Factors of prognostic and therapeutic significance in patients with bladder cancer

In a two-decade period, 451 patients with bladder cancer were treated by external megavoltage irradiation and/or radical cystectomy at the Memorial Sloan-Kettering Cancer Center. Radical cystectomy alone was performed in 137 patients. One-hundred nine patients underwent radical cystectomy for cancer recurrence or persistence +- 1 year after radical irradiation averaging 6000 rad tumor dose in 6 weeks. Planned preoperative pelvic irradiation either 4000 rad in 4 weeks in 119 patients or 2000 rad in 1 week in 86 patients was followed by radical cystectomy after average intervals of 6 weeks and 2 days, respectively. Similarly more favorable 5-year survival results were observed with prior radical or preoperative conventional or shorter regimen irradiation than with cystectomy alone. The main pelvic complications from this treatment are discussed