Treatment outcome of primary testicular non-Hodgkin’s lymphoma

2013 ◽  
Vol 154 (42) ◽  
pp. 1666-1673
Author(s):  
János László Iványi ◽  
Éva Marton ◽  
Márk Plander ◽  
Zoltán Vendel Engert ◽  
Csaba Tóth
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Nervous System ◽  
Treatment Outcome ◽  
Survival Rates ◽  
Testicular Lymphoma ◽  
Hodgkin's Lymphomas ◽  
Disease Free ◽  
Overall Survival Rates ◽  
Primary Testicular Lymphoma

Introduction: Primary testicular lymphoma constitutes a rare subgroup among extranodal non-Hodgkin’s lymphomas. Because of its aggressive clinical behaviour due to high grade histological features developing mainly in older population, patients with this disease usually have a poor prognosis. Orchidectomy followed by combination immunochemotherapy is a traditional treatment method with a rather inferior outcome. Aim: In this retrospective survey the authors analysed the clinical presentation, pathological features and treatment results of patients with primary testicular lymphoma diagnosed and treated in their haematology centre between 2000–2012 Method: During this period 334 patients with aggressive non-Hodgkin’s lymphomas were treated, of whom 8 patients (2.39%; age between 23 and 86 years; median, 60 years) underwent semicastration for primary testicular lymphoma (7 patients had diffuse, large B-cell lymphoma and one patient had Burkitt-like lymphoma). According to the Ann Arbor staging system a limited stage I-IIE was diagnosed in 7 patients and advanced stage was found in one patient. All but one patients were treated with rituximab added to CHOP regimen (6 or 8 cycles in every 21 or 28 days), whereas one patient received radiotherapy only. Central nervous system intrathecal prophylaxis was used in one case and no preventive irradiation of the contralateral testis was used. Results: With a median follow-up of 50 months complete remission was observed in 7 patients. However, two patients died (one due to progression and one in remission from pulmonary solid tumour). Complete remission rate proved to be 87.5%, disease-free survival was between 13 and 152 months (median 38 months) and overall survival rates were between 17 and 156 months (median 43 months). The 5-year disease-free and overall survival rates were 37.5 %. Conclusions: The relatively favourable treatment outcome could be mainly explained by the high number of patients with early-stage of the disease, early surgical removal of testicular lymphomas and the use if immunochemotherapy. This therapeutic regimen was effective to prevent localized and distant relapses. Despite omission of regular prophylaxis of the central nervous system, no relapse was detected. Orv. Hetil., 154 (42), 1666–1673.

EPID-24. TRANSCRIPT: A cenTRAl NERVOUS SYSTEM CANCER CLINICAL tRIals PostmorTem

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi91-vi91
Author(s):  
Yeonju Kim ◽  
Terri Armstrong ◽  
Mark Gilbert ◽  
Orieta Celiku
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Clinical Trials ◽  
Nervous System ◽  
Brain Tumor ◽  
Objective Response ◽  
Survival Rates ◽  
Maximum Tolerated Dose ◽  
Secondary Outcome ◽  
Patient Reported

