Article thumbnail

Pattern of Failure in Bladder Cancer Patients Treated with Radical Cystectomy: Rationale for Adjuvant Radiotherapy

By Yong Bae Kim, Sung Joon Hong, Seung Cheol Yang, Jae Ho Cho, Young Deuk Choi, Gwi Eon Kim, Koon Ho Rha, Woong Kyu Han, Nam Hoon Cho and Young Taek Oh


Thus far, the role of adjuvant radiotherapy (RT) after radical cystectomy (RC) in urinary bladder cancer patients has yet to be defined. The purpose of this study is to analyze patterns of failure, and suggest the rationale for RT. Between 1986 and 2005, a total of 259 patients treated with RC and pelvic lymph node dissection was enrolled. The age range was 27-82 yr (median, 62 yr). Node positivity increased according to tumor staging. Patients were divided into the following two groups based on pathologic analysis: organ-confined disease group (n=135) and extravesical/lymph node-positive disease group (n=80). Pelvic failures (PF) were observed in 8 (4.9%) in organ-confined disease group, and 21 (21.7%) in extravesical/lymph node-positive disease group. Five-year PF-free survival rates were 91.2% in organ-confined disease group and 68.0% in extravesical/lymph node-positive disease group. Five-year cancer-specific survival rates were 86.2% in organ-confined disease group and 53.9% in extravesical/lymph node-positive disease group. In conclusion, a relatively high PF rate was observed in extravesical lymph node-negative and lymph node-positive disease patients in this study. Adjuvant pelvic RT may be considered to reduce pelvic failures in extravesical lymph node-positive bladder cancer. Future prospective trials are required to test the clinical benefit of adjuvant RT

Topics: Original Article
Publisher: The Korean Academy of Medical Sciences
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2005). Cancer (ABC) Meta-analysis Collaboration. Adjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis of individual patient data Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Eur Urol
  2. (2009). Clinical outcomes and recurrence predictors of lymph node positive urothelial cancer after cystectomy.
  3. (1992). Combined pre- and postoperative adjuvant radiation therapy for bladder cancer--a ten year experience.
  4. (2003). Conventional 3D conformal versus intensity-modulated radiotherapy for the adjuvant treatment of gynecologic malignancies: a comparative dosimetric study of dose-volume histograms small star, filled. Gynecol Oncol
  5. Cystectomy for transitional cell carcinoma of the bladder: results of a surgery only series in the neobladder era.
  6. (1991). Dose fractionation and tumour repopulation in radiotherapy for bladder cancer. Radiother Oncol
  7. (2005). Feasibility of dose escalation using intensity-modulated radiotherapy in posthysterectomy cervical carcinoma.
  8. (2004). IMRT dose escalation for positive para-aortic lymph nodes in patients with locally advanced cervical cancer while reducing dose to bone marrow and other organs at risk.
  9. (2008). location and overall survival of pelvic recurrence after radical cystectomy for transitional cell carcinoma of the bladder.
  10. (2009). Longterm oncological outcomes in women undergoing radical cystectomy and orthotopic diversion for bladder cancer.
  11. (1992). Postoperative radiotherapy of carcinoma in bilharzial bladder: improved disease free survival through improving local control.
  12. (1997). Radical cystectomy for carcinoma of the bladder: critical evaluation of the results in 1,026 cases.
  13. (1994). Radical cystectomy for stages Ta, Tis and T1 transitional cell carcinoma of the bladder.
  14. (2001). Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients.
  15. (2007). The difference in the prognosis and characteristics between the progressive and primary muscle-invasive bladder cancer treated with radical cystectomy.
  16. (1993). The value of pathologic factors in predicting cancer-specific survival among patients treated with radical cystectomy for transitional cell carcinoma of the bladder and prostate. Cancer
  17. (1998). The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder.