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Genitourinary cancer
Single Early Intravesical Instillation of Epirubicin for Preventing Bladder Recurrence after Nephroureterectomy in Upper Urinary Tract Urothelial Carcinoma
Jong Hoon Lee, Chung Un Lee, Jae Hoon Chung, Wan Song, Minyong Kang, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Hwan Sung
Cancer Res Treat. 2024;56(3):877-884.   Published online January 17, 2024
DOI: https://doi.org/10.4143/crt.2023.1219
AbstractAbstract PDFPubReaderePub
Purpose
We aimed to assess the effectiveness of early single intravesical administration of epirubicin in preventing intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma.
Materials and Methods
Patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy between November 2018 and May 2022 were retrospectively reviewed. Intravesical epirubicin was administered within 48 hours if no evidence of leakage was observed. Epirubicin (50 mg) in 50 mL normal saline solution was introduced into the bladder via a catheter and maintained for 60 minutes. The severity of adverse events was graded using the Clavien-Dindo classification. We compared intravesical recurrence rate between the two groups. Multivariate analyses were performed to identify the independent predictors of bladder recurrence following radical nephroureterectomy.
Results
Epirubicin (n=55) and control (n=116) groups were included in the analysis. No grade 1 or higher bladder symptoms have been reported. A statistically significant difference in the intravesical recurrence rate was observed between the two groups (11.8% at 1 year in the epirubicin group vs. 28.4% at 1 year in the control group; log-rank p=0.039). In multivariate analysis, epirubicin instillation (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.20 to 0.93; p=0.033) and adjuvant chemotherapy (HR, 0.29; 95% CI, 0.13 to 0.65; p=0.003) were independently predictive of a reduced incidence of bladder recurrence.
Conclusion
This retrospective review revealed that a single immediate intravesical instillation of epirubicin is safe and can reduce the incidence of intravesical recurrence after radical nephroureterectomy. However, further prospective trials are required to confirm these findings.

Citations

Citations to this article as recorded by  
  • The role of intravesical chemotherapy following nephroureterectomy in upper tract urothelial carcinoma: A systematic review and meta-analysis
    Stefano Moretto, Andrea Piccolini, Andrea Gallioli, Roberto Contieri, Nicolomaria Buffi, Giovanni Lughezzani, Alberto Breda, Michael Baboudjian, Bas WG van Rhijn, Morgan Roupret, Alessandro Uleri, Benjamin Pradere
    Urologic Oncology: Seminars and Original Investigations.2025; 43(3): 191.e1.     CrossRef
  • 2,623 View
  • 106 Download
  • 1 Web of Science
  • 1 Crossref
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Oncological Outcomes in Men with Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide with versus without Confirmatory Bone Scan
Chang Wook Jeong, Jang Hee Han, Dong Deuk Kwon, Jae Young Joung, Choung-Soo Kim, Hanjong Ahn, Jun Hyuk Hong, Tae-Hwan Kim, Byung Ha Chung, Seong Soo Jeon, Minyong Kang, Sung Kyu Hong, Tae Young Jung, Sung Woo Park, Seok Joong Yun, Ji Yeol Lee, Seung Hwan Lee, Seok Ho Kang, Cheol Kwak
Cancer Res Treat. 2024;56(2):634-641.   Published online December 5, 2023
DOI: https://doi.org/10.4143/crt.2023.848
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
In men with metastatic castration-resistant prostate cancer (mCRPC), new bone lesions are sometimes not properly categorized through a confirmatory bone scan, and clinical significance of the test itself remains unclear. This study aimed to demonstrate the performance rate of confirmatory bone scans in a real-world setting and their prognostic impact in enzalutamide-treated mCRPC.
Materials and Methods
Patients who received oral enzalutamide for mCRPC during 2014-2017 at 14 tertiary centers in Korea were included. Patients lacking imaging assessment data or insufficient drug exposure were excluded. The primary outcome was overall survival (OS). Secondary outcomes included performance rate of confirmatory bone scans in a real-world setting. Kaplan-Meier analysis and multivariate Cox regression analysis were performed.
Results
Overall, 520 patients with mCRPC were enrolled (240 [26.2%] chemotherapy-naïve and 280 [53.2%] after chemotherapy). Among 352 responders, 92 patients (26.1%) showed new bone lesions in their early bone scan. Confirmatory bone scan was performed in 41 patients (44.6%), and it was associated with prolonged OS in the entire population (median, 30.9 vs. 19.7 months; p < 0.001), as well as in the chemotherapy-naïve (median, 47.2 vs. 20.5 months; p=0.011) and post-chemotherapy sub-groups (median, 25.5 vs. 18.0 months; p=0.006). Multivariate Cox regression showed that confirmatory bone scan performance was an independent prognostic factor for OS (hazard ratio 0.35, 95% confidence interval, 0.18 to 0.69; p=0.002).
Conclusion
Confirmatory bone scan performance was associated with prolonged OS. Thus, the premature discontinuation of enzalutamide without confirmatory bone scans should be discouraged.

Citations

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  • ECM-mimicking hydrogel models of human adipose tissue identify deregulated lipid metabolism in the prostate cancer-adipocyte crosstalk under antiandrogen therapy
    Agathe Bessot, Joan Röhl, Maria Emmerich, Anton Klotz, Akhilandeshwari Ravichandran, Christoph Meinert, David Waugh, Jacqui McGovern, Jenni Gunter, Nathalie Bock
    Materials Today Bio.2025; 30: 101424.     CrossRef
  • 3,520 View
  • 139 Download
  • 1 Web of Science
  • 1 Crossref
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Risk Factors and Patterns of Locoregional Recurrence after Radical Nephrectomy for Locally Advanced Renal Cell Carcinoma
Gyu Sang Yoo, Won Park, Hongryull Pyo, Byong Chang Jeong, Hwang Gyun Jeon, Minyong Kang, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Byung Kwan Park, Chan Kyo Kim, Sung Yoon Park, Ghee Young Kwon
Cancer Res Treat. 2022;54(1):218-225.   Published online April 15, 2021
DOI: https://doi.org/10.4143/crt.2020.1373
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We aimed to investigate the risk factors and patterns of locoregional recurrence (LRR) after radical nephrectomy (RN) in patients with locally advanced renal cell carcinoma (RCC).
Materials and Methods
We retrospectively analyzed 245 patients who underwent RN for non-metastatic pT3-4 RCC from January 2006 to January 2016. We analyzed the risk factors associated with poor locoregional control using Cox regression. Anatomical mapping was performed on reference computed tomography scans showing intact kidneys.
Results
The median follow-up duration was 56 months (range, 1 to 128 months). Tumor extension to renal vessels or the inferior vena cava (IVC) and Fuhrman’s nuclear grade IV were identified as independent risk factors of LRR. The 5-year actuarial LRR rates in groups with no risk factor, one risk factor, and two risk factors were 2.3%, 19.8%, and 30.8%, respectively (p < 0.001). The locations of LRR were distributed as follows: aortocaval area (n=2), paraaortic area (n=4), retrocaval area (n=5), and tumor bed (n=11). No LRR was observed above the celiac axis (CA) or under the inferior mesenteric artery (IMA).
Conclusion
Tumor extension to renal vessels or the IVC and Fuhrman’s nuclear grade IV were the independent risk factors associated with LRR after RN for pT3-4 RCC. The locations of LRR after RN for RCC were distributed in the tumor bed and regional lymphatic area from the bifurcation of the CA to that of the IMA.

Citations

Citations to this article as recorded by  
  • Early-Stage Renal Cell Carcinoma: Who Needs Adjuvant Therapy?
    Andreea Ioana Parosanu, Cornelia Nititpir, Ioana Miruna Stanciu, Catalin Baston
    Biomedicines.2025; 13(3): 543.     CrossRef
  • Survival pattern of metastatic renal cell carcinoma patients according to WHO/ISUP grade: a long-term multi-institutional study
    Joongwon Choi, Seokhwan Bang, Jungyo Suh, Chang Il Choi, Wan Song, Hyeong Dong Yuk, Chan Ho Lee, Minyong Kang, Seol Ho Choo, Jung Kwon Kim, Hyung Ho Lee, Jung Ki Jo, Eu Chang Hwang, Chang Wook Jeong, Young Hwii Ko, Jae Young Park, Cheryn Song, Seong Il Se
    Scientific Reports.2024;[Epub]     CrossRef
  • Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma: Current Landscape and Future Direction
    Dylan M Buller, Maria Antony, Benjamin T Ristau
    OncoTargets and Therapy.2023; Volume 16: 49.     CrossRef
  • 6,863 View
  • 150 Download
  • 4 Web of Science
  • 3 Crossref
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Genitourinary Cancer
Effects of Complete Bladder Cuff Removal on Oncological Outcomes Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma
Hyunsoo Ryoo, Jungyu Kim, Taejin Kim, Minyong Kang, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Hyun Hwan Sung
Cancer Res Treat. 2021;53(3):795-802.   Published online December 28, 2020
DOI: https://doi.org/10.4143/crt.2020.919
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to evaluate the effects of bladder cuff method on oncological outcomes in patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.
Materials and Methods
The records of 1,095 patients treated with RNU performed at our hospital between 1994 and 2018 were retrospectively reviewed; 856 patients with no bladder tumor history were enrolled in the present study. The management of bladder cuff was divided into two categories: extravesical ligation (EL) or transvesical resection (TR). Survival was analyzed using the Kaplan-Meier method and Cox regression analyses were performed to determine which factors were associated with intravesical recurrence (IVR)–free survival (IVRFS), cancer-specific survival (CSS), and overall survival (OS).
Results
The mean patient age was 64.8 years and the median follow-up was 37.7 months. Among the 865 patients, 477 (55.7%) underwent the TR and 379 (44.3%) the EL. Significantly higher IVRFS (p=0.001) and OS (p=0.013) were observed in the TR group. In multivariable analysis, IVR, CSS, and OS were independently associated with the EL. Among 379 patients treated with the EL, eight underwent remnant ureterectomy. Based on radical cystectomy–free survival, significant difference was not observed between the two groups. However, significantly higher IVRFS was observed in the TR group when the tumor was located in the renal pelvis.
Conclusion
Intramural complete excision of the distal ureter during RNU should be the gold standard approach compared with EL for the management of distal ureter in terms of oncological outcomes.

Citations

Citations to this article as recorded by  
  • Single Early Intravesical Instillation of Epirubicin for Preventing Bladder Recurrence after Nephroureterectomy in Upper Urinary Tract Urothelial Carcinoma
    Jong Hoon Lee, Chung Un Lee, Jae Hoon Chung, Wan Song, Minyong Kang, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Hwan Sung
    Cancer Research and Treatment.2024; 56(3): 877.     CrossRef
  • Violation of onco-surgical principles is associated with survival outcomes in upper tract urothelial carcinomas after radical nephroureterectomy
    Ioannis Patras, Johan Abrahamsson, Axel Gerdtsson, Martin Nyberg, Ymir Saemundsson, Elin Ståhl, Anne Sörenby, Åsa Warnolf, Johannes Bobjer, Fredrik Liedberg
    Scandinavian Journal of Urology.2024; 59: 131.     CrossRef
  • Differential effect of surgical technique on intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial cancer: a systematic review and Meta-analysis
    Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Robert J Schulz, Anna Cadenar, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Marcin Miszczyk, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koi
    World Journal of Urology.2024;[Epub]     CrossRef
  • The impact of bladder cuff excision on outcomes after nephroureterectomy for upper tract urothelial carcinoma: An analysis of the ROBUUST 2.0 registry
    Courtney Yong, James E. Slaven, Zhenjie Wu, Vitaly Margulis, Hooman Djaladat, Alessandro Antonelli, Giuseppe Simone, Raj Bhanvadia, Alireza Ghoreifi, Farshad Sheybaee Moghaddam, Francesco Ditonno, Gabriele Tuderti, Stephan Bronimann, Sohail Dhanji, Benjam
    Urologic Oncology: Seminars and Original Investigations.2024; 42(11): 373.e1.     CrossRef
  • A new nomogram for predicting extraurothelial recurrence in patients with upper urinary tract urothelial carcinoma following radical nephroureterectomy
    Hao Wu, Dan Jia, Xianyu Dai, Hongliang Cao, Fulin Wang, Tong Yang, Lei Wang, Tao Xu, Baoshan Gao
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Perioperative and oncological outcomes of distal ureter management during nephroureterectomy for upper urinary tract urothelial carcinoma: a systematic review and meta-analysis
    Andrea GALLIOLI, Michael BABOUDJIAN, Pietro DIANA, Marco MOSCHINI, Evanguelos XYLINAS, Francesco DEL GIUDICE, Ekaterina LAUKHTINA, Francesco SORIA, Andrea MARI, José D. SUBIELA, Mathieu ROUY, Angelo TERRITO, Giuseppe BASILE, Joan PALOU, Benjamin PRADERE,
    Minerva Urology and Nephrology.2023;[Epub]     CrossRef
  • Predicting and Decreasing Bladder Tumor Recurrence Following Nephroureterectomy
    Hiroko Miyagi, Elizabeth A. Di Valerio, Padraic O’Malley, Wayne G. Brisbane, Li-Ming Su, Paul L. Crispen
    Frontiers in Urology.2022;[Epub]     CrossRef
  • Inadvertent radical nephrectomy leads to worse prognosis in renal pelvic urothelial carcinoma patients: A propensity score-matched study
    Feixiang Wu, Pan Zhang, Lingxun Li, Shiqing Lin, Jianhong Liu, Yi Sun, Yuanlong Wang, Chengjun Luo, Yu Huang, Xiao Yan, Meng Zhang, Guixi Liu, Kun Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • 6,931 View
  • 152 Download
  • 8 Web of Science
  • 8 Crossref
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Atezolizumab in Patients with Pretreated Urothelial Cancer: a Korean Single-Center, Retrospective Study
Joon Young Hur, Youjin Kim, Ghee-Young Kwon, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Su Jin Lee, Se Hoon Park
Cancer Res Treat. 2019;51(4):1269-1274.   Published online January 9, 2019
DOI: https://doi.org/10.4143/crt.2018.604
AbstractAbstract PDFPubReaderePub
Purpose
Treatment targeting immune checkpoint with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors has demonstrated efficacy and tolerability in the treatment of metastatic urothelial carcinoma (mUC). We investigated the efficacy and safety of atezolizumab in mUC patients who failed platinum-based chemotherapy.
Materials and Methods
A retrospective study using the Samsung Medical Center cancer chemotherapy registry was performed on 50 consecutive patients with mUC treated with atezolizumab, regardless of their PD-L1(SP142) status, as salvage therapy after chemotherapy failure between May 2017 and June 2018. Endpoints included overall response rate (RR), progression-free survival (PFS), and safety.
Results
Among 50 patients, men constituted 76% and the median age was 68 years (range, 46 to 82 years). Twenty-three patients (46%) received atezolizumab as second-line therapy. PD-L1 (SP142) status IC0/1 and IC2/3 were found in 21 (42%) and 21 (42%) of patients, respectively; in eight patients (16%), PD-L1 (SP142) expression was not available. Atezolizumab was generally well tolerated, with pruritus and fatigue being the most commonly observed toxicities. As a result, partial response was noted in 20 patients (40%), with 12 (24%) stable diseases. RRwas higherin IC2/3 (62%) than in IC0/1 patients (24%, p=0.013). The median PFS was 7.4 months (95% confidence interval, 3.4 to 11.4 months). As expected, PFS also was significantly longer in IC2/3 patients than in IC0/1 (median, 12.7 vs. 2.1 months; p=0.005). PFS was not significantly influenced by age, sex, performance status, number of previous chemotherapy, site of metastases, or any of the baseline laboratory parameters.
Conclusion
In this retrospective study, atezolizumab demonstrated clinically efficacy and tolerability in unselected mUC patients who failed platinum-based chemotherapy.

Citations

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  • Real-world data of atezolizumab in patients with previously treated locally advanced or metastatic urothelial bladder cancer
    Rocío Díaz Acedo, Mercedes Galvan Banqueri, Silvia Artacho Criado, Eva María Fernández Parra, Rocío Jiménez Galán, Ana Isabel Gago Sánchez, Juan Francisco Marín Pozo, María José Martínez Bautista
    International Journal of Clinical Pharmacy.2024; 46(2): 382.     CrossRef
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    Biomedicines.2022; 10(8): 2005.     CrossRef
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    Inkeun Park, Jae Lyun Lee
    The Korean Journal of Internal Medicine.2020; 35(4): 834.     CrossRef
  • 7,694 View
  • 283 Download
  • 3 Web of Science
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Effects of Aspirin, Nonsteroidal Anti-inflammatory Drugs, Statin, and COX2 Inhibitor on the Developments of Urological Malignancies: A Population-Based Study with 10-Year Follow-up Data in Korea
Minyong Kang, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Chang Wook Jeong
Cancer Res Treat. 2018;50(3):984-991.   Published online October 27, 2017
DOI: https://doi.org/10.4143/crt.2017.248
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to determine the impact of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), statin, and cyclooxygenase 2 (COX-2) inhibitor on the development of kidney, prostate, and urothelial cancers by analyzing the Korean National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.
Materials and Methods
Among a representative sample cohort of 1,025,340 participants in NHIS-NSC database in 2002, we extracted data of 799,850 individuals who visited the hospital more than once, and finally included 321,122 individuals aged 40 and older. Following a 1-year washout period between 2002 and 2003, we analyzed 143,870 (male), 320,861 and 320,613 individuals for evaluating the risk of prostate cancer, kidney cancer and urothelial cancer developments, respectively, during 10-year follow-up periods between 2004 and 2013. The medication group consisted of patients prescribed these drugs more than 60% of the time in 2003. To adjustfor various parameters of the patients, a multivariate Cox regression model was adopted.
Results
During 10-year follow-up periods between 2004 and 2013, 9,627 (6.7%), 1,107 (0.4%), and 2,121 (0.7%) patients were diagnosed with prostate cancer, kidney cancer, and urothelial cancer, respectively. Notably, multivariate analyses revealed that NSAIDs significantly increased the risk of prostate cancer (hazard ratio [HR], 1.35). Also, it was found that aspirin (HR, 1.28) and statin (HR, 1.55) elevated the risk of kidney cancer. No drugs were associated with the risk of urothelial cancer.
Conclusion
In sum, our study provides the valuable information for the impact of aspirin, NSAID, statin, and COX-2 inhibitor on the risk of prostate, kidney, and urothelial cancer development and its survival outcomes.

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  • Association between Statin Use and Clinical Outcomes in Patients with De Novo Metastatic Prostate Cancer: A Propensity Score-weighted Analysis
    Tzu Shuang Chen, Hui Ying Liu, Yin Lun Chang, Yao Chi Chuang, Yen Ta Chen, Yu Li Su, Chun Chieh Huang, Yen Ting Wu, Hung Jen Wang, Hao Lun Luo
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    Gyoohwan Jung, Jung Kwon Kim, Seong Soo Jeon, Jae Hoon Chung, Cheol Kwak, Chang Wook Jeong, Hanjong Ahn, Jae Young Joung, Tae Gyun Kwon, Sung Woo Park, Seok-Soo Byun
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    Frontiers in Oncology.2018;[Epub]     CrossRef
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Conditional Survival and Associated Prognostic Factors in Patients with Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Study at a Single Institution
Minyong Kang, Hyung Suk Kim, Chang Wook Jeong, Cheol Kwak, Hyeon Hoe Kim, Ja Hyeon Ku
Cancer Res Treat. 2016;48(2):621-631.   Published online September 9, 2015
DOI: https://doi.org/10.4143/crt.2015.220
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study is to evaluate the changes of conditional survival (CS) probabilities and to identify the prognostic parameters that significantly affect CS over time post-surgery in upper tract urothelial carcinoma (UTUC) patients. Materials and Methods A total of 330 patients were examined in the final analysis. Primary end point was conditional cancer-specific survival (CSS), overall survival (OS), and intravesical recurrence-free survival (IVRFS) after surgery. The Kaplan-Meier method was used for calculation of CS. Cox regression hazard ratio model was used to determine the predictors of CS.
Results
UTUC patients who had already survived 5 years after radical nephroureterectomy had a more favorable CS probability in all given survivorships compared to those with shorter survival times. Patients with unfavorable pathologic features showed a higher increment of 5-year conditional CSS and OS compared to their counterparts. For 5-year conditional CSS, several factors, including high-grade tumor, lymphovascular invasion, and tumor location showed significant association with risk elevation over time. Only age remained as a predictor of 5-year conditional OS with increased risk in all given survivorships. For 5-year IVRFS, no variables remained as significant predictive factors over time after surgery. Conclusion Our study provides valuable information for practical survival estimation and relevant prognostic factors for patients with UTUC after surgery.

Citations

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  • Adjuvant Chemotherapy after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma with Variant Histology: A Systematic Review and Meta-Analysis of Survival Outcomes
    Jinhyung Jeon, Jae Heon Kim, Jee Soo Ha, Won Jae Yang, Kang Su Cho, Do Kyung Kim
    Urologia Internationalis.2024; 108(4): 339.     CrossRef
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    Yang Shi, Yuenan Zheng, Hao Zhang, Wenwu Dong, Ping Zhang
    Discover Oncology.2023;[Epub]     CrossRef
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    I-Hsuan Alan Chen, Chao-Hsiang Chang, Chi-Ping Huang, Wen-Jeng Wu, Ching-Chia Li, Chung-Hsin Chen, Chao-Yuan Huang, Chi-Wen Lo, Chih-Chin Yu, Chung-You Tsai, Wei-Che Wu, Jen-Shu Tseng, Wun-Rong Lin, Yuan-Hong Jiang, Yu-Khun Lee, Yeong-Chin Jou, Ian-Seng C
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  • A retrospective multicenter comparison of conditional cancer-specific survival between laparoscopic and open radical nephroureterectomy in locally advanced upper tract urothelial carcinoma
    Sung Han Kim, Mi Kyung Song, Ja Hyeon Ku, Seok Ho Kang, Byong Chang Jeong, Bumsik Hong, Ho Kyung Seo, Isaac Yi Kim
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