Early postoperative versus delayed radiotherapy in bladder sparring treatment of patients with high-grade urinary bladder cancer

Abstract

Objective. To study the prevalence and effect on the survival of high grade bladder cancer (G3 UBC) patients of external beam radiotherapy delivered in early or delayed period after the bladder preserving surgery. Materials and methods. We retrospectively studied the medical records of 522 G3 UBC patients, out of whom 101 (19.3%) were treated radically with organ preserving surgery, followed by the radiotherapy. All patients were split in group of early (upto 3 months postoperatively) and delayed radiotherapy. The radiotherapy was performed on the Oncor Impression Plus linear accelerator with total radiation dose of 62 Gy and daily fraction of 2Gy. Kaplan-Meier survival curves were built to test the hypothesis of equality of survival of patients of both groups. Results. The group of early radiotherapy accounted for 70.3% patients versus 29.7% in group of delayed radiotherapy. The survival in groups per Stages II, III and IV of G3 UBC was 48.6 vs. 26.4 months, 43.9 vs. 32.7 mo., 25.4 vs. 46.9 mo., respectively. The overall survival in both groups was 43 vs. 36 months (p=0.57). Conclusion. Majority of G3 UBC patients (70.3%) were treated with early radiotherapy following bladder sparring surgery. Survival of patients with delayed radiotherapy is worse than of patients with early radiotherapy, 36 vs. 43 months (p=0,57).

Keywords

• high-grade urinary bladder cancer, bladder sparring surgery, radiotherapy, survival.