Carcinoma of the bladder T3NxMo treated by preoperative irradiation followed by cystectomy.

Eighty-nine patients with bladder cancer T3NxMo have been treated by preoperative external irradiation (4000 rads in 4 weeks) followed by cystectomy. Five-year survival is 50%. Of patients with T-reduction (T3 becomes P0, P1, or P2) the 5-year survival is 70%. Treatment mortality has been reduced to 3% during the last 2 years. T-reduction cannot be predicted by histologic grade. A second staging by palpation under general anesthesia ("T" 4000) is reliable when T-reduction is felt; however, fibrosis can simulate a persisting T3 mass.