[Cystectomy as "ultima ratio" after failure of radiotherapy in bladder cancer (author's transl)].

20 patients were cystectomized an average of 2 years after unsuccessful curative radiotherapy. This technically difficult procedure has a high mortality rate of about 10--20%. None of the patients survived more than 5 years, but improved quality of life was the main subjective impression. A tumor-free specimen -- the effect of radio-induced downstaging -- is no guarantee of long-term survival. 4 of 6 patients without histological tumor cells in the cystectomy or lymph node specimens died of metastic disease. The indications for "salvage" cystectomy were: untreatable bladder hemorrhage, in some instances as emergency; frequently recurrent tumors; and subjectively unbearable state of disease.