Second primary bladder cancer following pelvic irradiation for other malignancies

Between 1985 and 1990, five cases of radiation-induced bladder cancer were treated at our center. The first primary neoplasm was uterine cervical cancer in three patients, uterine endometrial cancer in one patient, and Hodgkin's disease in one patient. Additional treatment for the primary neoplasm included panhysterectomy for the patient with endometrial cancer and cyclophosphamide-based combination chemotherapy for the patient with Hodgkin's disease. The mean age at development of bladder cancer was 60.4 years, and the average time interval between irradiation and development of bladder cancer was 14.6 years. All the bladder cancers were invasive. The treatment modalities included anterior pelvic exenteration in one patient, partial cystectomy in one patient, reirradiation in two patients, including the use of intraoperative electron therapy in one patient, and TUR plus endoscopic Nd:YAG laser treatment in one patient. Four patients are alive without disease at a mean follow-up period of 15 months from the diagnosis of bladder cancer.