CLINICAL AND ONCOLOGICAL OUTCOME OF SALVAGE CYSTECTOMY AFTER RADIOTHERAPY FAILURE IN BLADDER CANCER
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Abstract
Objectives: To analyze the clinical and oncological outcomes of Salvage Cystectomy after radiotherapy failure in bladder cancer.
Methodology: A retrospective study was conducted over a 12-year period (January 2005 to December 2017) at the Uro-oncology department of the Shaukat Khanum Memorial Cancer Hospital and Research Center, involving 21 patients who underwent salvage cystectomy. The patients were monitored through cystourethroscopy and imaging (CT/MRI) after receiving chemo-radiotherapy for bladder cancer. Those with histologically confirmed recurrence of malignancy were eligible for salvage cystectomy, excluding metastatic and non-resectable cases. Survival was calculated using the Kaplan-Meier method, and complications were divided into early and late categories.
Results: Of the 21 patients, 86% were male. The median age was 60 years (range, 45-73 years). The median follow-up duration from time of cystectomy was 43 months (range, 5-103 months). The three and five years disease free survival rates were 60% and 47%, respectively, while the calculated three and five years overall survival rates were 58% and 43%, respectively. RC with ileal conduit was performed in all patients. Tumor under staging was noted in 57 % of cases. Distant metastasis was reported in 12 patients (two patients had both local and distant recurrence). Of the 16 cases with complications, early complications (within a month) and delayed complications (after a month) were 9(43%) and 7(33%) respectively.
Conclusion: Salvage cystectomy remains a viable option with acceptable morbidity in bladder-sparing treatment failure for muscle-invasive bladder cancer.
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