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Urethral recurrence after radical radiotherapy for bladder cancer
J Cresswell1, J T Roberts, D E Neal
1Department of Surgery, The Medical School, University of Newcastle, Newcastle upon Tyne, United Kingdom.
The Journal of Urology
|March 21, 2001
Summary
Radical radiotherapy for bladder cancer showed a low urethral recurrence rate, comparable to orthotopic reconstruction. Continued urine contact may help prevent recurrence.
Area of Science:
- Urology
- Oncology
Background:
- Orthotopic reconstruction after cystectomy may reduce urethral recurrence risk compared to cutaneous diversion.
- Radical radiotherapy is an alternative treatment for bladder cancer.
Purpose of the Study:
- To evaluate the rate of urethral recurrence following radical external beam radiotherapy for bladder cancer.
- To compare urethral recurrence rates with those reported for orthotopic reconstruction.
Main Methods:
- Retrospective review of 214 men treated with radical radiotherapy between 1990-1995.
- Exclusion of patients treated with chemotherapy.
Main Results:
- Urethral recurrence occurred in 3.2% of patients (7/214).
- Excluding prostatic urethral recurrences, the rate decreased to 2.3%.
- At 5-year follow-up, recurrence rates were 4.7% (3.1% excluding prostatic urethra).
Conclusions:
- Urethral recurrence risk after radical radiotherapy is comparable to orthotopic reconstruction.
- Factors like multifocal disease, bladder neck, prostatic involvement, and CIS may increase risk.
- Continued urine contact might be protective against urethral recurrence.