title: Survival after bladder-preservation with brachytherapy versus radical cystectomy; a single institution experience.
abstract: OBJECTIVE
  To evaluate the long-term survival following brachytherapy and following cystectomy of patients with invasive bladder cancer treated in our institution.
  
  
  METHODS
  Between 1988 and 2000 108 patients with solitary, organ confined T1-T2 invasive bladder cancer of < or = 5 cm were treated with a transurethral resection, and a course of external beam radiotherapy (30 Gy) followed by 40 Gy brachytherapy. The overall and disease specific survival rates of these patients are compared with those of 77 patients with T1-T2 invasive bladder cancer treated with cystectomy between 1988-2003.
  
  
  RESULTS
  The 5/10 year overall survival rates were 62%/50% after brachytherapy and 67%/58% after cystectomy (p = 0.67). The 5/10 year disease specific survival rates were 73%/67% after brachytherapy and 72%/72% after cystectomy (p = 0.28). When adjusted for age, multiplicity, T-stage, N-stage and grade, the 5/10 year overall survival rates were 65%/53% after brachytherapy and 62%/51% after cystectomy, respectively. The adjusted disease specific survival rates were 75%/70% after brachytherapy and 66%/66% after cystectomy.
  
  
  CONCLUSIONS
  This study does not provide evidence regarding survival against the use of bladder preservation with brachytherapy for patients with solitary, T1-T2 invasive bladder cancer of < or = 5 cm diameter, seeking bladder-sparing alternatives to radical cystectomy.
authors: Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors: J A
authors: JA
authors: Nieuwenhuijzen
authors: F
authors: F
authors: Pos
authors: L M F
authors: LM
authors: Moonen
authors: A A M
authors: AA
authors: Hart
authors: S
authors: S
authors: Horenblas
mesh_terms: D000368:Aged; D001918:Brachytherapy; D016009:Chi-Square Distribution; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*