Post-irradiation total cystectomy for bladder cancer

Treatment with radiotherapy (6000 rad) followed by total cystectomy was carried out in 125 patients with T1-T3 bladder cancer, the tumour being poorly differentiated (grade III-IV) in 115 cases. Survival was significantly better, if the irradiation had resulted in complete tumour regression before cystectomy, and if the tumour at the initial examination was of category T1. The relative cumulative survival after 5 years for patients with T1-tumours was 60%, as opposed to 40% for patients with T3-tumours. 4 patients (2.4%) died within 30 days of the cystectomy, but 13 patients (10%) died within 3 years from complications of the treatment regime. 83 patients (66%) experienced non-fatal complications such as infected cavity and urinary or intestinal stenosis. 3 years after the cystectomy 62 patients (50%) were dead from recurrent tumour or from other causes.