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Simbolon, Edi Leonardo
Perbandingan luaran onkologi dan fungsional tata laksana giant cell tumor tulang yang dilakukan kuretase dan wide resection periode 1995-2014 di RS Cipto Mangunkusumo Jakarta = Giant cell tumor of bone oncological and functional outcome undergoing curettage or wide resection of longterm follow up / Edi Leonardo Simbolon
"[ABSTRAK
Pendahuluan: GCT tulang merupakan lesi jinak tetapi secara lokal dapat bersifat agresif pada daerah epifisis. Angka rekurensi yang tinggi, dilaporkan mencapai 75%. Tumor dapat bermetastasis ke paru (2-9%) dan tercatat 0-37% angka mortalitas akibat metastasis. Beberapa penelitian menghasilkan variasi berbeda penanganan tumor ini terhadap luaran onkologi dan fungsional serta angka kematian paska pembedahan. Penelitian ini bertujuan melaporkan pengalaman dalam penatalaksanaan pembedahan tumor ini dan untuk melihat adanya hubungan antara tatalaksana pembedahan dengan dampak klinis.
Metode: Penelitian ini merupakan kohort retrospektif, sebanyak 99 pasien GCT tulang menjalani tindakan kuretase ataupun wide resection di Rumah Sakit Cipto Mangunkusumo pada 1995 - 2014. Luaran onkologi berdasarkan angka rekurensi lokal, metastasis tumor serta mortalitas dan luaran fungsional berdasarkan sistem penilaian Musculoskeletal Tumor Society (MSTS).
Hasil: Lokasi tumor terutama di distal femur (25,2%). Rekurensi lokal terjadi pada 4 pasien, terutama di distal femur (50%). Rekurensi lokal terjadi seimbang pada wide resection dan kuretase dan secara statistik tidak bermakna (p 0.578, uji eksak Fischer). Tidak dijumpai kejadian rekurensi lokal pada seluruh pasien yang mengalami metastasis. Metastasis terjadi pada kelompok wide resection. Kematian terjadi pada 4 pasien yang mengalami metastasis. Sebagian besar pasien (51,1%) menunjukkan luaran fungsional kategori sangat baik (skor MSTS di atas 75%). Analisis kesintasan bebas rekurensi lokal secara statistik tidak bermakna (p 0.564). Analisis multivariat (regresi Cox) hanya faktor metastasis yang berpengaruh pada mortalitas (p. 0.001)
Kesimpulan: Terdapat hubungan yang bermakna antara stadium tumor dengan metastasis dan jenis tindakan operasi. Tidak terdapat perbedaan bermakna antara kejadian rekurensi lokal dan metastasis serta luaran fungsional dengan jenis tindakan operasi.
ABSTRACT
Introduction: Giant cell tumor of bone is benign lesion with ability to be locally aggressive in epiphysis. Its recurrence rate was reported as high as 75%. Tumor can metastasize to lungs (2-9%) and up to 37% mortality rate due to metastasis. Several studies have reported different rates of local recurrence, lung metastasis, mortality rate, and functional outcome. This study aims to report our experience and analyze the correlation between surgery and clinical findings.
Methods: In this retrospective cohort, 99 patients GCT of bone undergone curettage or wide resection in Cipto Mangunkusumo Hospital during 1995-2014. Oncological outcome were analyzed according to local recurrence rate, metastasis, and mortality rate, while functional outcome were measured according to Musculoskeletal Tumor Society Score (MSTS).
Results: Tumor location were predominantly in distal femur (25.2%). Local recurrence were observed in 4 patient and mainly in distal femur (50%). Local recurrence were evenly balanced between surgical curettage and wide resection (50% each) and thus not statistically significant (Exact Fischer, p=0.578). Metastasis were observed in patients who undergone wide resection, however, no significant correlation were found between metastasis incidence and types of surgical intervention (Exact Fischer, p=0.318). Four have died related to metastasis. No local recurrence were observed in patients suffering from metastasis. In more than half of patients (51.5%), the functional status were very good (MSTS >75. Recurrence-free survival analysis not significant statistically (p 0.564).Multivariate analysis (Cox regression) showed that only metastasis was found to be significantly correlated to mortality (p. 0.001).
