Salvage cystectomy. Review of 19 cases

Nineteen salvage cystectomies were performed during a period of 17 years, either on patients who failed definitive radiation therapy of bladder carcinoma or on those with massive bleeding or incapacitating irritative bladder symptoms after irradiation. In 16 cases a single-stage and in 3 a two-stage procedure was used. The postoperative hospital mortality rate was 11%. Early complications developed in 63%, late complications in 47% of the patients. The 5-year survival rate was 5%. In 11 cases, widespread transitional cell carcinoma was the cause of death. With more accurate preoperative tumor staging and subsequent patient selection, better results can be obtained by this procedure. A proposal for the treatment of patients with T3 bladder cancer is made.