Abstract BACKGROUND Despite the growing number of neuro-oncology clinical trials, there have been limited advances in the treatment of malignant primary central nervous system tumors. We surveyed the landscape of past, ongoing, and planned trials to assess trends in their interventions, outcomes, and design considerations to guide future studies. METHODS Data on interventional trials on ClinicalTrials.gov were accessed programmatically using AACT and R. Neuro-oncology trials were isolated using primary malignant brain tumor classification terms. Instrument names from PROQOLID were used to identify clinical outcome assessment (COA) use. Linear regression was used to assess chronological trends; power analyses utilized CBTRUS survival rates among trials investigating overall survival. RESULTS We identified 3039 interventional brain tumor trials that started between 1966 and 2025. Trials were most frequently phase II (43%), completed (40%), non-blinded (92%), single-group assignment (65%), non-randomized (51%) studies targeting glioblastoma (45%). Planned outcomes were reported by 93% of trials; this included adverse event or toxicity (54%), overall/x-year survival (44%), progression free survival (43%), maximum tolerated dose (16%), and objective response rate (14%). Evaluating the anticipated and actual trial enrollment, we estimate that only 10% and 8% of trial arms, respectively, were sufficiently powered to assess overall survival endpoints. 21% of trials mentioned the use of a COA (first trial initiated in 1992), majority of which were patient-reported outcomes. Among these, 25% and 58% reported COA as a primary or secondary outcome, respectively. The rate of COA use increased linearly over time at 1.1%/year but remained less than 5 trials per year until 2003. Ongoing work is investigating treatment mechanisms of actions and evidence of preclinical efficacy among brain tumor studies. CONCLUSIONS Low randomization rates and underpowered trial design may impede interpretability of efficacy. Increasing trends in COA use suggests cumulative influence of advocacy efforts to holistically evaluate net clinical benefit of interventions.

scholarly journals THE ROLE OF INTRATUMORAL DENDRITIC CELLS IN THE PROGRESSION OF SQUAMOUS CELL CARCINOMAS

2019 ◽  
Vol 18 (4) ◽  
pp. 50-58
Author(s):  
L. N. Bondar ◽  
L. A. Tashireva ◽  
O. V. Savenkova ◽  
E. L. Choynzonov ◽  
V. M. Perelmuter
Keyword(s):  
Overall Survival ◽  
Squamous Cell ◽  
Inflammatory Responses ◽  
Survival Rates ◽  
Metastatic Tumor ◽  
Squamous Cell Carcinomas ◽  
The Relationship ◽  
Disease Free ◽  
Overall Survival Rates

The aim of the studywas to summarize data on the role of tumor-associated dendritic cells (DC) in the formation of squamous cell carcinoma microenvironment, their participation in the development of immune inflammatory responses in the tumor stroma and relation to tumor progression.Material and Methods. We analyzed 79 publications available from Pubmed, Google Scholar, Elibrary databases from January 2000 to December 2017.Results. The characteristics of different types of DC, including Langerhans cells (CR), were presented. The different methods of DC identification were described. The information on the presence of DC in squamous cell carcinomas was analyzed. The influence of the tumor on DCs, as well as the relationship between the number and functional characteristics of DCs and invasive/metastatic tumor potentialities was described. The prognostic value of DCs and their effect on disease-free, metastasis-free and overall survival rates were analyzed. The data on the association between DCs and the response to chemoradiotherapy were presented. The analysis of the relationship between the DC characteristics and the development of immuno-inflammatory responses in the tumor microenvironment was carried out.Conclusion. The methodological approaches to the detection of DCs are variable, but the sensitivity of each method, as well as the comparison of different methods for estimating the number and functional characteristics of DCs, have been little studied. There is no data on the relationship between the length of DC dendrites and the parameters of invasive/metastatic tumor potentialities, disease-free, metastasis-free and overall survival rates. Numerous studies indicate the association between the number of DCs and the tumor progression, however these data are contradictory. There is no data about the relationship between the number of DCs and hematogenous metastasis of squamous cell carcinomas. The association of tumor-associated DC with the types of immunoinflammatory responses in the tumor microenvironment has been insufficiently studied. 

How important is the axillary nodal status for adjuvant treatment decisions at a breast cancer multidisciplinary tumor board? A survival analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11041-11041
Author(s):  
T. Reimer ◽  
R. Fietkau ◽  
S. Markmann ◽  
A. Stachs ◽  
B. Gerber
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Treatment ◽  
Survival Rates ◽  
Nodal Status ◽  
Tumor Board ◽  
Axillary Surgery ◽  
The Impact ◽  
Disease Free ◽  
Overall Survival Rates

