A comparison of short-course, low-dose and long-course, high-dose preoperative radiation for carcinoma of the bladder

This retrospective study failed to detect a significant difference in survival rates between patients with bladder carcinoma who underwent cystectomy after short-course, low-dose radiation and those who underwent cystectomy after long-course, high-dose radiation. The authors were able to identify in the long-course--high-dose group a subset of patients with an unusually good prognosis, but this advantage was not reflected in survival rates. The value of the ability of the long-course--high-dose preoperative technique to identify a subgroup of patients with a relatively good survival rate remains to be determined. In terms of the current management of bladder cancer, this ability to identify a favorable subset of patients is probably not worth the cost and morbidity involved. If, however, adjuvant chemotherapy is to be considered, this ability might be valuable.