Clinical Characteristics And Survival Status Of Patients With Primary Testicular Lymphoma

Objective: to further explore the clinical characteristics,treatment and related factors affecting the prognosis of patients with primary testicular lymphoma(PTL),so as to improve the overall survival rate and progression-free survival rate of patients with testicular lymphoma.Methods: a total of 51 patients with primary testicular lymphoma treated in the Department of Lymphoma in our hospital from January 2010 to December 2018 were analyzed retrospectively.Univariate analysis,multivariate analysis and Kaplan-Meier survival curve analysis were used to evaluate the clinical characteristics and prognostic factors of PTL.Results: among the 51 patients,37(72.5%)were in stage Ⅰ~Ⅱ,14(27.5%)in stage Ⅲ~Ⅳ,42(82.4%)in diffuse large B-cell lymphoma,4 cases(7.84%)in T-cell lymphoma,and 3 cases(5.88%)in unclassified B-cell lymphoma,Burkitt lymphoma in 2 cases(3.92%).The overall 5-year survival rate(OS)of the whole group was 37.8%.The 5-year progression-free survival rate(PFS)was 34.6%.Univariate analysis showed that the patients with IPI prognostic index≥2,increased LDH,clinical stage Ⅲ~IV,initial curative effect not reaching CR,uncompleted comprehensive treatment and non-intrathecal injection had a poor prognosis.The results of multivariate analysis showed that whether the comprehensive treatment was completed,whether the initial efficacy reached CR,IPI score were the risk factors for the prognosis of PTL patients.Conclusion: Primary testicular lymphoma usually occurs in elderly men with low incidence.Thema in clinical manifestation is painless and progressive enlargement of testis.The most common pathological type is DLBCL.The main treatment of PTL is radical orchiectomy combined with high ligation of spermatic cord,and postoperative systemic chemotherapy is recommended.Rituximab+anthracycline(R-CHOP)is recommended as the main chemotherapy regimen.For the prevention of recurrence of contralateral testis and central nervous system,high-dose intrathecal methotrexate injection and contralateral testis and regional lymph nodes radiotherapy are recommended.