A retrospective study of clinical characteristics and prognostic factors of primary testicular lymphoma

ObjectiveTo assess the clinical characteristics, prognostic factors, and treatment outcomes of primary testicular lymphoma (PTL).Materials and MethodsWe reviewed the medical records of PTL patients diagnosed between January 2000 and May 2012 at four hospitals in Taiwan. The following data were collected and analyzed: patient age at diagnosis, B symptoms (fever, night sweats, and/or weight loss), tumor localization (diffuse or testis alone), tumor site (left, right, or bilateral), stage of disease, histological pattern, International Prognostic Index, treatment method and outcome, relapse, and survival time. Kaplan–Meier curves were constructed to assess the effects of various factors on patient survival.ResultsThirty patients with PTL were included in this study. The median age at diagnosis was 62.5 years (range: 19–89 years) and median overall survival (OS) was 44 months. The majority of the patients had unilateral lymphoma, stage I/II disease, and diffuse large B-cell lymphoma. An absence of B symptoms, limited disease stage, lymphoma localized to testis only, and orchidectomy were considered to be significantly favorable prognostic factors of OS (p < 0.05). The PTL treatment regimen varied among patients and included orchidectomy, chemotherapy, and/or radiotherapy. Interestingly, although 50% patients achieved complete remission (CR) post-treatment, relapse was observed in 42% patients during the follow-up period. Nonetheless, patients who initially underwent orchidectomy appeared to have a significantly better survival rate, whereas chemotherapy proved more advantageous for those with the diffuse-type PTL.ConclusionPTL is characterized by unique clinical features and prognostic factors. Despite differing treatment regimens, 50% of patients achieved CR. Patients with testicular localization who underwent orchidectomy may achieve better outcomes, whereas chemotherapy proved to be beneficial in those with diffuse-type PTL.