Salvage cystectomy for bladder carcinoma

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Abstract
Sixty-two patients with carcinoma of the bladder who had received external radiation as definitive therapy underwent radical cystectomy for persistent or recurrent tumor. A preoperative clinical assessment correctly predicted whether the tumor was superficial or advanced in 74% of patients, which correlated with prognosis. Overall five-year survival rate after cystectomy was 43%, while five-year survival rates for patients with clinically staged superficial and advanced tumors were 64% and 25%, respectively. There have been no postoperative deaths, and morbidity was not greater than that of patients undergoing cystectomy after planned preoperative radiation therapy. We conclude that salvage cystectomy can be recommended without fear of increased mortality or morbidity for selected patients who have failed definitive radiation therapy.