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Riyan Adi Kurnia
Faktor-faktor prognostik pada tumor ginjal = Prognostic factors in kidney cancer
"ABSTRAK
Tujuan: 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.
ABSTRACT
Objective 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. "
Medan: Fakultas Kedokteran Universitas Indonesia, 2016
T58843
UI - Tesis Membership  Universitas Indonesia Library
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Harahap, Andre Lazuardi
Faktor-faktor yang mempengaruhi perbaikan fungsi ginjal pada pasien hidronefrosis akibat kanker cervix = Factors affecting kidney function improvement in patients hydronephrosis due to cervical cancer / Andre Lazuardi Harahap
"ABSTRAK
Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi perubahan fungsi ginjal setelah pengalihan hidronefrosis akibat kanker serviks. Dari 40 pasien, mayoritas subjek berusia 49 tahun, dengan 7 pasien mengalamihidronefrosis unilateral, 22 pasien hidronofrosis bilateral ringan dan 11 pasien dengan hidtonfrosis bilateral berat. Tiga puluh dua pasien menjalani nefrostomi dan sisanya menjalani pemasanganDJ stent. Studi ini menyimpulkan bahwa usia dan derajat hidronefrosis adalah faktor yang paling berpengaruh dalam peningkatan fungsi ginjal setelah pengalihan urin pada pasien dengan hidronefrosis akibat kanker serviks.
ABSTRACT
Abstract This is a descriptive analytic study to determine the factors that influence changes in kidney function after diversion of hydronephrosis due to cervical cancer. From 40 patients, majority of subjects was 49 years old, with 7 patients associated with unilateral hydronephrosis, 22 patients mild bilateral hydronephrosis and 11 patients with severed bilateral hydronephrosis. Thirty two patients underwent nephrostomy and the rest underwent DJ stent insertion. This study conclude that age and degree of hydronephrosis are the most influential factor in the improvement of renal function after urinary diversion in patients with hydronephrosis due to cervical cancer."
2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Pelupessy, Nugraha Utama
Marker cancer stem cells (CD133, CD44 dan ALDH1A1) sebagai faktor prognostik pada kanker ovarium tipe epitelial = Cancer stem cell CD133, CD44 and ALDH1A1 markers as prognostic factors on epithelial ovarian cancer
"ABSTRAK
Nama :Nugraha Utama PelupessyProgram Studi :S3 Ilmu KedokteranJudul :Marker Cancer Stem Cells CD133, CD44, dan ALDH1A1 Sebagai Faktor Prognostik pada Kanker Ovarium Tipe Epitelial Kanker ovarium merupakan penyakit yang bersifat heterogen dan kebanyakan pasien datang dengan stadium lanjut. Kanker ovarium epitelial tipe II mempunyai sifat pertumbuhan tumor yang cepat dan secara genetik labil dibandingkan tipe I. Keberadaan cancer stem cells CSC dianggap sebagai salah satu faktor prognostik terjadinya kemoresisten dan kesintasan hidup yang rendah.Penelitian ini bertujuan untuk membuktikan CSC sebagai faktor prognostik dengan menggunakan marker CD133, CD44, dan ALDH1A1 pada kanker ovarium tipe epitelial.Marker CD133, CD44, dan ALDH1A1 diperiksa dengan imunohistokimia dan flowcytometry. Hasil ekspresi marker CSC pasien kanker ovarium tipe I dan tipe II dimasukkan kedalam suatu tabel yang dihubungkan dengan respons kemoterapi dan kesintasan hidup. Analisis data dilakukan dengan program computer STATA 14. Analisis kesintasan dilakukan dengan analisis Kaplan-Meier dan uji asumsi cox proportional hazard. Analisis multivariat dipakai untuk model prognosis selama 10 bulan. Sistem skoring dibuat dengan menggunakan receiver operating characteristic ROC curve analyses.Data demografi kelompok terbanyak adalah usia ge; 45 tahun; 40 sampel 72,7 , stadium I, 23 sampel 41,8 , diferensiasi buruk 30 sampel 54,5 , dan tipe II 16 sampel 29,1 . Perbedaan yang bermakna antara tipe histopatologi dengan marker CSC hanya terlihat pada marker CD44. Skor Prediksi Kemoresisten SPKr 10 bulan yang dihubungkan dengan 4 variabel yaitu usia ge; 45 tahun, tipe II, stadium III minus;IV, dan CD44 tinggi dengan ROC 72,47 dan probabilitas post test 82,5 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 negatif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841. Skor Prediksi Kematian SPKm 10 bulan yang dihubungkan dengan 3 variabel yaitu stadium III minus;IV, tipe II, dan CD44 tinggi dengan AUC 80,44 dan probabilitas post test 78,7 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 positif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841.Simpulan: Marker CD44 terbukti berperan pada kanker ovarium tipe II. Skor Prediksi Kemoresisten dan Skor Prediksi Kematian dapat ditentukan selain dengan faktor klinikopatologi, juga dengan memakai marker CSC. Kata kunci: ALDH1A1, CD44, CD133, CSC, kanker ovarium epitelial, kesintasan hidup, respons kemoterapi.
