When would you recommend adjuvant radiation following cystectomy for urothelial bladder cancer?

Local-regional recurrence for patients with ≥pT3 disease after radical cystectomy is a significant problem (1) and warrants consideration of adjuvant radiation therapy in patients who are likely to tolerate such treatment. Chemotherapy has not been shown to reduce the risk of local-regional recurr...

There is sound rationale (1), and some clinical trial evidence, to administer post-operative radiation after cystectomy. Local recurrences do occur after cystectomy for locally advanced bladder cancer. In a patterns of failure analysis from our institution (2), we discovered a >30% rate of local-reg...