The role of endoscopic treatment after radical radiotherapy for invasive bladder cancer.

In a 6-year period 232 patients were treated by radical radiotherapy for transitional cell cancer of the bladder. Fifty-eight patients had secondary surgical management to control either locally persistent or recurrent tumour. Endoscopic treatment alone was used in 31 patients with down-staged tumours and the survival of this group compared favourably with that of 27 patients selected for salvage cystectomy (5-year survival rate 88% cf. 44%). A group of patients with favourable prognostic factors may be identified in whom cystectomy can be avoided without prejudice to survival.