Conclusion: Tumor stage was correlated to metastasis, and type of surgical intervention. No significant correlation were found between local recurrence, metastasis, and functional outcome to types of surgical intervention., Introduction: Giant cell tumor of bone is benign lesion with ability to be locally aggressive in epiphysis. Its recurrence rate was reported as high as 75%. Tumor can metastasize to lungs (2-9%) and up to 37% mortality rate due to metastasis. Several studies have reported different rates of local recurrence, lung metastasis, mortality rate, and functional outcome. This study aims to report our experience and analyze the correlation between surgery and clinical findings.
Methods: In this retrospective cohort, 99 patients GCT of bone undergone curettage or wide resection in Cipto Mangunkusumo Hospital during 1995-2014. Oncological outcome were analyzed according to local recurrence rate, metastasis, and mortality rate, while functional outcome were measured according to Musculoskeletal Tumor Society Score (MSTS).
Results: Tumor location were predominantly in distal femur (25.2%). Local recurrence were observed in 4 patient and mainly in distal femur (50%). Local recurrence were evenly balanced between surgical curettage and wide resection (50% each) and thus not statistically significant (Exact Fischer, p=0.578). Metastasis were observed in patients who undergone wide resection, however, no significant correlation were found between metastasis incidence and types of surgical intervention (Exact Fischer, p=0.318). Four have died related to metastasis. No local recurrence were observed in patients suffering from metastasis. In more than half of patients (51.5%), the functional status were very good (MSTS >75. Recurrence-free survival analysis not significant statistically (p 0.564).Multivariate analysis (Cox regression) showed that only metastasis was found to be significantly correlated to mortality (p. 0.001).
Conclusion: Tumor stage was correlated to metastasis, and type of surgical intervention. No significant correlation were found between local recurrence, metastasis, and functional outcome to types of surgical intervention.]"
2015
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UI - Tesis Membership  Universitas Indonesia Library
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Astuti Pitarini
Luaran onkologi dan fungsional tata laksana tumor tulang yang dilakukan prosedur Limb salvage surgery (Lss) dengan megaprostesis di RS Cipto Mangunkusumo Jakarta = Oncological and functional outcome of Limb salvage surgery (Lss) in bone tumor with megaprosthesis at Cipto Mangunkusumo Hospital Jakarta
"ABSTRAK
Pendahuluan Penggunaan megaprostesis sebagai pilihan dalam manajemen LSS
memberikan harapan baru bagi pasien tumor tulang di Indonesia. Namun, sampai
saat ini belum ada data hasil luaran dari tata laksana ini.
Metode Penelitian ini merupakan prospektif observational pada 34 pasien tumor
tulang di RS Cipto Mangunkusumo pada tahun 2011-2015. Diagnosis ditegakkan
melalui Clinical Pathological Conference. Evaluasi pascaoperasi dilakukan pada
bulan ke-3, 6, 9, 12, 24, 36, dan 48 dengan menggunakan skoring dari MSTS.
Luaran onkologi dievaluasi dengan adanya rekurensi dan metastasis jauh.
Komplikasi berupa infeksi, dislokasi, cedera saraf dan pembuluh darah, serta
gangguan mekanisme ekstensor juga dievaluasi.
Hasil Dua orang ahli bedah muskuloskeletal onkologi melakukan operasi LSS dan
rekonstruksi dengan megaprostesis. Dua pasien dieksklusi karena keputusan
intraoperatif untuk memakai non modular endoprostesis. Kehilangan darah
intraoperatif memiliki median (RAK) 890,0 (700,0?1200,0) ml. Skor MSTS
sebagian besar pasien menunjukkan kategori baik dan sangat baik, yaitu 67.9%
baik pada MSTS 6 bulan, 79,2% baik pada MSTS 9 bulan, 63.4% sangat baik
pada 12 bulan, 90% sangat baik pada 24 bulan dan 100% sangat baik pada MSTS
36 bulan. Terdapat hubungan bermakna antara karakteristik pasien yaitu jenis
tumor (p=0,001), usia (p=0,039), jenis kelamin (p=0,049), dan hasil laboratorium
ALP (p=0,031) dengan luaran fungsional MSTS 3 bulan. Terdapat hubungan
bermakna antara karakteristik pasien yaitu perdarahan intraoperatif (p=0,013) dan
ALP (p=0,009) dengan mortalitas; dan juga antara tumor tulang yang menjalani
rekonstruksi jaringan lunak ekstensif dengan komplikasi (p=0,019) namun antara
lokasi tumor dan komplikasi tidak terdapat hubungan bermakna.
Kesimpulan Luaran fungsional pada pasien yang dilakukan rekonstruksi
megaprostesis adalah baik dan sangat baik sehingga dapat menjadi tatalaksana
pilihan bagi pasien tumor tulang yang akan menjalani LSS. Luaran onkologi pada
pasien yang dilakukan prosedur LSS baik dengan rendahnya rekurensi lokal, metastasi, dan komplikasi. ABSTRACT
Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence."
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Guntur Utama Putera
Analisis Luaran Fungsional dari Tatalaksana Operasi Penyelamatan Ekstremitas pada Giant Cell Tumor Radius Distal yang Dilakukan Prosedur NVFG, FVFG, dan Arthrodesis = Functional Outcome Analysis of Management of Limb-Salvage Surgery in Distal Radius Giant Cell Tumor using NVFG, FVFG, and Arthrodesis
"Latar Belakang: Giant Cell Tumor (GCT) adalah tumor yang sering mengenai individu berusia 20-45 tahun. Penatalaksanaan GCT radius distal adalah untuk menghilangkan massa tumor sepenuhnya dan mempertahankan pergelangan tangan. Beberapa metode rekonstruksi dapat dilakukan seperti arthrodesis total, Free Vascularized Fibular Graft (FVFG) atau Non-Vascularized Fibular Graft (NVFG), dengan prosedur rekonstruksi terutama melibatkan artroplasti atau arthrodesis pergelangan tangan parsial. Penelitian ini disusun untuk mengetahui perbandingan luaran fungsional pasien rekonstruksi GCT radius distal menggunakan teknik FVFG, NVFG, dan arthrodesis. Metode: Penelitian ini merupakan penelitian analitik dengan desain studi potong lintang yang menilai keluaran. post operasi dan tidak pada subjek tidak terdapat perlakuan khusus pada pasien. Pengambilan data akan dilakukan di RSUPN Cipto Mangunkusumo, Jakara, dan dilaksanakan pada bulan Juli 2020 – Juli 2021. Populasi target pada penelitian ini yaitu pasien yang telah didiagnosis dengan GCT tulang distal radius dan telah dilakukan operasi penyelamatan ekstrimitas beserta prosedur rekonstruksi berupa NVFG atau FVFG atau arthrodesis. Hasil : Terdapat 21 pasien GCT radius distal di RSCM pada penelitian ini yang termasuk kriteria inklusi dan di ikutkan dalam proses analisis data. Jumlah subjek laki-laki adalah 12 orang dan perempuan 9 orang (rasio 4:3). Golongan usia yang paling banyak adalah 21-30 tahun (33,3%). Tidak didapatkan hubungan yang bermakna di antara ketiga prosedur tersebut dengan luaran fungsional pasien (p = 0,49). Namun apabila dilihat dari rerata skor MSTS yang terbaik adalah metode FVFG dengan skor 24,4. Rerata FVFG lebih baik bila dibandingkan dengan arthrodesis 23,2 dan NVFG 23,18. Kesimpulan: Tidak terdapat perbedaan luaran fungsional dari tatalaksana operasi penyelamatan ekstremitas pada pasien dengan GCT tulang distal radius yang dilakukan prosedur NVFG, FVFG, dan arthrodesis.
