title: [Cystectomy as "ultima ratio" after failure of radiotherapy in bladder cancer (author's transl)].
abstract: 20 patients were cystectomized an average of 2 years after unsuccessful curative radiotherapy. This technically difficult procedure has a high mortality rate of about 10--20%. None of the patients survived more than 5 years, but improved quality of life was the main subjective impression. A tumor-free specimen -- the effect of radio-induced downstaging -- is no guarantee of long-term survival. 4 of 6 patients without histological tumor cells in the cystectomy or lymph node specimens died of metastic disease. The indications for "salvage" cystectomy were: untreatable bladder hemorrhage, in some instances as emergency; frequently recurrent tumors; and subjectively unbearable state of disease.
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
vernacular_title: Zystektomie als "Ultima ratio" nach Versagen der Radiotherapie beim Blasenkarzinom (Sog. "Salvage"-Zystektomie).