[Adjuvant radiotherapy for bladder cancer in patients with risk of locoregional recurrence: Who, what and how?]

Radical cystectomy with extended pelvic lymph node dissection remains the standard of care for non-metastatic muscle-invasive bladder cancer. Locoregional control is a key factor in the outcome of patients since it is related to overall survival, metastasis-free survival and specific survival. Locoregional recurrence rate is directly correlated to pathological results and the quality of lymphadenectomy. In addition, while pre- or postoperative chemotherapy improved overall survival, it showed no impact on locoregional recurrence-free survival. Several recent publications have led to the development of a nomogram that predicts the risk of locoregional recurrence, in order to identify patients for which adjuvant radiotherapy could be beneficial. International cooperative groups have then come together to provide the rational for adjuvant radiotherapy, reinforced by recent technical developments limiting toxicity, and to develop prospective studies to reduce the risk of relapse. The aim of this critical literature review is to provide an overview of the elements in favor of adjuvant radiation for patients treated for muscle-invasive bladder cancer.

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique. 2017 Feb 07 [Epub ahead of print]

P Sargos, S Larré, O Chapet, I Latorzeff, A Fléchon, G Roubaud, M Orré, S Belhomme, P Richaud

Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France. Electronic address: ., Service d'urologie, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France., Département de radiothérapie, CHU Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France., Département de radiothérapie, groupe Oncorad Garonne, clinique Pasteur, bâtiment Atrium, 1, rue de la Petite-Vitesse, 31300 Toulouse, France., Département d'oncologie médicale, centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France., Département d'oncologie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France., Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France., Département de physique médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.