Similar treatment outcomes for radical cystectomy and radical radiotherapy in invasive bladder cancer treated at a United Kingdom specialist treatment center.
OBJECTIVE
To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer.


METHODS
Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.


RESULTS
There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age of radiotherapy patients but not the cystectomy patients was higher than in the 1996-2000 cohort (78.4 years vs. 75.3 years for radiotherapy and 67.9 years vs. 68.2 years for surgery).


CONCLUSIONS
Although the patients undergoing radical cystectomy were significantly younger than the radiotherapy patients, treatment modality did not influence survival. Bladder cancer patients are an increasingly elderly group. Radical radiotherapy is a viable treatment option for these patients, with the advantage of organ preservation.
Kotwal
Sanjeev
S
Pyrah Department of Urology, St. James's University Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Choudhury
Ananya
A
Johnston
Colin
C
Paul
Alan B
AB
Whelan
Peter
P
Kiltie
Anne E
AE
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012044:Regression Analysis; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*