Bladder cancer after radiotherapy for prostate cancer: Detailed analysis of pathological features and outcome after radical cystectomy
Bladder cancer after radiotherapy for prostate cancer: Detailed analysis of pathological features and outcome after radical cystectomy
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DOI：
10.1016/j.juro.2007.08.157
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发表时间：
2008-01-01
影响因子：
6.6
通讯作者：
Samavedi, Srinivas
中科院分区：
文献类型：
--
作者：
Bostrom, Peter J.;Soloway, Mark S.;Samavedi, Srinivas
目的：我们回顾了膀胱癌患者行膀胱切除术并有前列腺癌放射治疗史的结果和特征。材料和方法：我们对迈阿密大学膀胱切除术数据库进行了回顾性分析，并确定了34例有前列腺癌放疗史的患者。使用年龄和分期匹配的对照组来比较生存率。我们的整个男性膀胱切除术人群被用来比较临床病理特征。结果：34例膀胱切除术患者的平均年龄为75岁，前列腺癌放疗后平均潜伏期为5年。34例前列腺癌患者中32例放疗为主要治疗方式，2例接受辅助放疗。86%的患者接受了外束放疗。86%的病例以血尿为首发症状。53%的患者最初诊断为肌肉浸润性膀胱癌。33例采用回肠导尿方法。9%的患者出现主要围手术期并发症。围手术期死亡1例，死亡率2.9%。54%的患者表现为局部晚期（pT3-4）肿瘤。有前列腺癌放射治疗史的患者总体生存率和膀胱癌特异性生存率明显低于对照组。结论：大多数有前列腺癌放射史的膀胱癌患者表现为局部晚期肿瘤，患者的生存率低于年龄和分期匹配的对照组。
Purpose: We reviewed outcomes and features in patients with bladder cancer who underwent cystectomy and had a history of radiation for prostate cancer.Materials and Methods: We performed a retrospective analysis of the University of Miami cystectomy database and identified 34 patients with a history of radiotherapy for prostate cancer. An age and stage matched control group was used to compare survival. Our entire male cystectomy population was used to compare clinicopathological features.Results: Mean age in the 34 patients with cystectomy was 75 years with a mean latency of 5 years from prostate cancer radiation. Radiotherapy was the primary treatment modality for prostate cancer in 32 of 34 patients and 2 received adjuvant radiation. Of the patients 86% received external beam radiation. Hematuria was the initial symptom in 86% of the cases. In 53% of the patients the initial diagnosis was muscle invasive bladder cancer. An ileal conduit was the method of urinary diversion in 33 cases. Major perioperative complications developed in 9% of the patients. There was 1 perioperative death, resulting in a mortality rate of 2.9%. Of the patients 54% presented with a locally advanced (pT3-4) tumor. Patients with a history of radiation therapy for prostate cancer had significantly poorer overall and bladder cancer specific survival than the matched control group.Conclusions: Most bladder cancers in patients with a history of radiation for prostate cancer present as locally advanced tumors and patients have poorer survival than age and stage matched controls.