Radiation Therapy to Recurrence Sites for Patients Post-Radical Cystectomy

Radiation therapy (RT) to recurrence sites may not have an effect on oncologic outcomes in patients with muscle invasive bladder cancer (MIBC) who experience local recurrence or pelvic lymph node metastases after radical cystectomy (RC), according to new research presented at the 2024 American Urological Association Annual Meeting.

Patients with MIBC often experience local recurrence or pelvic lymph node metastases after RC. While chemotherapy and immunotherapy treatment options are often utilized in this setting, the effects of RT to recurrence sites are not fully understood.

Researchers conducted a multi-institutional, retrospective study of 950 patients with MIBC who underwent RC. Of these patients, 106 experienced local recurrence or pelvic lymph node metastases without distant metastases. The subsequent analysis was divided into 2 patient groups: those who were treated with RT to the recurrence sites and those who were not.

Multivariable Cox proportional hazards regression analyses were performed to investigate the effects of RT on cancer-specific survival (CSS) and overall survival (OS) after recurrence.

The median follow-up period after recurrence was 13 months. Of the 106 patients, 65 (61%) received neoadjuvant chemotherapy and 30 (28%) were treated with RT after recurrence, researchers noted.

CSS and OS were not significantly different between the 2 groups (P=.569 and P=.456, respectively).

Univariable analyses showed that neoadjuvant chemotherapy, pure urothelial carcinoma, tumor grade, and lymphovascular invasion were significantly associated with CSS, and the same variables plus pathological lymph node involvement were significantly associated with OS. After adjusting for these variables, researchers found that RT to recurrence sites was not significantly associated with prolonged CSS and OS.

“RT to recurrence sites might have no effect on oncological outcomes in patients who experienced local recurrence and/or pelvic lymph node metastases after RC,” they concluded.