Bladder carcinoma: results with preoperative radiation therapy and radical cystectomy.

The records of 159 patients treated with preoperative radiotherapy and radical cystectomy were reviewed to ascertain the influence on survival rates and disease-free intervals of tumor stage, tumor grade, tumor appearance, lymphatic permeation, history of previous bladder tumors, and downstaging (pathologic stage < clinical stage). Knowledge of grade, tumor appearance, lymphatic invasion, and history of previous bladder tumors did not make possible an accurate prediction of response to integrated therapy. However, both downstaging and the absence of muscle invasion were associated with significantly improved survival rates and disease-free intervals.