11041 Background: Postoperative tumor board recommendations for breast cancer are mainly based on patient characteristics and tumor parameters such as size, histologic grade, lymphovascular invasion (LVI), hormone receptor and HER2/neu status. In the era of potential avoidance of axillary surgery in clinically node-negative patients we evaluate the impact of pathologic nodal status for adjuvant treatment decisions. Methods: The postoperative tumor board records of 207 consecutive breast cancer patients over a 1-year period were rediscussed without knowledge of pathologic nodal status. Differences between the two board recommendations for each patient were classified as major (chemo- and/or radiotherapy: present/absent) or minor (different chemotherapeutic protocols) discrepancies. The disease-free and overall survival rates among subgroups with different recommendations were calculated using Adjuvant! Online tool. The binary logistic regression was performed to analyze the impact of factors for prediction the major discrepancy subgroup. Results: The tumor board without information of pathologic nodal status resulted in treatment changes in 72 of the 207 patients studied (34.8%). Major discrepancies were observed in 37 patients (17.9%) leading to a complete shift of postoperative management. Disease-free and overall survival rates were not significantly different due to a balanced over- and undertreatment in this subgroup (21 cases with under-, 16 cases with overtreatment). The major discrepancies were related to LVI (P=0.001), postmenopausal status (P=0.047), and positive hormone receptor status (P=0.17) in the univariate setting. LVI was an independent parameter to predict the subgroup with major discrepancies performing a multivariate analysis (P=0.006; RR=4.5 [95%CI: 1.5–13.4]). Conclusions: The knowledge of pathologic nodal status is important for postoperative chemotherapy and postmastectomy radiotherapy indications. There is a risk for one third of all patients when avoiding axillary surgery to get an adjuvant therapy which differ from the current treatment guidelines. It is mandatory to know the nodal status for breast tumors with LVI. No significant financial relationships to disclose.

scholarly journals PRIMARY TESTICULAR LYMPHOMA: A SINGLE CENTRE EXPERIENCE

2015 ◽  
Vol 37 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Y Kemal ◽  
F Teker ◽  
G Demirag ◽  
I Yucel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Initial Therapy ◽  
Clinicopathological Characteristics ◽  
Contralateral Testis ◽  
Testicular Lymphoma ◽  
Single Centre Experience ◽  
Prophylactic Chemotherapy ◽  
Primary Testicular Lymphoma

Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin’s lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. Materials and Methods: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. Results: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53–79 years). The mean follow-up time was 24.8 months (range 7–98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4–6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system after 6 months who had not received intrathecal prophylaxis. No contralateral testis relapse was observed. Conclusions: Primary testicular NHL is an uncommon entity and we evaluated 8 patients; with one relapse in central nervous system and no relapse in the contralateral testis.

scholarly journals Various Neurological Symptoms by Neurolymphomatosis as the Initial Presentation of Primary Testicular Lymphoma

2015 ◽  
Vol 8 (1) ◽  
pp. 200-204 ◽  
Author(s):  
Yoshitaka Sunami ◽  
Akihiko Gotoh ◽  
Yasuharu Hamano ◽  
Yuriko Yahata ◽  
Hiroko Sakurai ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Malignant Lymphoma ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Imaging Findings ◽  
Testicular Lymphoma ◽  
Old Japanese ◽  
Central Nervous System Infiltration ◽  
Primary Testicular Lymphoma

Neurological symptoms induced by the infiltration of malignant lymphoma into the nervous systems are subsumed under the term neurolymphomatosis (NL). Here, we report the case of a 30-year-old Japanese man with primary testicular lymphoma complicated, as seen in various neurological findings, by secondary NL prior to testicular swelling. Painless right scrotal enlargement was noticed more than 1 month after the appearance of neurological complications such as right upper extremity numbness, dysarthria, facial palsy, and diplopia. Proactive investigation and biopsies of extranodal sites at high risk of central nervous system infiltration of malignant lymphoma, such as the testes, should be considered when secondary NL is suspected based on imaging findings.

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