Background: Giant Cell Tumor (GCT) is a tumor that often affects individuals aged 20- 45 years. Management of the distal radius GCT is to completely remove the tumor mass and preserve the wrist. Several reconstruction methods can be performed such as total arthrodesis, Free Vascularized Fibular Graft (FVFG) or Non-Vascularized Fibular Graft (NVFG), with the reconstructive procedure primarily involving arthroplasty or partial wrist arthrodesis. This study was structured to compare the functional outcomes of patients with distal radius GCT reconstruction using FVFG, NVFG, and arthrodesis techniques. Method: This study is an analytic study with a cross-sectional design that assesses outcomes. postoperatively and not on the subject there is no special treatment for the patient. Data collection will be carried out at Cipto Mangunkusumo General Hospital, Jakarta, and will be held in July 2020 – July 2021. The target population in this study are patients who have been diagnosed with GCT of the distal radius and have undergone extremity rescue surgery along with reconstruction procedures in the form of NVFG or FVFG or arthrodesis. Result: There were 21 distal radius GCT patients at the RSCM in this study which included the inclusion criteria and were included in the data analysis process. The number of male subjects was 12 people and 9 female subjects (4:3). The most common age group is 21-30 years (33.3%). There was no significant relationship between the three procedures and the patient's functional outcome (p = 0.49). However, when viewed from the average MSTS score, the best is the FVFG method with a score of 24.4. The mean FVFG was better when compared to arthrodesis 23.2 and NVFG 23.18. Conclusion: There was no difference in the functional outcome of limb salvage surgical management in patients with GCT of the distal radius who underwent NVFG, FVFG, and arthrodesis procedures."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Muhammad Deryl Ivansyah
Luaran Onkologi dan Fungsional dari Pasien Metastasis Tulang Panjang dan Axial di RSUPN Dr Cipto Mangunkusumo Periode 2008-2018 = Oncological and functional outcome of patients with Long and Axial metastatic bone disease at Cipto Mangunkusumo Hospital on 2008 - 2018
"Pendahuluan: Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Metode: Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 – 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Hasil: Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 – 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 – 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 – 7,6). Kesimpulan: Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD.
Introduction: Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates quite morbidity and in the end affect the patient’s quality of life and survival. Methods: This study uses cross sectional design with total sampling at Cipto Mangunkusumo Hospital. MBD diagnosed patient during 2008 – 2018 were evaluated for characteristics, survival rate. Survived patient will evaluated for functional score with SF-36 and MSTS. Results: From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 – 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 – 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 – 7,6). Conclusion: Surgery has a significant association with MBD patient survival."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tesis Membership  Universitas Indonesia Library
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Adisa Yusuf Reksoprodjo
Luaran onkologi dan fungsional dari pasien metastasis tulang panjang dan axial Di RSUPN Dr Cipto Mangunkusumo Periode 2008-2018 = Oncological and functional outcome of patients with Long and Axial metastatic bone disease at Cipto Mangunkusumo Hospital on 2008 - 2018
"Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 - 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 - 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 - 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 - 7,6). Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD.
Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates morbidity and affect patient s quality of life and survival. This study uses cross sectional design with total sampling at one tertiary referral center. MBD patient during 2008 - 2018 were evaluated for characteristics, treatment received, and survival rate. Survived patients were evaluated for functional score with SF-36 and MSTS. From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 - 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 - 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 - 7,6). Surgery has a significant association with MBD patient survival."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T55548
UI - Tugas Akhir  Universitas Indonesia Library
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Riko Satriyo Wibowo
Analisis Faktor Praoperatif Dan Intraoperatif Yang Mempengaruhi Pascaoperatif, Luaran Fungsional Dan Onkologi Pada Pembedahan Tumor Muskuloskeletal Malignant Anak Di RS Cipto Mangunkusumo Jakarta = Analysis of Preoperative and Intraoperative Factors Affecting The Postoperative, Functional and Oncologic Outcome In Pediatrics Malignant Musculosceletal Surgery At Ciptomangunkusumo Hospital, Jakarta
"Pendahuluan: Pembedahan pada anak berbeda dengan orang dewasa, khususnya pada pembedahan tumor malignant muskuloskeletal anak. Kompleksitas kondisi preoperatif, termasuk status nutrisi, kemoterapi neoadjuvant, kondisi klinis umum yang buruk serta jenis pembedahan dapat mempengaruhi kondisi pascaoperatif, dan luaran baik klinis dan onkologi. Penelitian ini bertujuan untuk mengevaluasi kondisi preoperatif, intraoperatif yang mempengaruhi pascaoperatif, luaran fungsional dan onkologi.
Metode: Penelitian ini secara retrospektif meninjau delapan puluh tiga subjek pasien tumor muskuloskeletal ganas pediatrik yang menjalani operasi baik sebagai salavage atau prosedur amputasi dari 2017-2021. Data perioperatif, hasil fungsional dan onkologis pada tindak lanjut 1 tahun dikumpulkan.     
