Radical cystectomy for @entity150 after XXXX treatment.

@entity1 @entity263 @entity4153 @entity242 @entity190 @entity532 @entity189 @entity150 @entity204 @entity130
OBJECTIVES: To review our perioperative experience with @entity1 presenting with high-risk @entity150 who had undergone prior therapy for @entity263 . With the increase in diagnosis and subsequent treatment of @entity263 , more @entity1 presenting with high-risk @entity150 have undergone prior therapy for @entity263 . Radical cystectomy in these @entity1 can be technically challenging and may be associated with added morbidity. METHODS: A retrospective review of 458 @entity1 treated with radical cystectomy between January 1993 and January 2002 revealed 29 @entity1 (mean age 72 years) who had received definitive treatment for @entity263 prior to cystectomy for @entity150 . The initial treatment in this cohort was radical prostatectomy or external beam radiotherapy in 12 (41%) and 17 (59%) @entity1 , respectively. Cystectomy was performed for transitional cell @entity189 in 25 (86%), @entity4153 in 2 (6%), and @entity242 in 2 (6%) @entity1 . RESULTS: At the time of cystectomy, the mean @entity190 was 1175 mL (range 275 to 3500), and the median length of hospitalization was 8 days (range 4 to 23). No intraoperative or perioperative @entity204 occurred in this cohort. Twenty-seven early @entity532 were identified in 16 (55%) of 29 @entity1 ; no @entity130 occurred. @entity1 with prior radiotherapy had a higher rate of extravesical @entity150 (60%) than those @entity1 treated with prior prostatectomy (33%). An orthotopic neobladder diversion was created in 5 @entity1 (17%). CONCLUSIONS: @entity1 with @entity150 previously treated for @entity263 with external beam radiotherapy or radical prostatectomy have an increased risk of perioperative @entity532 compared with @entity1 undergoing cystectomy without prior therapy. This risk is not prohibitive, and radical cystectomy should remain the treatment of choice for high-risk @entity150 in this population. Furthermore, orthotopic urinary diversion may be a reasonable option and should be considered in select @entity1 .