ABSTRACT
Name : Nugraha Utama PelupessyStudy Program : Doctoral Program Medical SciencesTitle :Cancer Stem Cell CD133, CD44 andALDH1A1 Markers As Prognostic Factors on Epithelial Ovarian Cancer. Ovarian cancer is a heterogeneous disease and most of the patients came with an advanced stage. Epithelial ovarian cancer type II has the characteristic of rapid tumor growth and genetically more labile than that of type I. The presence of cancer stem cells CSC is considered as one of the prognostic factors of low mortality and survival.The aims of this study was to prove CSC as prognostic factors using CD133, CD44, and ALDH1A1 markers on epithelial ovarian cancer.Clinicopathology and demographic data were collected from medical records. CD133, CD44, and ALDH1A1 markers were examined with flowcytometry and immunohistochemistry. CSC marker expression of the patients with ovarian cancer type I and II was connected with chemotherapy and survival response. Data analysis was done by using STATA 14 software. Survival analysis was done by using Kaplan-Meier analysis and Cox proportional hazard test. Multivariate analysis is used for prognosis model for ten months. Receiver Operating Characteristic ROC curve analyses was used as the system scoring. The highest group demographic data were age ge; 45 years; 40 samples 72.7 , stage I, 23 samples 41.8 , poor differentiation 30 samples 54.5 , and type II 16 samples 29.1 . A significant difference between the histopathologic type and the CSC marker was seen only in CD44 marker. Chemoresistance Prediction Score in 10 months was associated with 4 variables ie age ge; 45 years, type II, stage III minus;IV, and CD44 high with ROC 72.47 and posttest probability 82.5 . The highest chemoresitency scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, negative CD133, high CD44, and high ALDH1A1, was 0.841. Mortality Prediction Score in 10 months was associated with 3 variables is stage III minus;IV, type II, and CD44 high with AUC 80.44 and posttest probability 78.7 . The highest mortality scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, positive CD133, high CD44, and high ALDH1A1, was 0.841. Conclusion: The CD44 marker has a role in type II ovarian epithelial cancer. Chemoresistance Prediction Score and Mortality Prediction Score can be determined from clinicopathological factors and using CSC marker. Keywords: ALDH1A1, CD44, CD133, chemotherapy response, CSC, Epithelial Ovarian Cancer, survival"
Depok: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Disertasi Membership  Universitas Indonesia Library
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Nina Dwi Putri
Kesintasan kehidupan dan fungsi Ginjal Sindrom Nefrotik Resisten Steroid pada anak dan faktor-faktor prognostiknya = Survival of Steroid Resistant Nephrotic Syndrome in children and their prognostic factors / Nina Dwi Putri
"ABSTRAK
Latar Belakang. Sindrom nefrotik resisten steroid (SNRS) jarang ditemukan pada anak. Kesintasan kehidupan anak SNRS pada umumnya baik. Akan tetapi, anak SNRS sering mengalami penurunan fungsi ginjal dan pada perjalanan penyakitnya dapat mengalami end stage renal disease (ESRD). Tujuan. Mengetahui kesintasan kehidupan dan fungsi ginjal anak SNRS pada tahun ke-1, 2, 3, 4, dan 5. Mengetahui pengaruh usia, fungsi ginjal, dan hipertensi saat awitan serta tipe resistensi terhadap kesintasan kehidupan dan fungsi ginjal anak SNRS.
