Uncertainty and discordance in the staging and prognosis of diffuse large B-cell lymphoma with isolated bilateral testicular involvement

Ronald S. Go, Jacob D. Gundrum

Research output: Contribution to journalArticle

4 Scopus citations


The Ann Arbor staging was originally developed in 1971 for Hodgkin lymphoma at a time when radiation was the primary treatment [1]. It was subsequently adopted for use in non-Hodgkin lymphoma (NHL). Although the Ann Arbor staging continues to be valuable in nodal NHL, its application in extranodal NHL has limitations [2,3]. Proper staging and accurate prognosis of diffused large B-cell lymphoma (DLBCL) with isolated bilateral testicular involvement are unclear. Here we show that even lymphoma experts do not have a consensus on these issues with 60.7% choosing Stage IV and the remaining favoring either Stage IE or IIE. To determine the prognosis of DLBCL patients with isolated bilateral testicular involvement, we performed disease-specific survival analyses using data from the Surveillance Epidemiology and End Results Program (SEER). The survival was not significantly different from age-matched Stage II unilateral disease (P = 0.549) and was better when compared with Stage IV unilateral disease (P = 0.034). Our study suggests that a limited stage designation is more appropriate due to a relatively better prognosis. To provide uniform staging for clinical trial and prognostic purposes, development of site- and histology-specific modified staging for primary extranodal lymphoma involving paired organs may be warranted.

Original languageEnglish (US)
Pages (from-to)762-763
Number of pages2
JournalAmerican journal of hematology
Issue number11
StatePublished - Nov 1 2009


ASJC Scopus subject areas

  • Hematology

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