Recurrences were analyzed in 142 patients with invasive bladder cancer, who were treated either by definitive irradiation or preoperative irradiation and cystectomy. In 52 patients an estimation of the radiation response, by endoscopic re-examination soon after reaching 40 Gy, was done. The aim of this procedure was to select those patients who can probably be cured by radiotherapy alone. However, the predictive value of the examination seems to be low. It is concluded that for about 40% of all patients, removal of the bladder is of real benefit. The problem remains how to select this group of patients.