Metode. Penelitian kohort retrospektif dengan menggunakan data sekunder berupa rekam medis anak SNRS yang datang berobat ke Poliklinik Nefrologi Departemen Ilmu Kesehatan Anak dan praktik swasta konsultan Divisi Nefrologi dalam periode Januari 2000-Januari 2011. Kesintasan fungsi ginjal yang dinilai pada penelitian ini adalah kenaikan kreatinin ≥2 kali dan ESRD.
Hasil. Sebanyak 45 anak SNRS diikutsertakan dalam penelitian. Lama sakit adalah 24 (rentang 3-95) bulan. Sebanyak 20% anak meninggal dunia, 31,1% anak mengalami kenaikan kreatinin ≥2 kali, dan 13,4% anak menjadi ESRD pada akhir penelitian. Kesintasan kehidupan anak SNRS pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 93, 84, 80, 72, dan 61%. Kesintasan anak SNRS terhadap terjadinya kenaikan kreatinin ≥2 kali pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 92, 72, 56, 42, dan 34%. Kesintasan anak SNRS terhadap terjadinya ESRD pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 97, 88, 81, 70, dan 58%. Usia, fungsi ginjal, hipertensi saat awitan dan tipe resistensi tidak berpengaruh terhadap kesintasan kehidupan, kenaikan kreatinin ≥2 kali, maupun terjadinya ESRD (semua nilai p>0,05).
Simpulan. Penelitian ini mendapatkan hasil bahwa anak SNRS rentan untuk mengalami kenaikan kreatinin ≥2 kali dan ESRD. Faktor-faktor prognostik yang dipikirkan mempengaruhi kesintasan kehidupan dan fungsi ginjal seperti usia, fungsi ginjal dan hipertensi saat awitan serta tipe resistensi tidak terbukti berperan dalam kesintasan.
ABSTRACT
Background: Steroid resistant nephrotic syndrome (SRNS) is seldom found in children. Children with SRNS generally have good survival although during the course of the disease may develop decreased kidney function, leading to end stage renal disease (ESRD). Data on survival of children with SRNS is still scarce. Objective: To determine survival in children with SRNS on the first, second, third, fourth and fifth year; to study the effect of age at onset, initial kidney function, hypertension and type of resistance towards the survival of children with SRNS.
Method: A retrospective cohort is performed using secondary data obtained from medical record of outpatient and inpatient clinic from Division of Nephrology, Department of Child Health, Cipto Mangunkusumo Hospital as well as private clinic of the Pediatric Nephrology consultant from January 2000-January 2011. Kidney survival was determined as doubling of base creatinine levels and ESRD.
Results: This study includes 45 children with SRNS. Median time of illness was 24 (range 3-95) months. Twenty percent died due to various reasons; 31.1% had a doubling of base creatinine levels and 13.4% develop ESRD. Survival on the first, second, third, fourth and fifth year are 93, 84, 80, 72 and 61% respectively. Kidney survival on the first, second, third, fourth and fifth year towards doubling of base creatinine levels are 92, 72, 56, 42 and 34%, whereas towards ESRD are 97, 88, 81, 70 and 58% respectively. Age at onset, initial kidney function, hypertension and type of resistance does not affect the survival of children with SRNS (all P>0.05).
Conclusion: Children with SRNS is prone to develop a doubling of base creatinine levels and ESRD. Factors such as age at onset, initial kidney function, hypertension and type of resistance does not affect the survival of children with SRNS."
2012
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UI - Tesis Membership  Universitas Indonesia Library
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Siregar, Marsintauli Hasudungan
Gambaran klinis radiologis histopatologis dan faktor prognostik tumor otak pada anak = Clinical radiology histopathology features and prognostic factor of child brain tumor
"[ABSTRAK
Tumor otak (TO) merupakan penyebab kematian kedua dari
semua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologis
dan histopatologis yang sangat bervariasi karena proses pengembangan sel-sel
jaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TO
pada anak masih sedikit.
Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktor
prognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr.
Ciptomangunkusumo Jakarta periode tahun 2010 - 2015.
Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TO
primer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RS
Dr. Ciptomangunkusumo Jakarta.
Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari
3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan
47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dan
kejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebral
ventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yang
terbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usia
lebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan
(65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum
(24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yang
terbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%).
Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yang
bermakna.
Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologis
letak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenis
tumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkan
faktor prognostik TO pada anak.
ABSTRACT
Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.]"
