The Role of Endoscopic Treatment after Radical Radiotherapy for Invasive Bladder Cancer

Smith, Gordon; Quilty, P.M.; Duncan, W.; Chisholm, G. D.; Newsam, J. E.; Hargreave, T. B.

doi:10.1111/j.1464-410x.1985.tb07034.x

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…A selected group of patients from this series who were surgically managed after primary radiotherapy has recently been reported (Smith et al, 1985). Downstaging was also shown to be present in many who were managed endoscopically.…”

Section: Discussionmentioning

confidence: 92%

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Results of Surgery Following Radical Radiotherapy for Invasive Bladder Cancer

et al. 1987

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Five hundred and ninety-one of 889 patients with T1 to T4 transitional cell carcinoma of the bladder had persistent or recurrent cancer after radical radiotherapy. Durable local control was significantly poorer for patients with grade 1 or T4 cancer before radiotherapy. Three hundred and twenty-two patients received additional surgical treatment: 21 1 were endoscopically managed and 11 1 had secondary cystectomy. The survival of patients with residual or recurrent cancer after radiotherapy was significantly improved by secondary local treatment (P< 0.0001 ). A comparison

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Section: Discussionmentioning

confidence: 92%

“…Factors influencing local tumour control after radiotherapy have been studied. A detailed comparison of secondary cys-tectomy and endoscopic treatment has been made to see whether the results claimed by the earlier review (Smith et al, 1985) can be substantiated.…”

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confidence: 99%

Results of Surgery Following Radical Radiotherapy for Invasive Bladder Cancer

et al. 1987

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“…Although salvage cystectomy remains the standard treatment, it has appreciable mortality and morbidity (Crawford and Skinner, 1980;Bloom et af., 1982) and may not be appropriate in some patients who might have difficulty in managing a urostomy appliance. It has been shown that recurrent bladder cancer after radiotherapy can be managed reasonably successfully by endoscopic means (Smith et al, 1985). However, in only two of their patients was the recurrent tumour invading muscle, unlike this series when all recurrent tumours were invading muscle and most were deeply invasive.…”

Section: Discussionmentioning

confidence: 54%

The Role of Partial Cystectomy in the Treatment of Recurrent Invasive Bladder Cancer Following Radiotherapy

Matthews

Minton

Haw

et al. 1987

British Journal of Urology

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Seventeen patients with recurrent invasive bladder cancer following radical radiotherapy were treated by partial cystectomy. Thirteen patients required augmentation enterocystoplasty, using an ileal patch in 10 patients and large bowel in the others. After 4 years' follow-up, eight patients are alive and disease-free with good bladder function. Of the nine patients who died, six died from bladder cancer and three of these suffered local recurrences. Responsiveness to radiotherapy or tumour stage were not helpful in predicting local recurrences, but all patients who had this complication had anaplastic tumours. In selected patients this procedure offers an alternative to salvage cystectomy, especially where a urinary diversion may be inappropriate.

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Results of radical cystectomy for transitional cell carcinoma of the bladder and the effect of chemotherapy

Soloway

Lopez

Patel

et al. 1994

Cancer

107

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Background. Radical cystectomy continues to be one of the primary modalities of treatment for locally advanced bladder cancer. However, long‐term survival after cystectomy has improved only marginally in the last decade, and still, nearly half of the patients die from the disease within 5 years. Adjuvant treatments such as radiation therapy and chemotherapy have been used, but a clear advantage has not been demonstrated. Methods. The authors reviewed 130 patients who underwent radical cystectomy by the same surgeon as treatment for transitional cell carcinoma of the bladder. Morbidity, postoperative mortality, overall survival time, and accuracy of clinical staging as well as the effect of perioperative chemotherapy were evaluated. Results. The overall actuarial survival rate at 2, 5, and 10 years was 80%, 53%, and 45%, respectively. The survival rate based on T‐classification at 5 years was 82%, 65%, and 28% for less than pT2, pT2, and greater than pT2, respectively. Regional lymph node status had a significant effect on survival. The 5‐year survival rate for all patients with negative nodes was 65%, whereas patients with positive nodes had a 18% 5‐year survival rate. The overall clinical staging error was 61.5%, with 41.5% of the cancers understaged. Of the patients with cTis, 60% were found to be of greater extent than pT1 tumors. No apparent survival advantage was noted for those patients who received perioperative chemotherapy when compared with patients who were followed conservatively or received chemotherapy upon relapse. These results, however, are not conclusive because this was an observation study and the number of patients was limited. Conclusions. Only a modest improvement in survival time after radical cystectomy has been observed in the last decade, despite the use of adjuvant treatments such as radiation and chemotherapy. The pathologic (pT) classification is the most accurate prognostic indicator. Clinical errors in classification are common and impair the evaluation of neoadjuvant treatments. A high incidence of invasive tumors of greater extent than pT1 was found among patients with clinical cTis; this supports an aggressive approach when these patients do not respond promptly to intravesical chemotherapy. Prospective randomized studies are needed to evaluate objectively the benefit of perioperative adjuvant treatment in locally advanced transitional cell carcinoma of the bladder.

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The Role of Endoscopic Treatment after Radical Radiotherapy for Invasive Bladder Cancer

Cited by 4 publications

References 10 publications

Results of Surgery Following Radical Radiotherapy for Invasive Bladder Cancer

Results of Surgery Following Radical Radiotherapy for Invasive Bladder Cancer

The Role of Partial Cystectomy in the Treatment of Recurrent Invasive Bladder Cancer Following Radiotherapy

Results of radical cystectomy for transitional cell carcinoma of the bladder and the effect of chemotherapy

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