965P - Prolonged relapse pattern in primary testicular lymphoma after successful induction therapy

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Lymphomas
Presenter Joanna Romejko-Jarosinska
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors J. Romejko-Jarosinska1, M. Szymczyk2, L. Poplawska1, G. Rymkiewicz1, K. Domańska-Czyz1, B. Ostrowska1, E. Mroz1, M. Osowiecki1, J.A. Walewski1
  • 1Lymphoma Department, MSC Memorial Cancer Centre and Institute Maria Sklodowska-Curie, 02-781 - Warsaw/PL
  • 2Department Of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute and Cancer Center, 02-781 - Warsaw/PL

Abstract

Aim

Testicular lymphoma is characterised by aggressive clinical course and in cases of treatment failure frequently involviesCNS and contralateral testis. Late relapses have been reported in occasional series. Here we looked at clinical features and outcome of patients treated at a single instiution over a period of 25 years.

Methods

We retrospectively reviewed medical records of consecutive patients diagnosed with primary testicular lymphoma treated at our institution between 1988 and 2013.

Results

Sixty four patients with a diagnosis of diffuse large B-cell lymphoma and primary testicular involvement were identified. Median age was 67. All patients had initial surgery including bilateral orchiectomy in 5 patients. Majority of patients (n = 48, 75%) were in clinical stage IE ad IIE at presentation. Risk category according to the modified NCCN-IPI was low or low-intermediate in 48 (75%) patients. Chemotherapy was given to 57 (89%) inluding rituximab in 29 (45%) of patients. CNS prophylaxis with intrathecal methotrexate was applied in 35 (55%) patients. Radiotherapy to contralateral testis was applied to 3 patients. Out of 48 (70%) patients in complete remission after initial treatment, 19 (38%) subsequently relapsed at median (range) of 36 (3.5 -144) months with many relapses occuring far beyond of 3 years. 62% of relapsed patients died of disease. In patients who relapse late, extranodal sites were frequently involved. Eight patients had CNS relapse including 6 patients not given CNS prophylaxis. Four patients relapsed in contralateral testis.

Conclusions

Despite low- or low-intremediate risk status of majority of patients median time to relapse of 3years is disappointing and many relapses occurred late. Non-use of radiotherapy seems unlikely reason as only 4 patients relapsed in contralateral testis. Less than half of the patients received rituximab which might contribute to the worse outcome.

Disclosure

All authors have declared no conflicts of interest.