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Articles by C. H Kang
Total Records ( 2 ) for C. H Kang
  C. H Chen , C. H Kang and P. H. Chiang
  Objective

Patients with penile cancer sometimes refuse surgery under the consideration of cosmetic and functional impact. The efficacy of intra-arterial (IA) chemotherapy for penile cancer has not been well defined.

Methods

Five patients with penile cancer, receiving at least two courses of IA chemotherapy, were analyzed from January 2005 to January 2009. These patients all refused surgery initially. The drug combinations were as follows: methotrexate, mitomycin C, bleomycin, cisplatin and 5-fluorouracil. Carboplatin was used instead of cisplatin for one patient with renal insufficiency.

Results

The overall response rate (complete or partial) was 100%. One case achieved complete remission and four cases achieved partial remission. Among the partial responders, three cases underwent subsequent partial penectomy to preserve partial appearance. Mild (Grades I–II) anorexia is the most common adverse effect of IA chemotherapy. Hematological toxicity included two episodes of Grade III anemia and one episode of Grade III febrile neutropenia.

Conclusions

Organ- and function-sparing approaches are proposed using combination therapies, especially for those with huge tumor burden. Our preliminary data indicated that a combination of IA neoadjuvant chemotherapy and surgery may have the potential to achieve the goal in the treatment of penile cancer with negative lymph node.

  C. H Kang , C. H Chen and P. H. Chiang
  Objective

In this study, we assessed the clinical and pathological characteristics of urothelial cancers of the upper urinary tract (UUT) in patient under dialysis and evaluated the efficacy and complications of surgical management of the disease.

Methods

A total of 70 dialysis patients with primary urothelial carcinoma (UC) of the UUT were identified with 5-year follow-up after surgery (61–122 months). Potential factors were analysed to determine the risk factors of subsequent tumours and unfavourable prognostic factors of overall survival. Incidence of urothelial tumours and overall survival of 7503 dialysis patients were also evaluated.

Results

The incidence of primary UC of the UUT in dialysis patients in Taiwan was 0.93%. The 2-year and 5-year overall survival rates of dialysis patients with primary UC of the UUT were 74.3% and 42.9%, respectively. Subsequent bladder tumours and contralateral UUT tumours developed in 52.6% and 37.9% patients, respectively. No significant risk factor could be identified to predict subsequent tumours in dialysis patients. Pathological stage (P = 0.021) and grade (P < 0.001) were the unfavourable prognostic factors in the log-rank test. No significant difference was observed in perioperative mortality and overall survival between patients receiving one-stage nephroureterectomy and those receiving two-stage bilateral nephroureterectomy; however, the cystectomy procedure increased perioperative mortality according to the 2 test (P = 0.042).

Conclusions

Closely monitoring the residual urinary tracts after nephroureterectomy in dialysis patients with primary UC of the UUT should be performed. There is no statistical difference for overall survival between one-stage and two-stage bilateral nephroureterectomy.

 
 
 
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