Bladder cancer patients having post-radiotherapy salvage cystectomy appear to fare no worse than patients opting for primary cystectomy, according to a new study presented at the Canadian Urological Association annual meeting in Ottawa.
Investigators led by Ahmed S. Zakaria, MD, of McGill University in Montreal, examined post-operative complication and mortality rates for 103 bladder cancer patients who had salvage radical cystectomy following external beam radiotherapy in Quebec, Canada, between 2000 and 2009. Roughly half of patients were younger than 65 years, and 70% were men.
The researchers determined that about one-third of patients developed at least 1 post-surgical complication, and nearly one-quarter had multiple complications. Urinary tract complications were the most common (17%), followed by gastrointestinal tract problems (8%).
Post-operative mortality rates were 3%, 6%, and 7% at 30, 60, and 90 days, respectively. The overall survival rate at 5 years was 46%, and average survival spanned 4.7 years. The death rate was 49% over the follow-up period.
After matching patients having primary and salvage radical cystectomy by age and sex, investigators found no statistically significant survival difference. Unlike previous reports, these results indicate that patients undergoing salvage radical cystectomy have no worse oncologic outcomes than patients having primary radical cystectomy.