T3 Bladder Cancer-the Case for Salvage Cystectomy

Abstract

Seven hundred and four patients with bladder cancer treated by radiotherapy at the London Hospital between 1965 and 1974 have been followed for a minimum period of 5 years. Invasive tumours were usually treated by radical radiotherapy. Cystectomy was reserved for patients whose tumours did not respond to radiation, recurred later on, or who developed complications from radiotherapy. The crude 5-year survival rate for T3 tumours in this series was 38%--similar to that obtained in other centres using pre-operative radiation followed by cystectomy, but this overall figure conceals the important difference between 2 distinct tumour populations. Nearly half of these tumours appear to be radiosensitive, giving a 56% crude 5-year survival rate for T3 tumours. The remainder are radioinsensitive, with only a 17% crude 5-year survival rate for T3 tumours. When there is a good initial response to radiotherapy there would seem to be no necessity to insist upon cystectomy.

Neutron Therapy of Bladder Carcinoma: Can a High Rate of Severe Complications Be Avoided in Neutron Therapy?

“…In the present series of T2-T4 tumors (58 patients), the overall 5-year actuarial survival rate reached 30%, which compares well with the 24-31% reported after current photon treatment [15][16][17][18]. For the T3 tumors (32 pa tients), a 5-year survival rate of 14 and 22.5% was observed in treatments A and B, respectively, compared to 15-29% after photon treatment [16][17][18][19].…”

An evaluation of gemcitabines differential radiosensitising effect in related bladder cancer cell lines

“…Radical radiotherapy as a treatment for invasive TCC of the bladder is well established. The overall 5-year survival rates are 24 -29% (Blandy et al, 1980;Fossa et al, 1993), a figure lower than in some surgical series (Skinner et al, 1991). However, in some reported series, radiotherapy has overall 5-year survival figures similar to radical cystectomy (Jenkins et al, 1988).…”

Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

“…3 A combined approach with irradiation and surgery was described in the early 1960s and popularized by Wallace and Hendry in the early 1970s and Blandy in the 1980s. [4][5][6] In the Wallace 1 surgical technique (Fig. 2, part A), described in 1966, both ureters are spatulated to the same length.…”