Postoperative radiotherapy in partial and total cystectomy versus total cystectomy of T1/T2 bladder cancer

ABSTRACT

We have studied 52 patients with-early bladder cancer [TI/T2] who underwent partial or total cystectomy between January 1987 and December 1992 and this represent about 1% of the total recorded bladder cancer cases. The ten partial and eleven total cystectomy patients received postoperative radiotherapy. The remaining 31 cases underwent radical cystectomy only with no postoperative treatment The mean age of the studied group was 51.3 years. Twenty percent of cases had bladder tumor less than 3 cm while, in 80% it was more than 3 cm in diameter. Squamous cell carcinoma [SCO represented 52% compared to 42 transitional cell carcinoma [TCC] and 6% adenocarcinoma. During the first three years partial cystectomy showed 40% recurrence and 39% of total cystectomy only compared to 27% when postoperative radiotherapy was applied. Grade 3 histology showed 51% and 41% recurrence in SCC and TCC compared to 33% and 25% grade 2 respectively. Distant metastases occurred in 10% of the whole series with nearly equal percentage in the three subgroups. The over all three year survival rate was 75% of the whole series with a higher percentage when total cystectomy was followed with postoperative radiotherapy. There were 4 deaths due to disease and another two fatal surgical complications while there were 3 non-fatal major complications due to surgery and irradiation in the whole series with morbidity rate of 17%