Hasil: Dari 83 subjek penelitian, osteosarkoma adalah tumor yang paling banyak ditemukan (90,4%), Ewing sarkoma (3,6%), rhabdomyosarcoma (3,6%), Ewing sarkoma ekstraskeletal (1,2%), dan limfoma ganas (1,2%). Tingkat kelangsungan hidup 1 tahun adalah 72,3%, dan 37,3%. Usia, jenis tumor, tormbosit praoperatif, albumin, dan ASA dihubungkan dengan durasi operasi (p<0,01). Faktor-faktor yang terkait dengan jumlah kehilangan darah adalah usia, jenis operasi, dan kadar albumin (p<0,01). Usia dan kehilangan darah memiliki hubungan dengan hasil fungsional (p<0,01).
Kesimpulan: Faktor praoperatif yang mempengaruhi hasil adalah usia. Pada kelompok subjek yang memiliki komplikasi pasca operasi relatif memiliki tingkat metastasis yang lebih tinggi. Kehilangan darah intraoperatif adalah salah satu faktor prognostik untuk komplikasi pasca operasi yang dikaitkan dengan jenis tumor, usia, dan tingkat albumin. 
Introduction: Surgical procedure in children is different from adults, especially in pediatric malignant musculoskeletal surgery. The complexity of preoperative condition, including nutritonal status, neoadjuvant chemoteraphy, anemic, poor general condition and type of surgery that may affect the postoperative and outcome. This study aims to evaluate preoperative, intraoperative parameters that affect the postoperative, functional and oncologic outcome.
Methods: The study retrospectively reviewed eighty-three subjects of pediatric malignant musculoskeletal tumor patients who underwent surgery either as salavage or ablation procedures from 2017-2021. Perinoperative data, functional and oncological outcomes on a 1-year follow-up were collected.           
Results: Of  the 83 study subjects, osteosarcoma was the most common tumor (90.4%), Ewing sarcoma (3.6%), rhabdomyosarcoma (3.6%), extraskeletal Ewing sarcoma (1.2%), and malignant lymphoma (1.2%). The 1-year survival rate was 72.3%, and 37.3%. Usia, tumor type, preoperative tormbocytes, albumin, and ASA were associated with surgical duration (p<0.01). Factors associated with the amount of blood loss are age, type of surgery, and albumin levels (p<0.01). Age and  blood loss have a relationship with functional outcomes (p<0.01).
Conclusion: The preoperative factor influencing outcomes is age. In the group of subjects who had postoperative complications relatively had a higher rate of metastases. Intraoperative blood loss is one of the prognostic factors for postoperative complications associated with tumor type, age, and albumin levels. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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Paul Steven
Ekspresi imunohistokimia Ki-67 dan p53 sebagai faktor prediktor rekurensi giant cell tumor tulang = Expression of Ki-67 And p53 as an immunohistochemistry predict marker for recurrence in giant cell tumor of bone
"Pendahuluan : Giant Cell Tumor tulang (GCT) merupakan tumor tulang jinak yang dapat secara lokal bersifat agresif dengan tingkat rekurensi mencapai 20%. Antigen Ki-67 dan p53 adalah penanda imunohistokimia pada GCT yang menandakan proliferasi sel dan supresi tumor. Penelitian ini menganalisis hubungan antara penanda Ki-67 dan p53 dengan rekurensi pada kasus GCT.
Metode : Penelitian adalah suatu studi Cross-sectional kategorikal. Data yang dikumpulkan adalah data demografis pasien, keterangan terkait diagnosis dan tindakan serta hasil pemeriksaan Ki-67 dan p53. Data pasien Ekspresi Ki-67 dan p53 dievaluasi dengan teknik pewarnaan imunohistokimia menggunakan metode avidin-biotin complex perioxidase dengan menggunakan kit LSAB2.
Hasil : Terdapat 26 laki-laki dan 37 perempuan dengan usia rata-rata adalah 34,77 tahun berkisar antara 16 sampai 61 tahun. 13 kasus dengan rekurensi lokal. Tidak terdapat hubungan antara rekurensi dengan karakteristik tumor (jenis kelamin, usia, ukuran tumor, lokasi tumor, stadium tumor dan tindakan operasi). Tidak ada hubungan antara Ki-67 (p=0.524) dan rekurensi lokal serta terdapat hubungan yang signifikan antara p53 dengan rekurensi lokal (p=0.048).
Kesimpulan : Ekspresi Ki-67 tidak berhubungan dengan rekurensi, sedangkan ekspresi p53 berhubungan dengan rekurensi giant cell tumor tulang. Tidak terdapat hubungan antara rekurensi lokal dengan karakteristik tumor (jenis kelamin, usia, lokasi tumor, ukuran tumor, stadium tumor dan tindakan operasi).
Introduction : Giant cell tumor of bone (GCTB) is a benign neoplasm that may be locally aggressive with recurrence rate reaching 20%. Ki-67 and p53 are immunochemistry markers that marked cell proliferations and tumor suppression. This research analyze the association between Ki-67 and p53 with recurrence of GCT.
Method :This study is a Cross-sectional categorical study. Demography of the patients, diagnosis and treatment related to the GCT, and Ki-67 and p53 results were taken. The expression of Ki-67 and p53 were evaluated using a immunochemistry staining with avidin-biotin complex peroxidase by using KSAB2 kit.
Result : There are 26 men and 37 women with an average age is 34.77 years ranged from 16 to 61 years. 13 cases with local recurrence. There is no association between recurrence and tumor characteristics (sex, age, tumor size, tumor location, stage and operation). There is no association between Ki-67 with local recurrence (p=0,524) and a significant association between p53 and local recurrence (p=0,048).
Conclusion : Ki-67 was not associated with recurrence, mean while p53 was associated with recurrence of GCT. There is no association between recurrence and tumor characteristics (sex, age, tumor size, tumor location, stage, and operation)."
Depok: Fakultas Kedokteran Universitas Indonesia, 2017
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Muhammad Reza Saputra
Penggunaan Denosumab pada Tata Laksana Giant Cell- Tumour: Meta Analisis = Denosumab in the Management of Giant Cell Tumor: A Meta Analysis
"Pendahuluan: World Health Organization (WHO) mendefinisikan Giant Cell-Tumour (GCT) merupakan tumor tulang yang bersifat jinak, mempunyai sifat dan kecenderungan untuk agresif lokal. Tujuan tata laksana GCT adalah menghilangkan jaringan tumor, mempertahankan fungsi tulang yang terkena, serta mencegah rekurensi. Sampai saat ini belum ada konsensus seragam untuk tata laksana GCT primer. Denosumab merupakan antibodi monoklonal yang berikatan dengan RANKL. Dengan adanya ikatan antara denosumab dengan RANKL, ikatan antara RANKL dengan RANK tidak terjadi, sehingga diharapkan tidak terjadi pertumbuhan tumor. Akan tetapi masih ada beberapa masalah yang masih menjadi pertanyaan antara lain: apakah pemakaian denosumab menurunkan angka rekurensi dibandingkan tata laksana konvensional sebelumnya, bagaimana efikasi denosumab pada tata laksana GCT, serta berapa dosis dan lama terapi denosumab diberikan. Dengan belum adanya pedoman baku penggunaan denosumab, dan belum adanya telaah sistematis serta penelitiannya di Indonesia, maka meta-analisis ini dilakukan untuk menjawab pertanyaan-pertanyaan tersebut dalam membantu menyusun pedoman penggunaannya sehingga menghasilkan kebijakan baru dalam tata laksana GCT di Indonesia.
Metode: Telah dilakukan pencarian dalam lima database menggunakan kata kunci ("DENOSUMAB" AND ("GIANT CELL TUMOR" OR "GCT") AND "OUTCOME"). Penilaian risiko bias studi dengan desain randomized controlled trial dilakukan dengan Cochrane Collaboration’s tool for assessing risk of bias, sedangkan penilaian risiko bias studi dengan desain nonrandomized controlled trial dan kohort dilakukan dengan Newcastle-Ottawa Quality Assessment Form for cohort study.
Hasil Setelah diseleksi, didapatkan 21 studi yang dilakukan penilaian risiko bias. Meta-analisis menemukan bahwa terdapat 85,5% (IK95%: 74,9-96,0%) pasien mendapatkan perbaikan klinis; perbaikan radiologis pada 82.4% (95% IK: 73,3-91,4%) pasien; perubahan histopatologis pada 96,5% (95% IK: 93,6-99,3%) pasien; serta rekurensi sebesar 27,2% (95% IK: 18,7-35,7%) dan rekurensi pada denosumab dibanding kontrol yakni RR: 2,6 (95% CI: 1,66-4,09); total kejadian efek samping berat pada rahang sebesar 2,7% (95% IK: 1,4-4,0%).
Kesimpulan: Administrasi Denosumab pada pasien GCT sebagai terapi sistemik memiliki efikasi yang baik dalam perbaikan klinis; perbaikan radiologis; penurunan aktivitas sel GCT; potensi efek samping yang rendah; akan tetapi angka kejadian rekurensi lebih tinggi dibanding kontrol. Meski demikian, studi komparatif eksperimen acak terkontrol dirasa perlu lebih banyak untuk meningkatkan kualitas hasil studi.
Introduction: The World Health Organization (WHO) defines GCT as a benign bone tumor, with the nature and tendency for local aggressiveness. The goal of GCT management is to remove tumor tissue, maintain the function of the affected bone, and prevent recurrence. To date there has been no uniform consensus for primary GCT management. Denosumab is a monoclonal antibody that binds to RANKL. With the bond between denosumab and RANKL, the bond between RANKL and RANK does not occur, so that no tumor growth is expected. However, there are still a number of questions that remain questionable, among others: whether the use of denosumab reduces recurrence rates compared to previous conventional management, how the efficacy of denosumab in the management of GCT, and how much dose and duration of denosumab therapy is given. With no standard guidelines for using denosumab, and no systematic study and research in Indonesia. This meta-analitic study was conducted to answer these questions in helping to develop guidelines for their use so as to produce new policies in the management of GCT in Indonesia.
Methods: Five databases have been searched using keywords ("DENOSUMAB" AND ("GIANT CELL TUMOR" OR "GCT") AND "OUTCOME"). After being selected, 21 studies were carried out with a bias risk assessment with the Newcastle-Ottawa Quality Assessment Form for cohort studies for studies with cohort designs and nonrandomized controlled trials while for one study a randomized controlled trial was conducted with the Cochrane Collaboration's tool for assessing risk of bias with results 4 poor quality studies.
Results: The meta-analysis found that there were 85.5% (CI 95%: 74.9-96.0%) patients received clinical improvement, there was a reduction in VAS scale pain in 98.9% (CI 95%: 96.5-101.4% ) patient; radiological improvement in 85.5% 82.4% (95% CI: 73.3-91.4%) patients; histopathological changes in 96.5% (95% CI: 93.6-99.3%) patients; and recurrence of 27.2% (95% CI: 18.7-35.7%) and recurrence in denosumab compared to controls namely RR: 2.6 (95% CI: 1.66-4.09); the total incidence of severe side effects on the jaw was 2.7% (95% CI: 1.4-4.0%).
Conclusions: Denosumab administration in GCT patients as a systemic therapy has good efficacy in clinical improvement; radiological repair; decreased GCT cell activity; low potential for side effects; however the recurrence rate is higher than the control. However, comparative studies of randomized controlled trials are deemed necessary to improve the quality of study results."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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Zecky Eko Triwahyudi
Kualitas hidup dan luaran fungsional pasien tumor ekstremitas bawah yang menjalani prosedur amputasi di RSUPN dr. Cipto Mangunkusumo = Quality of life and functional outcome of oncology patient after lower extremity amputation in Cipto Mangunkusumo Hospital
"Jumlah kasus tumor muskuloskeletal di Indonesia semakin meningkat. Di antara pilihan tata laksana yang ada, tindakan amputasi masih menjadi salah satu modalitas utama. Penelitian ini bertujuan untuk enilai hubungan antara faktor-faktor klinis dan demografis dengan kualitas hidup dan luaran fungsional pasien-pasien dengan tumor ekstremitas bawah yang menjalani amputasi Penelitian ini merupakan studi analitik observasional potong lintang dengan subjek seluruh pasien tumor ekstremitas bawah di RSUPN dr. Cipto Mangunkusumo selama 2014-2019. Kualitas hidup dan luaran fungsional diukur menggunakan instrumen SF-36 dan MSTS. Total 72 pasien memiliki rerata usia 31 tahun dan 65% pria, 33 di antaranya teridentifikasi hidup. Mayoritas subjek memiliki diagnosis osteosarkoma (58%), dilakukan amputasi transfemoral (50%) dan lokasi tumor di distal femur (44,4%). Rerata SF-36 adalah 61,63, sementara skor MSTS adalah 35%. Hanya 1 pasien yang menggunakan prosthesis, di mana skor SF-36 pasien tersebut paling baik (74) di antara subjek lain. Rerata SF-36 lebih baik pada pria dibandingkan wanita (p=0,011). Skor MSTS lebih baik pada tingkat pendapatan menengah ke atas (p=0,04). Kesintasan 3 tahun pasca amputasi sebesar 45,8%. Tidak ada perbedaan kesintasan antara osteosarkoma dan tumor lain. Kualitas hidup berkaitan dengan faktor jenis kelamin dan penggunaan alat bantu gerak, sementara luaran fungsional berkaitan dengan tingkat pendapatan.
