The clinical and morphologic features of 90 cases of squamous cell carcinoma of the bladder are reviewed. The lesions were solitary in 90% of the patients, developed without a history of vesical malignant disease in 82% and were invasive at the time of diagnosis in all cases. Ureteral obstruction was demonstrated in 42% of the group. The over all survival rate at 5 yr was only 10.6%. There were 17 patients who received no therapy, all of whom were dead before 2 yr. Unassisted supervoltage radiation therapy for patients with stages B2 and C lesions yielded a 5 yr survival rate of only 17.7%. However, preoperative radiotherapy followed by simple total cystecomy and urinary diversion in a small number of patients with stages B2 and C lesions resulted in a 5 yr survival rate in excess of 34%. These results were found to be encouraging; combination therapy warrants further clinical trial.
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