Purpose: Our study was conducted to compare the effects of neoadjuvant external beam radiotherapy and radical cystectomy to surgery alone for the patients suffering with pathologic stage T3 (pT3) bladder transitional cell carcinoma (TCCa). Materials and Methods: We retrospec tively analyzed 45 patients who were diagnosed between 1990 and 1998 as having pT3 bladder TCCa in their final cystectomy specimens. Among them, 22 patients underwent preoperative external beam radiotherapy, and the other 23 patients underwent radical cystectomy alone. The radiation consisted of a total dose of 2,000 cGy delivered to the pelvis in 5 equal fractions that consisted of 400cGy daily. Systemic chemotherapy was not used in either group unless there was evidence of recurrent disease. Results: There we re no preoperative demographic differences between the two groups. The local recurrence rate was significantly lower in the preoperative radiotherapy group (p=0.0397), but the overall survival rate was not significantly different (p=0.2695). The distant metastasis free survival rate was not significantly different between the two groups (p=0.4682). Conclusions: We have shown that preoperative radioth erapy is an effective way to achieve local control of locoregionally advanced (pT3) bladder TCCa. However, our study did not have sufficient statistical power to identify a survival difference between the two groups.
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