THE MANAGEMENT AND OUTCOME OF STAGE IA(E) NONHODGKINS LYMPHOMA OF THETESTIS

Purpose: The initial management of stage I nonHodgkin's lymphoma of th e testis is by orchiectomy but the role and efficacy of adjuvant strat egies are uncertain. We reviewed cases of lymphoma at our institution to determine whether adjuvant treatment was beneficial. Materials and Methods: A retrospective review of outcome was conducted on 26 patient s who presented to our institution. Median followup for the group was 54 months. Kaplan-Meier actuarial analyses were performed on the entir e group and subsets. Results: Actuarial 5 and 10-year overall survival rates were 79% and 63%, and relapse-free survival rates were 61% and 46%, respectively. In patients who received adjuvant combination chemo therapy the 5-year relapse-free survival rate improved (75% versus 50% ) but effect did not achieve;statistical significance and was lost by 10 years. No relapse-free survival advantage was noted for patients re ceiving adjuvant irradiation to the pelvic and para-aortic nodes. Pati ents who did not receive irradiation remained free of isolated relapse s in the pelvic or para-aortic regions. Conclusions: These data lend s upport to the use of adjuvant chemotherapy but do not support a role f or adjuvant nodal irradiation.