Post-Operative Outcomes after Radical Cystectomy in Patients with Prior Pelvic Radiation

To compare complication rates, perioperative outcomes, and survival after radical cystectomy (RC) in patients with prior abdominal and/or pelvic radiation therapy (RT) versus those without an RT history.

We retrospectively reviewed patients undergoing RC for urothelial carcinoma (UC) between January 2008 and January 2016. Patients were stratified by receipt of RT, and differences in complications (any, minor, and major) at 30 and 90 days, as well as, estimated blood loss, length of surgery, length of hospital stay, and pathologic stage were compared. Recurrence-free, cancer-specific, and overall survival was compared using the Kaplan-Meier method and log-rank test.

We identified 518 patients who underwent RC between 2008 and 2016. Of these, 55 (11%) patients had a history of RT. There were no significant differences in complications rates (66% versus 69%, p=0.80) between patients who did not to those who did have a history of RT. Similarly, there were no differences in any perioperative or pathologic outcome by receipt of prior RT (all p>0.05). Meanwhile, at a median follow-up of 26 (IQR 13-46) months among patients alive at last follow-up, no differences in survival were observed by prior RT (p=0.08).

Among patients with a history of prior abdominal/pelvic RT treated at a tertiary referral center, there was no difference in complication rates, perioperative, or pathologic outcomes. Importantly, no differences in survival were noted by prior RT receipt. Therefore, our data supports the use of RC, when indicated, in patients with a prior history of abdominal/pelvic RT.

Urology. 2018 Mar 12 [Epub ahead of print]

Philip A Fontenot, Brian D Barnes, William P Parker, Hadley Wyre, Eugene K Lee, Jeffrey M Holzbeierlein

Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: ., Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.