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Treatment of Advanced Bladder Cancer With Combined Preoperative Irradiation and Radical Cystectomy Versus Radical Cystectomy Alone: A Phase III Intergroup Study

1997; Lippincott Williams & Wilkins; Volume: 157; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(01)65047-x

1527-3792

Joseph A. Smith, E. David Crawford, Jorge C. Paradelo, Brent A. Blumenstein, Barry R. Herschman, H. Barton Grossman, Debra W. Christie,

Urological Disorders and Treatments

No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1997Treatment of Advanced Bladder Cancer With Combined Preoperative Irradiation and Radical Cystectomy Versus Radical Cystectomy Alone: A Phase III Intergroup Study Joseph A. Smith, E. David Crawford, Jorge C. Paradelo, Brent Blumenstein, Barry R. Herschman, H. Barton Grossman, and Debra W. Christie Joseph A. SmithJoseph A. Smith , E. David CrawfordE. David Crawford , Jorge C. ParadeloJorge C. Paradelo , Brent BlumensteinBrent Blumenstein , Barry R. HerschmanBarry R. Herschman , H. Barton GrossmanH. Barton Grossman , and Debra W. ChristieDebra W. Christie View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65047-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Our study was designed to compare the effects of preoperative irradiation and cystectomy to surgery alone in patients with transitional cell carcinoma of the bladder. Materials and Methods: A total of 140 patients with documented invasive bladder cancer or rapidly recurring superficial high grade tumors was randomized to receive 2,000 rad of pelvic irradiation followed by cystectomy within 1 week or surgery alone. Results: The 5-year survival rate was 53% (95 confidence intervals 41 to 65%) in the surgery only group and 43% (95% confidence intervals 30 to 56%) in the irradiation plus surgery group. The p value for the log rank statistic comparing the survival distributions was 0.23. Conclusions: Although this trial showed no benefit for preoperative irradiation and cystectomy, the confidence intervals were wide. This finding does not exclude the possibility of a favorable effect of radiation in a subset of patients with high stage tumors. Overall, however, the dominant effect of distant disease as a cause of treatment failure diminishes any potential impact of radiation on results. References 1 : Treatment of T3 bladder cancer: controlled trial of preoperative radiotherapy and radical cystectomy versus radical radiotherapy. Second report and review (for the Clinical Trials Group, Institute of Urology). Brit. J. Urol.1982; 54: 136. Google Scholar 2 : Bladder carcinoma: results with preoperative radiation therapy and radical cystectomy. Urology1980; 16: 569. Google Scholar 3 : Radical cystectomy with or without prior irradiation in the treatment of bladder cancer. J. Urol.1977; 118: 184. 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Google Scholar 10 : A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer. Cancer1977; 40: 1077. Google Scholar 11 : Preoperative irradiation and cystectomy for bladder cancer. Cancer1982; 49: 869. Google Scholar 12 : Preoperative irradiation as an adjuvant in the surgical management of invasive bladder carcinoma. J. Urol.1971; 105: 223. Link, Google Scholar 13 : Five-year follow-up results of a collaborative study of therapies for carcinoma of the bladder. J. Surg. Oncol.1977; 9: 393. Google Scholar 14 : Clinical research. A simple recipe for doing it well. Anesthesiology1994; 80: 923. Google Scholar Vanderbilt University, Nashville, Tennessee, University of Colorado, Denver, Colorado, Kansas City Clinical Oncology Program, Kansas City, Missouri, Southwest Oncology Group Statistical Center, Seattle, Washington, Providence Hospital, Southfield, Michigan, University of Texas M. D. Anderson Cancer Center, Houston, Texas and University of Mississippi Medical Center, Jackson, Mississippi© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySchellhammer P (2018) Editorial: A worldwide View of Bladder CancerJournal of Urology, VOL. 158, NO. 2, (406-407), Online publication date: 1-Aug-1997. Volume 157Issue 3March 1997Page: 805-808 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Joseph A. Smith More articles by this author E. David Crawford More articles by this author Jorge C. Paradelo More articles by this author Brent Blumenstein More articles by this author Barry R. Herschman More articles by this author H. Barton Grossman More articles by this author Debra W. Christie More articles by this author Expand All Advertisement PDF downloadLoading ...