Radical Cystectomy after BCG Immunotherapy for High-Risk Nonmuscle-Invasive Bladder Cancer in Patients with Previous Prostate Radiotherapy. (15th July 2013)

• Record Type: Journal Article
• Authors: Rao, Manoj V.; Quek, Marcus L.; Jayram, Gautam; Ellimoottil, Chandy; Sondej, Timothy; Hugen, Cory M.; Flanigan, Robert C.; Steinberg, Gary D.
• Other Names: Salah M. A. Academic Editor.; Tsui K. H. Academic Editor.
• Is Part Of: ISRN urology. Volume 2013(2013)
• Publication Date: 2013-07-15
• Subjects: Urology -- Periodicals; Urologic Diseases; Urology; Periodical; Periodicals; Fulltext; Internet Resources; Periodicals; Electronic journals; 616.6
• DOI: 10.1155/2013/405064
• Languages: English
• ISSNs: 2090-5807

Abstract

Abstract : Purpose . Intravesical Bacillus Calmette-Guerin (BCG) immunotherapy is indicated for high-grade nonmuscle-invasive bladder cancer (NMIBC). The efficacy of BCG in patients with a history of previous pelvic radiotherapy (RT) may be diminished. We evaluated the outcomes of radical cystectomy for BCG-treated recurrent bladder cancer in patients with a history of RT for prostate cancer (PC). Methods . A retrospective chart review was performed to identify patients with primary NMIBC. We compared the outcomes of three groups of patients who underwent radical cystectomy for BCG-refractory NMIBC: those with a history of RT for PC, those who previously underwent radical prostatectomy (RP), and a cohort without PC or RT exposure. Results . From 1996 to 2008, 53 patients underwent radical cystectomy for recurrent NMIBC despite BCG. Those with previous pelvic RT were more likely to have a higher pathologic stage and decreased recurrence-free survival compared to the groups without prior RT exposure. Conclusion. Response rates for intravesical BCG therapy may be impaired in those with prior prostate radiotherapy. Patients with a history of RT who undergo radical cystectomy after failed BCG are more likely to be pathologically upstaged and have decreased recurrence-free survival. Earlier consideration of radical cystectomy may be warranted for those with NMIBC who previously received RT for PC.