Results of radiotherapy on ureteric obstruction in muscle-invasive bladder cancer.
OBJECTIVE
To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer.


METHODS
Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephrostomy or ureteric catheters in addition to radiotherapy.


RESULTS
Drainage improved in 20% of kidneys and the diverting catheter was withdrawn permanently in one (17%) of the diverted patients. The median survival was 11 months. Irradiation was followed by significant complications in 37 patients (67%).


CONCLUSIONS
The results of this study raise doubts about the assumed beneficial effect of irradiation on ureteric obstruction due to muscle-invasive bladder cancer. The short median survival of 11 months confirms that ureteric obstruction is a poor prognostic factor in muscle-invasive bladder cancer.
Department of Urology, Bispebjerg Hospital, Copenhagen, Denmark.
M
M
Honnens de Lichtenberg
J
J
Miskowiak
H
H
Rolff
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D014547:Urinary Diversion