Radical Radiotherapy for Muscle Invasive Transitional Cell Carcinoma of the Bladder: Failure Analysis

Abstract

Patients with muscle invasive carcinoma of the bladder treated with radical radiation were prospectively documented and followed in an attempt to identify prognostic factors predictive of the response to treatment. Data on 121 consecutive patients treated with radical radiation between 1981 and 1985 are presented. Over-all actuarial survival of the patient population (median age 70 years) was 31.6% at 5 years and cause-specific survival was 44.8%. At analysis 33 of 121 patients (27.3%) were alive with preserved bladder function. Independent prognostic factors for cause-specific survival and for complete response with radical radiation were tumor configuration, hemoglobin level and clinical stage. The rate free of local relapse was significantly influenced by stage and presence of coexistent carcinoma in situ. The study suggests that factors other than stage and grade influence prognosis in invasive bladder cancer and should be considered in interpreting treatment results.

Retinoblastoma protein expression is an independent predictor of both radiation response and survival in muscle-invasive bladder cancer

“…B-haemoglobin below normal limits was independently associated with decreased overall survival but not with disease-free survival in the Cox analysis, implicating a more general effect. Grade of atypia of the tumour has been shown to carry independent prognostic information concerning survival in some studies of radical radiotherapy in bladder cancer (Gospodarowicz et al, 1989;Greven et al, 1990), while others have failed to find such an association (Fossa et al, 1993;Fung et al, 1991). The present study did not show statistically significant correlation between grade and CR to radiotherapy.…”

“…Low haemoglobin increases the risk of tumour hypoxia, which has been demonstrated to influence the outcome of radiotherapy in bladder cancer (Gospodarowicz et al, 1989;Hoskin et al, 1999). Anaemia, on the other hand, also often accompanies advanced cancer disease as well as other wasting diseases and may, consequently, be a marker hereof and as such associated with decreased overall survival.…”

Evaluation of Acute Toxicity and Symptoms Palliation in a Hypofractionated Weekly Schedule of External Radiotherapy for Elderly Patients with Muscular Invasive Bladder Cancer

“…Cystectomy is the standard approach for the treatment of invasive bladder cancer. As a single modality, however, results were disappointing, with high local failure rates and poor survival (5,6).…”

Erythropoetin in Urologic Oncology

“…In a big Canadian study 13% of the patients developed anemia not requiring transfusion. Interestingly, Gospodarowicz et al [16]found a negative statistical correlation between anemia (Hb<12 g%) and tumor specific survival.…”