In approximately 50% of patients will experience a local or distant recurrences following radical cystectomy, most within 24 months. The risk of both local and distant recurrence increases with advancing pathologic stage and nodal involvement. Postoperative monitoring for late surgical and diversion-related complications is mandatory. Also, with the assumption of close monitoring will result in earlier detection and thus better treatment of the recurrent disease regular follow-up is usually advocated. However, threre is no sufficient evidence based data showing that diagnosis of cancer recurrence following cystectomy by routine follow up results in better survival than symptom driven diagnosis.

In this article both the risk and pattern of recurrence and treatment strategies for the progressive disease following radical cystectomy were reviewed in the light of current literature data.