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Postoperative Outcomes After Radical Cystectomy in Patients With Prior Pelvic Radiation
Philip A Fontenot1, Brian D Barnes1, William P Parker1
1Department of Urology, University of Kansas Medical Center, Kansas City, KS.
Urology
|March 17, 2018
Summary
Radical cystectomy (RC) is safe for patients with prior radiation therapy (RT). Prior RT history did not impact complication rates, perioperative outcomes, or survival after RC for urothelial carcinoma.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Radical cystectomy (RC) is a standard treatment for urothelial carcinoma.
- Prior abdominal or pelvic radiation therapy (RT) may affect outcomes after RC.
- Evidence comparing outcomes in patients with and without prior RT is limited.
Purpose of the Study:
- To compare complication rates, perioperative outcomes, and survival after RC in patients with and without a history of prior abdominal or pelvic RT.
- To evaluate the safety and efficacy of RC in patients with prior RT exposure.
Main Methods:
- Retrospective review of 518 patients undergoing RC for urothelial carcinoma (2008-2016).
- Patients stratified by prior RT history (n=55, 11%) vs. no prior RT history.
- Comparison of complication rates (30/90 days), perioperative outcomes, and survival (Kaplan-Meier, log-rank test).
Main Results:
- No significant differences in overall complication rates (66% vs. 69%, P=.80) between groups.
- No differences observed in perioperative outcomes (blood loss, surgery/hospital stay length, pathologic stage) (all P>.05).
- No significant differences in recurrence-free, cancer-specific, or overall survival (P=.08) at median 26-month follow-up.
Conclusions:
- Prior abdominal or pelvic RT does not negatively impact complication rates, perioperative outcomes, or survival after RC.
- RC is a viable and safe treatment option for patients with urothelial carcinoma and a history of prior RT.
- These findings support the use of RC in indicated cases, irrespective of prior RT exposure.
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