Morbidity after preoperative radiotherapy and cystectomy in patients with bladder cancer.
The therapy-related morbidity was evaluated in 121 patients with muscle-invasive or recurrent superficial bladder cancer treated with radiotherapy and cystectomy. In 103 patients cystectomy succeeded 39-52 Gray (Gy) preoperative irradiation and in 18 patients cystectomy was done as a salvage procedure after previous full-dose radiotherapy. The overall frequency of complications was high; 71% of the patients treated with preoperative and 78% treated with full-dose radiotherapy had clinically relevant complications related to radiotherapy or surgery or both. The rate of intestinal complications was 39% for preoperative and 67% for full-dose radiotherapy. The overall mortality rate in intestinal complications was 3.3%. This study shows that the combination of radiotherapy and radical surgery in patients with bladder cancer is associated with a high rate of intestinal complications. The complications are significantly related to the irradiation dose and are long lasting and even life threatening.
Tomic
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R
Department of Urology, Umeå University, Sweden.
Granfors
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T
Modig
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H
D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality / Q000473:pathology; D011832:Radiation Injuries / Q000401:mortality / Q000473:pathology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D011882:Radiotherapy, High-Energy; D016879:Salvage Therapy; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D014547:Urinary Diversion