Survival outcomes and prognostic factors in bladder cancer treated with radiotherapy

This study evaluated survival outcomes and prognostic factors in patients with bladder cancer treated with radiotherapy. A retrospective analysis was conducted on 488 patients across all cancer stages who received radiotherapy at two institutions between 1 January 2000 and 31 December 2022. Overall survival (OS) was assessed based on treatment intent (radical or palliative) and cancer stage. Among these patients, 304 with Stage II-III disease who underwent radical radiotherapy were further analyzed for OS and prognostic factors using Kaplan-Meier methods and Cox regression analysis. In the radical radiotherapy group, median survival times (MSTs) were 43 months for Stage 0-I, 29 months for Stage II-III, and 17 months for Stage IV (M0). In the palliative radiotherapy group, MSTs were 16 months (95% confidence interval [CI]: 11-25) for M0 and 9 months (95% CI: 7-15) for M1. Among the 304 patients with Stage II-III disease treated with radical radiotherapy, the 3-year OS rate was 43.0%. Hydronephrosis was the only independent prognostic factor significantly associated with worse OS (hazard ratio: 1.915, P < 0.001). Age, sex, stage, treatment era, prophylactic pelvic radiotherapy, chemotherapy and prescribed dose had no significant impact on OS. Radiotherapy remains a viable treatment option for patients at any stage of cancer. Although hydronephrosis negatively affects survival, it should not preclude the use of radiotherapy.