[Invasive tumors of the bladder. A study of 56 cases treated at the Gustave-Roussy Institute by total cystectomy and radiotherapy].

Between July 1973 and December 1984, 56 patients with invasive bladder cancer were treated at the Gustave-Roussy Institute by total cystectomy and, generally, radiotherapy (45 patients). Four modalities of irradiation were used: preoperative flash (21 patients), preoperative flash and postoperative irradiation (9 patients), preoperative irradiation according to conventional fractionation (12 patients), postoperative irradiation (3 patients). The actuarial 5 year survival for all of the patients treated was 28%. The essential prognostic factors were depth of emboli. Analysis of the deaths revealed loco-regional recurrence in 8 patients (14%), metastases in 11 patients (20%) another cause in 14 patients (24%); treatment appeared to be directly involved in 13 cases. However, toxicity has been considerably reduced since 1980, due to more rigorous patient selection for total cystectomy, improvement in pre- and postoperative intensive care and by the use of a radiotherapy protocol no longer involving large concentrated fractions.