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"The result of breast cancer therapy is usually evaluated using the five-year survival rate. Besides therapeutical aspects, several factors also determine the five-year survival rate, e.g. the stage of cancer and tumor size. The goal of this study is to determine the probability of 5-year survival among breast cancer patients at Dharmais Cancer Hospital Jakarta, and the relationship between cancer stage, tumor size, and 5-year survival rate.The design was a longitudinal study. Data were collected from the medical records of breast cancer patients admitted to Dharmais Cancer Hospital between 1993 and 1996. The sample was 137 women. Data was collected from the medical record as well as by telephoning or sending post mail to establish how long each breast cancer patient survived.The results show that the 5-year survival rate for breast cancer patients at Dharmais Cancer Hospital was 48%, with a median survival rate of 54 months. The 5-year survival rate of patients of early operable stages was 72%, while that of those from late stages was 12%. By us ing patients from early operable stages for baseline comparison, the risk-ratio of death in the late stage was 6.612 (95% CI: 4.014; 10.78). Moreover, the 5-year survival rate of patients with tumors that were less than 5 cm in size was 81 %, whilst the 5-year survival rate of patients with tumors larger than 5 cm was 24%. If compared to patients with a tumor size < 5 cm, the risk-ratio of death among patients with tumors over 5 cm in size was 6,612 (95% CI: 5.50; 12.48)."

"This important book provides up-to-date information on a series of topical issues relating to the approach to minimal residual disease in breast cancer patients. It first explains how the study of minimal residual disease and circulating and disseminated tumor cells (CTCs/DTCs) can assist in the understanding of breast cancer metastasis. A series of chapters then discuss the various technologies available for the detection and characterization of CTCs and DTCs, pinpointing their merits and limitations. Detailed consideration is given to the relevance of CTCs and DTCs, and their detection, to clinical research and practice. The role of other blood-based biomarkers is also addressed, and the closing chapters debate the challenges facing drug and biomarker co-development and the use of CTCs for companion diagnostic development. This book will be of interest and assistance to all who are engaged in the modern management of breast cancer."

"ABSTRAKTujuan: Meninjau status faktor-faktor prognostik tumor ginjal. Metode: Jenis penelitian ini adalah studi deskriptif analitik pada seluruh pasien tumor ginjal yang berobat ke RSUP H. Adam Malik tahun 2011 hingga 2015. Hasil: Jumlah sampel pada penelitian ini adalah 38 pasien. Dijumpai tujuh pasien hidup. Dari hasil uji multivariat, tindakan nefrektomi merupakan satu-satunya faktor prognostik pada pasien tumor ginjal. Tingkat mortalitas 0.056x lebih rendah pada pasien yang dilakukan nefrektomi dibanding pasien yang tidak dilakukan nefrektomi. Kesimpulan: Tindakan nefrektomi masih memiliki tempat dalam penanganan tumor ginjal, bahkan pada pasien yang berobat dengan stadium lanjut.

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ABSTRACTObjective To review the status of prognostic factors in kidney cancer. Methods This is an analytic descriptive study of all kidney cancer patients treated at Haji Adam Malik Hospital between 2011 and 2015. Results The number of samples analyzed in this study were 38 patients. We found seven patients remain alive. From the results of multivariate analysis, nephrectomy is the only prognostic factor in patients with kidney cancer. Mortality rate was 0.056x lower in patients who underwent nephrectomy compared with patients who did not underwent nephrectomy. Conclusion Nephrectomy still has a place in kidney cancer management, even in patients with advanced stage. "

"Latar belakang: Lingkungan mikro tumor telah terlibat dalam berbagai jenis kanker dan memegang peran penting dalam menentukan keberhasilan pengobatan terutama dengan imunoterapi. Pada kanker nasofaring, peran prognostik sel imun ini dalam lingkungan mikro tumor masih diragukan. Metode: Kami melakukan penelitian yang melibatkan 25 spesimen biopsi kanker nasofaring untuk mencari hubungan yang lebih langsung antara sel imun yang menginfiltrasi tumor dan progresifitas tumor. Selain itu, kami juga memeriksa protein PD-L1 melalui imunohistokimia. Hasil: PD-L1 diekspresikan secara positif dalam semua 25 sampel kami dengan kanker nasofaring WHO tipe 3 histologi. Sampel mayoritas memiliki> 50% ekspresi PD-L1 dalam membrane sitoplasma sel tumor. Kami juga menemukan bahwa sebaran sel imun pada sekitar tumor yang lebih padat memiliki volume tumor lokal yang relatif jauh lebih kecil. Kebalikannya juga berlaku, dengan volume tumor lokal rata-rata adalah 181,92 cm3 ± 81,45 cm3, 111,29 cm3 ± 92,75 cm3, dan 56,26 cm3 ± 26,55 cm3 untuk tiap skor infiltrasi sel imun sedikit, sedang, dan banyak, berturut-turut (p = 0,013).Kesimpulan: Oleh karena itu, kami menyimpulkan bahwa infiltrasi sel imun pada tumor memainkan peran penting dalam perkembangan tumor, karenanya mengevaluasi faktor sederhana dan prediktif ini dapat memberi kami beberapa informasi prognostik yang berharga.

