Korean J Urol.  2006 Mar;47(3):232-236. 10.4111/kju.2006.47.3.232.

The Effects of Neoadjuvant External Beam Radiotherapy on Pathologic Stage T3 Bladder Transitional Cell Carcinoma

Affiliations
  • 1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Korea. sjhong346@yumc.yonsei.ac.kr
  • 2Department of Radiation Oncology, Yonsei University College of Medicine, Korea.
  • 3Department of Urology, Inje University College of Medicine, Seoul, Korea.

Abstract

PURPOSE: Our study was conducted to compare the effects of neoadjuvant external beam radiotherapy and radical cystectomy to surgery alone for the patients suffering with pathologic stage T3 (pT3) bladder transitional cell carcinoma (TCCa).
MATERIALS AND METHODS
We retrospectively analyzed 45 patients who were diagnosed between 1990 and 1998 as having pT3 bladder TCCa in their final cystectomy specimens. Among them, 22 patients underwent preoperative external beam radiotherapy, and the other 23 patients underwent radical cystectomy alone. The radiation consisted of a total dose of 2,000 cGy delivered to the pelvis in 5 equal fractions that consisted of 400cGy daily. Systemic chemotherapy was not used in either group unless there was evidence of recurrent disease.
RESULTS
There were no preoperative demographic differences between the two groups. The local recurrence rate was significantly lower in the preoperative radiotherapy group (p=0.0397), but the overall survival rate was not significantly different (p=0.2695). The distant metastasis free survival rate was not significantly different between the two groups (p=0.4682).
CONCLUSIONS
We have shown that preoperative radiotherapy is an effective way to achieve local control of locoregionally advanced (pT3) bladder TCCa. However, our study did not have sufficient statistical power to identify a survival difference between the two groups.

Keyword

Bladder neoplasms; Radiotherapy; Cystectomy

MeSH Terms

Carcinoma, Transitional Cell*
Cystectomy
Drug Therapy
Humans
Neoplasm Metastasis
Pelvis
Radiotherapy*
Recurrence
Retrospective Studies
Survival Rate
Urinary Bladder Neoplasms
Urinary Bladder*

Figure

  • Fig. 1 The local recurrence free survival curve. The local recurrence rate is significantly lower for the preoperative radiotherapy group that for the surgery only group (p=0.0397).

  • Fig. 2 Distant metastasis free survival curve. The distant metastasis free survival rate is not significantly different between the two groups (p=0.4682).

  • Fig. 3 The overall survival curve. The overall survival rate is not significantly different between the two groups (p=0.2695).


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