Comparative study of actuarial survival rates in P3 P4 (N+ Mo) transitional cell carcinoma of bladder managed by total cystectomy alone or associated with preoperative radiotherapy and pelvic lymphadenectomy.

In P3 P4 (N+ Mo) bladder cancer patients we conclude the following: 1) The addition of preoperative radiotherapy and meticulous pelvic cellulo-lymphadenectomy to total cystectomy has improved the actuarial survival at five years from 10.5% to 41%. 2) With this protocol, the pelvic recurrence has been reduced from 47.4% to 4.5% and presently the failures are due to undectectable distant metastases.