Invasive bladder carcinoma managed by irradiation and surgery

Four hundred forty-four patients with invasive vesical carcinoma were entered in a nonrandomized treatment program of preoperative irradiation and surgical extirpation of the primary lesion. Fifteen of the patients did not undergo surgery, and an additional 13 were found at operation to have an inoperable lesion. Thus, 416 patients, at risk for more than two years, were available for statistical study. Pathologic findings constitute the basis for the calculation of crude survival rates. Five-year survival for 107 patients without residual carcinoma was 66 per cent, approximating the 71 per cent for the 160 patients with low-stage carcinoma. By contrast, 149 patients with high-stage carcinoma had a five-year survival of 31 per cent. The need for a yet undefined adjuvant modality is evident.