Effectiveness of neoadjuvant radiation therapy in muscle-invasive bladder cancer

Aim. To evaluate results of bimodal (preoperative radiotherapy + cystectomy) and only surgical treatment in patients with muscle-invasive bladder cancer.

Methods. A retrospective cohort observational study of patients with muscle-invasive bladder cancer from 2006 to 2012 was conducted. Continuous sampling was used. Patients who received radiation therapy in the preoperative period before cystectomy (25 patients) composed the main group, the patients who underwent surgery alone (167 patients) composed the control group.

Results.. 9 of the 25 patients, who underwent neoadjuvant external-beam radiotherapy before cystectomy, died, the overall survival rate during follow-up was 64.0%. In the group of patients who underwent cystectomy alone, the survival rate was 48.5%. We analyzed the survival rate depending on various criteria or prognostic factors. Factors such as age (under 65 years), male gender, degree of differentiation G2, disease stage (II and III as compared with stage IV), lymph nodes negative status are relatively favorable for disease prognosis, and patients survival rates were significantly higher when using neoadjuvant external beam radiotherapy.

Conclusion. The effectiveness of neoadjuvant treatment (radiotherapy) followed by cystectomy for bladder cancer in some situations may have a positive effect; the tumor degree of differentiation, the regional lymph nodes state, clinical stage and age have a prognostic value irrespective of the therapy method.