JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
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Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 1. P. 44-48
DOI: 10.12737/25057
Safety of Salvage Cystectomy after the Failure of Organ Preserving Treatment in Patients with Muscle Invasive Bladder Cancer
M.I. Volkova, M.M. Tkhakokhov, V.A. Cherniaev, K.M. Figurin, S.A. Kalinin, M.V. Peters, O.I. Evsukova, V.A. Romanov, A.D. Panakhov, V.B. Matveev
«N.N. Blokhin RCRC» Russian Ministry of Health, Moscow City, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
M.M. Tkhakokhov - graduate student; M.I. Volkova - leading researcher, MD, member of the Working Group for writing clinical guidelines of the European Association of Urology; V.A. Cherniaev - PhD, Senior Researcher; K.M. Figurin - Professor MD, leading researcher, member of the European Association of Urology; S.A. Kalinin - PhD, Associate Professor; M.V. Peters - PhD; O.I. Evsukova - graduate student; V.A. Romanov - PhD, Senior Researcher, member of the European Association of Urology; A.D. Panakhov - PhD, Senior Researcher; V.B. Matveev - Corresponding Member of Russian Academy of Sciences, Professor, MD, Head of the Urology Department, member of the Working Group for writing clinical guidelines of the European Association of Urology
Abstract
Purpose: To prove the safety of the salvage cystectomy after organ preserving treatment in patients with muscle invasive bladder cancer.
Material and methods: In the research retrospective data of 130 patients with muscle invasive transitional cell carcinoma of the bladder were selected. In the main group 66 patients undergoing of the salvage cystectomy after radiotherapy were included, in the control group - 64 patients who underwent of radical cystectomy without prior treatment. The main and control groups were matched by age, gender, category with cN (p > 0.05 for all). In the main group tumors which were beyond the bladder wall, hydronephrosis were more frequently diagnosed; during the salvage operations pelvic lymph node dissection rarely performed (p = 0.03) and orthotopic bladder substitution was made (p = 0.027).
Results: The median of duration of the salvage cystectomy was 310 min, which was not significantly different from 300 minutes in the control group (p = 0.711). The median of amount of bleeding of the patients undergoing surgery after irradiation, was not significantly lower than that the patients who had cystectomy which performed without prior radiation therapy (1329 and 1802 ml respectively, p = 0.118). The frequency of intraoperative complications of saving cystectomy was 10.6 %, which did not differ from 7.8 % in the control group (p = 0.300). Only one kind of complication of cystectomy after radiation therapy was difficult to control the bleeding in 6 cases (9.1 %). The frequency of postoperative complications - 42.7 % in the main and control group 42.2 % (p = 0.530). The perioperative mortality was equal to 6.1 %. The operating time, blood loss, frequency, structure and severity of complications i did not differ significantly n the main and control groups (p > 0.05 for all).
Conclusion: The salvage cystectomy is indicated to a sick muscle-invasive bladder cancer with an incomplete effect, relapse or intolerable toxicity, organ-preserving treatment, including radiation therapy. Desmoplastic reactions of the irradiated tissue cause the technical complexity of the interference and worsen the conditions for reparation. The most common intraoperative complication of salvage cystectomy is bleeding, in the structure of postoperative complications infections, intestinal obstruction and complications of the urinary anastomoses dominate. The accumulation of surgical experience make the frequency and severity complications of the salvage radical cystectomy comparable, offsetting an increase of operational risk in previously irradiated patients.
Key words: bladder, muscle invasive cancer, salvage cystectomy, radiotherapy, complications
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For citation: Volkova MI, Tkhakokhov MM, Cherniaev VA, Figurin KM, Kalinin SA, Peters MV, Evsukova OI, Romanov VA, Panakhov AD, Matveev V.B. Safety of Salvage Cystectomy after the Failure of Organ Preserving Treatment in Patients with Muscle Invasive Bladder Cancer. Medical Radiology and Radiation Safety. 2017;62(1):44-8. Russian. DOI: 10.12737/article_58f0b9572d7131.31568909
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