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Background: Tumor microenvironment have been implicated in many kind of cancers to hold an important role in determining treatment success especially with immunotherapy. In nasopharyngeal cancer, the prognostic role of this immune cells within tumor microenvironment is still doubtful. Method: We conducted a study that included 25 nasopharyngeal cancer biopsy specimens to seek a more direct relationship between tumor infiltrating immune cells and tumor progression. Apart from that, we also checked the PD-L1 protein through immunohistochemistry.

Result: The PD-L1 was positively expressed in all our 25 samples with nasopharyngeal cancer WHO type 3 histology. Majority samples have >50% PD-L1 expression in tumor cells. We also found that denser local tumor infiltrating immune cells population have relatively much smaller local tumor volume. The inverse applied, with the mean local tumor volumes were 181.92 cm3 ± 81.45 cm3, 111.29 cm3 ± 92.75 cm3, and 56.26 cm3 ± 26.55 cm3 for mild, moderate, and heavy immune cells infiltration respectively (p=0.013).

Conclusion: Therefore, we concluded that tumor infiltrating immune cells play an important role in tumor progression, hence evaluating this simple and predictive factor may provide us with some valuable prognostic information."

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Glioma adalah tumor yang bermula dari tulang belakang atau otak yang berasal dari sel glial, dan merupakan salah satu keganasan yang sering ditemukan di Indonesia. TGF-I²1 mempunyai peran yang penting dalam mengontrol homeostasis jaringan dan peranjakan keganasan kanker, oleh sebab itu TGF-I²1 mempunyai potensi untuk menjadi biomarker untuk membedakan antar glioma keganasan tinggi dan rendah. Tujuan dari penelitian ini adalah untuk menganalisis ekspresi relatif TGF-I²1 glioma tingkat tinggi dan rendah, untuk melihat potensi menjadi biomarker. Dalam eksperimen terdapat 28 sampel yang digunakan dalam studi ini,16 jaringan dengan keganasan rendah, 10 dengan keganasan tinggi dan 2 jaringan otak normal yang didapat dari Rumah Sakit Cipto Mangunkusumo, Indonesia. Jaringan telah digolongkan berdasarkan klasifikasi yang diberikan oleh World Health Organization, derajat 1 dan 2 sebagai keganasan rendah dan derajat 3 dan 4 sebagai derajat tinggi. Ekspresi relatif dari TGF-I²1 dianalisa menggunakan Real-Time RT PCR dengan 18sRNA sebagai houskeeping gene. Dari hasil terlihat bahwa adanya penurunan ekspresi relatif TGF-I²1 di glioma keganasan tinggi saat dibandingkan dengan ekspresi di glioma keganasan rendah. Tetapi setelah dianalisis secara statistik, hasil penemuan ini tidak signifikan. Kegunaan dari TGF-I²1 sebagai biomarker belum terbukti, maka dari itu studi lebih lanjut harus dilakukan untuk menjelaskan fungsi dari TGF-I²1 sebagai biomarker untuk glioma.

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Glioma is a term used to describe tumors which originate from the spinal cord or brain, specifically the glial cells. This type of tumor is one of the most commonly found brain malignancies in Indonesia. TGFI²1 has a key role in the maintenance of tissue homeostasis and progression of cancer, due to this fact TGF-I²1 has the potential as a tissue biomarker to differentiate low grade and high grade gliomas. The goal of this study is to analyze the relative expression of TGF-²1 in both high grade and low grade glioma to explore its potential as a biomarker. In the experiment there was a total of 28 samples, 16 low grade glioma, 10 high grade glioma and 2 normal brain tissue obtained from Cipto Mangunkusumo Hospital, Indonesia. The sample was categorized to low grade and high grade glioma based on the guideline given by the World Health Organization. Grades 1 and 2 are considered to be low grade gliomas and grades 3 and 4 are considered to be high grade gliomas. The relative expression of TGF-I²1was measured through Real-Time RT-PCR with 18sRNA as a housekeeping gene. It was seen that there was a decrease in the expression of TGF-I²1 in high grade glioma as to low grade glioma. However, when the result was analyzed it is proven to be statistically insignificant.The role of TGF-I²1 as a definitive biomarker for glioma grading is yet to be proven, therefore further research must be conducted to elaborate the role of the gene as a glioma biomarker.