The number of musculoskeletal tumors in Indonesia is increasing. Among all treatment options, amputation is still frequently performed. The purpose of this study is to identify demographical and clinical characteristics associated with quality of life and functional outcome of patients with lower extremity tumor who underwent amputation. This study was a cross-sectional study with subjects from all lower extremity tumor patients who underwent amputation in Cipto Mangunkusumo Hospital during the 2014-2019. Quality of life and functional outcome were measured using SF-36 and MSTS questionnaires.There were 72 subjects, consisted of 65% men and have average age of 31 years. Among the patients, 33 of whom were identified alive and interviewed. Mean SF-36 score is 61.63, while mean MSTS score is 35%. There was only 1 patient who wore prosthesis, scoring the best SF-36 of 74. Mean SF-36 of male is better than female (p=0.011). Better MSTS score was found in subjects with better education level (p=0.04). The 3-year survival rate of our patients was 45.8%. There was no difference of survival rate between patients with osteosarcoma and other diagnosis. Quality of life is associated with gender and use of walking aids, while functional outcome is associated with level of income."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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Riza Aprizal
Evaluasi penyembuhan tulang dan perbandingan luaran fungsional pasca tindakan injeksi perkutaneus steroid dan kuretase dengan hidroksiapatit pada simple bone cyst = Evaluation of bone healing and comparison of functional outcome of simple bone csyt after percutaneus steroid injection and curretage with hydorxyapatite
"ABSTRAK
Latar Belakang: Simple bone cyst (SBC) adalah tumor tulang jinak, berisi cairan.
Tujuan utama terapi SBC adalah mendapatkan penyembuhan tulang, mencegah
fraktur patologis, dan manajemen gejala khususnya nyeri. Terdapat berbagai
metode pengobatan SBC, namun saat ini masih kontroversial karena angka
kesembuhan dan tingkat invasi operasi. Terapi injeksi perkutaneus steroid
merupakan metode operasi dengan tingkat invasi rendah sehingga penyembuhan
tulang dan luaran fungsional lebih baik.
Metode: Total terdapat 10 pasien (6 laki-laki, 4 perempuan, rerata usia13 tahun)
SBC yang terbagi dalam dua kelompok. 5 pasien (proksimal femur 3; proksimal
humerus 1; calcaneus 1) dilakukan terapi injeksi perkutaneus steroid dan 5 pasien
(proksimal femur 2; proksimal humerus 2, radius 1) terapi kurease dengan
hidroksiapatit. Injeksi perkutaneus steroid dilakukan sebanyak tiga kali dengan
interval waktu tiap satu bulan. Rerata follow up adalah 12-26 bulan. Evaluasi
penyembuhan tulang dinilai secara radiologi dengan kriteria Chang dkk. Luaran
fungsional dinilai berdasarkan skor MSTS.
Hasil: Penyembuhan tulang komplit didapatkan pada kedua kelompok, namun
solid union lebih cepat terjadi pada kelompok terapi injeksi perkutaneus steroid.
Luaran fungsional didapatkan nilai yang lebih baik pada kelompok injeksi
perkutaneus steroid terutama pada bulan ke-3 (55%) dan ke-6 (84%) pasca operasi
berdasarkan skor MSTS dibandingkan terapi kuretase dengan hidroksiapatit
(bulan ke-3 47% dan ke-6 69,3%).
Simpulan: Terapi injeksi perkutaneus steroid masih tetap menjadi pilihan utama
metode terapi SBC dengan solid union lebih cepat, tingkat prosedur operasi invasi rendah, lebih mudah, efektif, dan aman.
ABSTRACT
Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe."
Fakultas Kedokteran Universitas Indonesia, 2015
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