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.
RCT Entities:
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.
Authors: Kristen Mcalpine; Dean A Fergusson; Rodney H Breau; Luke F Reynolds; Risa Shorr; Scott C Morgan; Libni Eapen; Ilias Cagiannos; Chris Morash; Luke T Lavallée Journal: Can Urol Assoc J Date: 2018-05-28 Impact factor: 1.862
Authors: Elliott Freudenburg; Iyla Bagheri; Sunay Srinivas; Ariza Martinez; Nagireddy Putluri; Zachary Klaassen; Ashish M Kamat; Badrinath R Konety; William Y Kim; Lars Dyrskjøt; David J McConkey; Stephen J Freedland; Peter C Black; Siamak Daneshmand; James W F Catto; Stephen B Williams Journal: Cancer Causes Control Date: 2022-06-14 Impact factor: 2.532
Authors: T Qayyum; G Fyffe; M Duncan; P A McArdle; M Hilmy; C Orange; G Halbert; M Seywright; P G Horgan; M A Underwood; J Edwards Journal: Br J Cancer Date: 2012-02-21 Impact factor: 7.640
Authors: S A Hussain; D D Stocken; D R Peake; J G Glaholm; A Zarkar; D M A Wallace; N D James Journal: Br J Cancer Date: 2004-06-01 Impact factor: 7.640