Bladder cancer after radiotherapy for prostate cancer: detailed analysis of pathological features and outcome after radical cystectomy.
OBJECTIVE
We reviewed outcomes and features in patients with bladder cancer who underwent cystectomy and had a history of radiation for prostate cancer.


METHODS
We performed a retrospective analysis of the University of Miami cystectomy database and identified 34 patients with a history of radiotherapy for prostate cancer. An age and stage matched control group was used to compare survival. Our entire male cystectomy population was used to compare clinicopathological features.


RESULTS
Mean age in the 34 patients with cystectomy was 75 years with a mean latency of 5 years from prostate cancer radiation. Radiotherapy was the primary treatment modality for prostate cancer in 32 of 34 patients and 2 received adjuvant radiation. Of the patients 86% received external beam radiation. Hematuria was the initial symptom in 86% of the cases. In 53% of the patients the initial diagnosis was muscle invasive bladder cancer. An ileal conduit was the method of urinary diversion in 33 cases. Major perioperative complications developed in 9% of the patients. There was 1 perioperative death, resulting in a mortality rate of 2.9%. Of the patients 54% presented with a locally advanced (pT3-4) tumor. Patients with a history of radiation therapy for prostate cancer had significantly poorer overall and bladder cancer specific survival than the matched control group.


CONCLUSIONS
Most bladder cancers in patients with a history of radiation for prostate cancer present as locally advanced tumors and patients have poorer survival than age and stage matched controls.
Bostrom
Peter J
PJ
Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Soloway
Mark S
MS
Manoharan
Murugesan
M
Ayyathurai
Rajinikanth
R
Samavedi
Srinivas
S
D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery*