Syamsu Hudaya
Department of Surgery, Fatmawati General Hospital, Jakarta

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Paclitaxel, Iphospamide, and Cisplatin (TIP) as Bleomycin, Etoposide, and Cisplatin (BEP) Alternative for First-Line Therapy of Metastatic Germ Cell Tumor (GCT): A Case Series Syamsu Hudaya; Adianti Khadijah
Indonesian Journal of Cancer Vol 13, No 3 (2019): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (617.637 KB) | DOI: 10.33371/ijoc.v13i3.659

Abstract

Background: Bleomycin, etoposide, and cisplatin (BEP) is a standard first-line therapy for metastatic germ cell tumor (GCT), while paclitaxel, ifosfamide, and cisplatin (TIP) are commonly used as salvage therapy after failed BEP treatment. The unavailability of first-line drugs can be the reason for the use of second-line therapy. In this paper, we reviewed two initial cases of patients with metastatic GCT treated with TIP as first-line chemotherapy in our center.Case Presentation: We reviewed the medical record and followed up two patients who had been treated with TIP as first-line chemotherapy for metastatic GCT due to lack of BEP regiment. We evaluated efficacy and toxicity of this treatment. These two patients were diagnosed with seminoma, with intermediate-risk according to International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Both achieved complete response after four courses of TIP chemotherapy with toxicities mainly consisted of myelosuppression.Conclusions: TIP demonstrated efficacy serves as the first-line therapy for germ cell tumors with an acceptable safety profile. Further studies with larger subjects are still needed for evaluation. However, TIP is more expensive compared to BEP, making BEP is still superior to TIP in public hospital setting where cost-effectiveness of treatment is important.
Radical Cystectomy Procedures in Fatmawati General Hospital, Jakarta, Indonesia: Preliminary Report Syamsu Hudaya; Karina Evelyn Sidabutar
Indonesian Journal of Cancer Vol 13, No 1 (2019): March
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (719.023 KB) | DOI: 10.33371/ijoc.v13i1.598

Abstract

Background: Radical cystectomy (RC) and urinary diversion (UD) are among the most complex urological procedures with high postoperative morbidity, That caused only a few urologists are prepared to perform this operation. We dedicated to enroll this procedure since the number of bladder tumor cases is increasing in our third referral general hospital. We evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of radical cystectomy.Methods: This retrospective descriptive study collected medical record of patients with RC in Fatmawati Hospital, Jakarta, Indonesia from 2014-2016. All surgeries were performed by the same surgeon. Variables related to the surgical and postoperative outcomes and complications in the patients were analyzed.Results: There were 11 patients during this study period. The average age of the patients was 60.9 ± 9.6 years old with 7 male and 4 female patients. All patients underwent ileal conduit as urinary diversion. The mean operation time was 392.7 ± 117 minutes. The estimated blood loss was 1,272.7 ± 538.7 mL. No intraoperative death was recorded. The hospital stay length was 15.8 ± 8.3 days, visual analog scale (VAS) score in the first day after surgery was 2.7 ± 0.2, and the drain was kept in for 13.9 ± 7.4 days. All of the histopathology results were urothelial carcinomas.Conclusions: Our initial experience with radical cystectomy results in acceptable blood loss, manageable post-operative pain, and acceptable hospital stay. Therefore it is still a treatment of choice for muscle-invasive bladder cancer in our hospital.