome. Their efficacy is under evaluation in a prospective clinical trial.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Canada</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Pérou</li>
<li>Roumanie</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Canton de Vaud</li>
<li>Communauté de Madrid</li>
<li>Grand Manchester</li>
<li>Latium</li>
<li>Piémont</li>
<li>Rhône-Alpes</li>
</region>
<settlement>
<li>Lausanne</li>
<li>Lyon</li>
<li>Madrid</li>
<li>Manchester</li>
<li>Rome</li>
<li>Turin</li>
</settlement>
</list>
<tree>
<noCountry>
<name sortKey="Ambrosetti, A" sort="Ambrosetti, A" uniqKey="Ambrosetti A" first="A." last="Ambrosetti">A. Ambrosetti</name>
<name sortKey="Balzarotti, M" sort="Balzarotti, M" uniqKey="Balzarotti M" first="M." last="Balzarotti">M. Balzarotti</name>
<name sortKey="Called, V" sort="Called, V" uniqKey="Called V" first="V." last="Called">V. Called</name>
<name sortKey="Cavalli, F" sort="Cavalli, F" uniqKey="Cavalli F" first="F." last="Cavalli">F. Cavalli</name>
<name sortKey="Conconi, A" sort="Conconi, A" uniqKey="Conconi A" first="A." last="Conconi">A. Conconi</name>
<name sortKey="Cortelazzo, S" sort="Cortelazzo, S" uniqKey="Cortelazzo S" first="S." last="Cortelazzo">S. Cortelazzo</name>
<name sortKey="Ferreri, A J M" sort="Ferreri, A J M" uniqKey="Ferreri A" first="A. J. M." last="Ferreri">A. J. M. Ferreri</name>
<name sortKey="Gianni, M A" sort="Gianni, M A" uniqKey="Gianni M" first="M. A." last="Gianni">M. A. Gianni</name>
<name sortKey="Gomez Moreno, H" sort="Gomez Moreno, H" uniqKey="Gomez Moreno H" first="H." last="Gomez Moreno">H. Gomez Moreno</name>
<name sortKey="Gospodarowicz, M K" sort="Gospodarowicz, M K" uniqKey="Gospodarowicz M" first="M. K." last="Gospodarowicz">M. K. Gospodarowicz</name>
<name sortKey="Grisanti, S" sort="Grisanti, S" uniqKey="Grisanti S" first="S." last="Grisanti">S. Grisanti</name>
<name sortKey="Klasa, R" sort="Klasa, R" uniqKey="Klasa R" first="R." last="Klasa">R. Klasa</name>
<name sortKey="Laveder, F" sort="Laveder, F" uniqKey="Laveder F" first="F." last="Laveder">F. Laveder</name>
<name sortKey="Martelli, M" sort="Martelli, M" uniqKey="Martelli M" first="M." last="Martelli">M. Martelli</name>
<name sortKey="Martinelli, G" sort="Martinelli, G" uniqKey="Martinelli G" first="G." last="Martinelli">G. Martinelli</name>
<name sortKey="Mead, G M" sort="Mead, G M" uniqKey="Mead G" first="G. M." last="Mead">G. M. Mead</name>
<name sortKey="Mozzana, R" sort="Mozzana, R" uniqKey="Mozzana R" first="R." last="Mozzana">R. Mozzana</name>
<name sortKey="Mughal, T I" sort="Mughal, T I" uniqKey="Mughal T" first="T. I." last="Mughal">T. I. Mughal</name>
<name sortKey="Oltean, G" sort="Oltean, G" uniqKey="Oltean G" first="G." last="Oltean">G. Oltean</name>
<name sortKey="Ozsahin, M" sort="Ozsahin, M" uniqKey="Ozsahin M" first="M." last="Ozsahin">M. Ozsahin</name>
<name sortKey="Pinotti, G" sort="Pinotti, G" uniqKey="Pinotti G" first="G." last="Pinotti">G. Pinotti</name>
<name sortKey="Provencio, M" sort="Provencio, M" uniqKey="Provencio M" first="M." last="Provencio">M. Provencio</name>
<name sortKey="Roy, P" sort="Roy, P" uniqKey="Roy P" first="P." last="Roy">P. Roy</name>
<name sortKey="Sarris, A H" sort="Sarris, A H" uniqKey="Sarris A" first="A. H." last="Sarris">A. H. Sarris</name>
<name sortKey="Seymour, J F" sort="Seymour, J F" uniqKey="Seymour J" first="J. F." last="Seymour">J. F. Seymour</name>
<name sortKey="Thieblemont, C" sort="Thieblemont, C" uniqKey="Thieblemont C" first="C." last="Thieblemont">C. Thieblemont</name>
<name sortKey="Vitolo, U" sort="Vitolo, U" uniqKey="Vitolo U" first="U." last="Vitolo">U. Vitolo</name>
</noCountry>
<country name="Australie">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</country>
<country name="France">
<region name="Auvergne-Rhône-Alpes">
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</region>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</country>
<country name="Pérou">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
</country>
<country name="Roumanie">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
</country>
<country name="Espagne">
<region name="Communauté de Madrid">
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</region>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</country>
<country name="Royaume-Uni">
<noRegion>
<name sortKey="Zucca, E" sort="Zucca, E" uniqKey="Zucca E" first="E." last="Zucca">E. Zucca</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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