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"Latar belakang: Penelitian ini bertujuan untuk membandingkan kadar serum penanda biologis: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), matrik-metaloproteinase-2 (MMP-2), dan vascular endothelial growth factor (VEGF) pada endometriosis stadium I-II dan stadium III-IV.Metode: Penelitian ini adalah penelitian potong lintang pada empat puluh pasien endometriosis yang didiagnosis berdasarkan laparoskopi. Sampel serum diambil sebelum operasi, pemeriksaan penanda biologis dilakukan pada akhir penelitian dengan metode ELISA. Rerata kadar serum dibandingkan dengan menggunakan uji t tidak berpasangan.Variabel yang memiliki perbedaan rerata bermakna diuji dengan pemeriksaan ROC dan ditentukan titik potong optimal.Hasil: Kadar serum IL-6, TNF-a, dan MMP-2 tidak berbeda bermakna pada pasien endometriosis stadium I-II dan stadium III-IV dengan hasil rerata 1,58 ± 0,78 vs 1,55 ± 0,98 pg/mL; 1,5 ± 0,47 vs 1,49 ± 0,29 pg/mL; 152,04 ± 27,32 vs 140,98 ± 28,08 ng/mL. Hanya kadar VEGF yang memiliki perbedaan yang bermakna (289,76 ± 188,13 vs 581,29 ±512,85 pg/mL (p < 0,05)). Perbedaan rerata VEGF memiliki nilai AUC 74,5%. Titik potong optimal VEGF = 314,75 pg/mL dengan sensitivitas 78,6% dan spesifisitas 69,2%.Kesimpulan: Penelitian ini menunjukkan penanda biologis serum VEGF (tetapi tidak IL-6, TNF-a, dan MMP-2)dapat digunakan untuk mengukur derajat keparahan endometriosis. Kadar VEGF dari 314,75 pg/mL merupakan titik potong antara stadium yang lebih rendah dan lebih tinggi dari derajat keparahan.

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Background: The focus of this study was to compare serum biomarkers: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), matrix-metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in endometriosis stage I-II and stage III-IV.

Methods: This is a cross-sectional study. Forty endometriosis patients were diagnosed using laparoscopy procedure. Serum

sample was taken before the surgery. The serum biomarkers (IL-6, TNF-α, MMP-2, and VEGF) were analyzed with ELISA method at the end of research. Mean of serum biomarkers in endometrosis stage I-II and stage III-IV were compared using unpaired t-test. Variables that show significant mean difference were tested using ROC measurement and the optimal cut-off point was determined.

Results: There was no significant difference in mean serum biomarkers level of IL-6, TNF-α, and MMP-2 between endometriosis stage I-II and stage III-IV (1.58 ± 0.78 vs 1.55 ± 0.98 pg/mL, 1.5 ± 0.47 vs 1.49 ± 0.29 pg/mL, and 152.04 ± 27.32 vs 140.98 ± 28.08 ng/mL, respectively). On the other hand, the comparison of VEGF level in endometriosis stage I-II and stage III-IV demonstrated significant difference (289.76 ± 188.13 vs 581.29 ± 512.85 pg/mL (p < 0.05)). Mean

difference of VEGF had AUC of 74.5%. Optimal cut-off point for VEGF was ≥ 314.75 pg/mL with sensitivity 78.6% and specificity 69.2%.

Conclusion: This study showed that serum biomarkers of VEGF level (but not IL-6, TNF-α, and MMP-2) can be used to measure the degree of severity in endometriosis. VEGF level of 314.75 pg/mL represents the cut-off point between lower and higher stage of severity."

"Metastasis merupakan proses penyebaran sel induk kanker dari satu jaringan ke jaringan lain. Kejadian tersebut merupakan salah satu tanda utama kanker. Kanker yang dihasilkan dari metastasis disebut dengan kanker metastasis. Pertumbuhan kanker metastasis dapat dimodelkan ke dalam persamaan matematika. Pada pemodelan ini diasumsikan tubuh manusia sudah memiliki sebuah kanker yang akan memicu pertumbuhan kanker metastasis dan banyak niche (ruang dimana sel induk kanker melakukan segala aktivitasnya seperti proliferasi dan diferensiasi) yang ada dalam tubuh manusia adalah konstan. Metode kinetik Monte Carlo dapat digunakan untuk mensimulasikan pertumbuhan kanker metastasis sehingga dapat diestimasi waktu pertumbuhan kanker metastasis tersebut.

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Metastases is the spread of the cancer stem cells from one tissue to another. The occurence of the process is one of the major signs of cancer. The cancer resulting from metastases of cancer is called metastases. The growth of metastases cancer can be modeled into mathematical equation. On this modeling, the human body is assumed to already have a cancer that will trigger the growth of metastases cancers and the number of niches (the space where the cancer stem cells do all their activities such as proliferation and differentiation) in the human body is a constant. Kinetic Monte Carlo method can be used to simulate the growth of metastases cancer so that the estimation time of the growth can be found."