OBJECTIVETo study the clinical and pathological features of primary lymphoma of the testis and try to find out the rational treatment modality.

METHODSRetrospective and follow-up analysis was conducted in 23 patients with primary lymphoma of the testis. Survival analysis was performed by Kaplan-Meier process.

RESULTSThe primary clinical symptom was painless tumefaction. 78.3% lesions were Stage I(E) on diagnosis. Most of them were intermediate grade B cell lymphoma. All patients received orchiectomy followed by chemotherapy and some followed by radiotherapy. The median survival time was 42 months. The overall survival rates at 1, 3 and 5 years were 100.0%, 59.8% and 36.5%, respectively. The disease-free survival rates at 1, 3 and 5 years were 66.7%, 42.3% and 36.3%, respectively.

CONCLUSIONPrimary lymphoma of the testis is preferably treated by multi-modality treatment. More than 6 cycles of chemotherapy is rational after orchiectomy. Regional radiotherapy tends to reduce the local relapse.

Adult ; Aged ; Humans ; Lymphoma ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Testicular Neoplasms ; mortality ; pathology ; surgery

For children with stage II testicular malignant germ cell tumors (MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes (relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months (range, 4 months to 17 years) were enrolled in this study. In 20 cases (83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients (76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively (P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively (P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors.
Adolescent ; Chemotherapy, Adjuvant ; Child ; Child, Preschool ; Combined Modality Therapy ; Humans ; Infant ; Male ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal ; mortality ; pathology ; therapy ; Survival Rate ; Testicular Neoplasms ; mortality ; pathology ; therapy

PURPOSE: To evaluate the clinicopathologic and oncological outcomes of advanced metastatic testicular cancer in Korean men who underwent retroperitoneal lymph node dissection (RPLND) following chemotherapy. MATERIALS AND METHODS: Data of 26 patients with testicular cancer who underwent RPLND after chemotherapy at 2 hospitals in Korea between September 2004 and June 2016 were retrospectively analyzed. Clinical and histopathological variables such as stage of the testicular cancer, age of the patients during surgery, size of the retroperitoneal lymph nodes (RPLNs), histopathological results, duration and complications related to the surgery, cancer recurrence, and mortality were analyzed. RESULTS: During testicular surgery, the T stage was pT1, pT2, and pT3 in 50% (n=13), 26.9% (n=7), and 15.3% (n=4) of the patients, respectively. Mixed germ cell tumor was the most common finding, seen in 73.1% (n=19) of patients. The indications for RPLND were residual lymph nodes after chemotherapy, 84.6% (n=22); and disease progression and remission, 7.7% (n=2). Pathological analysis revealed viable tumors in 19.2% of patients (n=5), necrotic/fibrotic tissue in 42.3% (n=11), and teratoma in 34.6% (n=9). Intraoperative and postoperative complications occurred in 23.1% (n=6) and 19.2% of patients (n=5). The median duration of follow-up was 27.5 months (interquartile range, 1.3–108.2 months); 11.5% (n=3) patients had recurrence, and 3.8% (n=1) died of progressive metastatic testicular cancer. CONCLUSIONS: Viable germ cell tumors were present in 19.2% of patients with testicular cancer who underwent RPLND after chemotherapy. This is the first study of its kind in the Korean population.
Disease Progression ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Lymph Node Excision* ; Lymph Nodes* ; Male ; Mortality ; Neoplasms, Germ Cell and Embryonal ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Teratoma ; Testicular Neoplasms*

This study aims to investigate the effect of different local testicular treatments and validate common prognostic factors on primary testicular lymphoma (PTL) patients. We retrospectively reviewed the clinical records of 32 patients from 1993 to 2017 diagnosed with PTL and included 22 patients for analysis. The Kaplan-Meier method, Log-rank test, and multivariate Cox proportional hazard regression analysis were applied to evaluate progression-free survival (PFS), overall survival (OS), and determine prognosis predictors. The median follow-up time was 30 months. Median OS and PFS were 96 months and 49 months, respectively. In univariate analysis, advanced Ann Arbor stage (III/IV) (P < 0.001), B symptoms (P < 0.001), and extranodal involvement other than testis (P = 0.001) were significantly associated with shorter OS and PFS. In multivariate analysis, Ann Arbor stage was significantly associated with OS (OR = 11.58, P = 0.049), whereas B symptom was significantly associated with PFS (OR = 11.79, P= 0.049). In the 10 patients with the systemic usage of rituximab, bilateral intervention could improve median OS from 16 to 96 months (P = 0.032). The study provides preliminary evidence on bilateral intervention in testes in the rituximab era and validates common prognostic factors for Chinese PTL patients.
Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use* ; Asian People ; China/epidemiology* ; Humans ; Kaplan-Meier Estimate ; Lymphoma/mortality* ; Male ; Middle Aged ; Prognosis ; Progression-Free Survival ; Retrospective Studies ; Rituximab/therapeutic use* ; Survival Analysis ; Testicular Neoplasms/mortality* ; Treatment Outcome

OBJECTIVETo improve the diagnosis, therapy and prognosis of testicular tumor in Mongolian men.

METHODSA retrospective review of 35 cases of testicular tumors in Mongolian men from seven medical centers dated from 1990 to 2004 was performed.

RESULTSThe usual presentation of a testicular tumor was a nodular or painless swelling of one gonad. The mean delay in diagnosis was 40.03 +/- 53.45 weeks. For 16 patients, delay in diagnosis was more than or equal to six months. The histologic composition of this series was 21 (60%) seminoma, 10 (28.6%) nonseminoma, 2 (5.7%) lymphoma, 1 (2.35%) fibroneuroma and 1 (2.35%) leiomyoma. Regarding stage, 22, 2, and 5 of 29 germ cell tumors were seen initially as stage I, II, and III, respectively. Combined therapy, including radical orchiectomy, radiotherapy and chemotherapy, were taken. 29 cases have been followed for 2 months to 10 years, 4 out of them died of distant metastasis, one died of other disease, one lives with tumor, the others live without relapse and metastasis. Three and 5-year survival rates for Mongolian patients with seminoma and nonseminoma were 95.0%, 95.0%, 57.1% and 42.8%, respectively.

CONCLUSIONIn this article, the rate of seminoma to germ cell tumors is higher than that of general population. There is an increased mean delay in diagnosis for Mongolian patients. Three and 5-year survival rates for nonseminoma are lower than that for seminoma. Better public awareness regarding testicular tumor in this population, advances in diagnosis and therapy will help to improve therapeutic effectiveness and prognosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child, Preschool ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Testicular Neoplasms ; diagnosis ; mortality ; therapy