2016
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Niniek Hardini
Perbedaan ekspresi Matrix Metalloproteinase-2 pada Malignant Peripheral Nerve Sheath Tumor derajat tinggi dan derajat rendah dan hubungannya dengan faktor prognostik = The different expression of Matrix Metalloproteinase-2 in high and low grade Malignant Peripheral Nerve Sheath Tumor and its correlation with prognostic factors
"[ABSTRAK
Latar belakang: Malignant peripheral nerve sheath tumor (MPNST) adalah sarkoma jaringan lunak yang sulit dibedakan dengan beberapa sarkoma sel spindel karena morfologinya yang serupa. MPNST bersifat agresif dengan angka rekurensi yang tinggi dan cenderung bermetastasis terutama ke paru. Salah satu tahap metastasis adalah invasi dengan cara mendegradasi matriks ekstraseluler dimana Matrix Metalloproteinase (MMP) memainkan peranan penting dalam proses ini. MMP tipe gelatinase yaitu MMP-2 dan MMP-9 memiliki kemampuan dalam mendegradasi membran basal dan kolagen fibrilar sehingga dapat membuka jalur invasi bagi sel tumor. MMP-2 mampu mendegradasi lebih banyak tipe kolagen dan MES non kolagen dibandingkan MMP-9. Penelitian ini bertujuan untuk menilai hubungan antara peningkatan ekspresi MMP-2 dengan derajat keganasan histologik dan variabel prognostik klinis lainnya.
Bahan dan cara: Dilakukan pulasan imunohistokimia MMP-2 pada 39 kasus yang terdiri atas 19 MPNST derajat rendah dan 20 MPNST derajat tinggi. Selanjutnya dilakukan analisis hubungan antara peningkatan ekspresi MMP-2 dengan derajat keganasan dan variabel klinis seperti usia, jenis kelamin, ukuran dan lokasi tumor.
Hasil: Peningkatan ekspresi MMP-2 ditemukan pada 19 (95%) kasus MPNST derajat tinggi dan 3 kasus (15,8%) kasus MPNST derajat rendah (p=0.000). Terdapat hubungan yang kuat antara peningkatan ekspresi MMP-2 dengan derajat keganasan MPNST. Tidak ditemukan hubungan antara ekspresi MMP-2 dengan jeni usia, jenis kelamin, ukuran dan lokasi tumor.
Kesimpulan: Peningkatan ekspresi MMP-2 sejalan dengan peningkatan derajat histologik, sehingga dapat digunakan untuk membantu menentukan progresifitas MPNST.
ABSTRACT
Background: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma that is difficult to differentiate with other spindle cell sarcomas, because of their similar morphology. The behavior of MPNST is aggressive, with a high recurrence and tend to metastases hematogenous, especially to lung. Important step of metastases is invasion by degradating extracellular matrix, in which Matrix Metalloproteinase (MMP) play important role in this process. Gelatinase type of MMP, MMP-2 and MMP-9 have ability to degrade basal membrane and fibriler collagen, in order to open the way of invasion. MMP-2 can degrade type collagen and non collagen extracellular matrix than MMP-9. The aim of this study is to see the correlation between expression of MMP-2 and histopathology grading and other prognostic clinical variables.
Methods: This study enrolled 39 cases of consisted of 19 low grade MPNST and 20 high grade MPNST. The case were stained for MMP-2 imunnohistochemistry and the expression of MMP-2 were scored. Analysis the correlation between over expression of MMP-2 and histopathology grading and other clinical variables , such as age, sex, size and location of the tumor.
Results: Overexpression of MMP-2 was observed in 19 (95%) cases of high grade MPNST and 3 (15,8%) cases of low grade MPNST (p=0.000). There is a significant correlation between MMP-2 over expression and histopathology grade. There is no correlation between MMP-2 expression and age, sex, siize and location of tumor.
Conclusion: High expression of MMP-2 is in parallel with high histologic grade, therefore it may be of additional use as prognostic factor., ackground: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma that is difficult to differentiate with other spindle cell sarcomas, because of their similar morphology. The behavior of MPNST is aggressive, with a high recurrence and tend to metastases hematogenous, especially to lung. Important step of metastases is invasion by degradating extracellular matrix, in which Matrix Metalloproteinase (MMP) play important role in this process. Gelatinase type of MMP, MMP-2 and MMP-9 have ability to degrade basal membrane and fibriler collagen, in order to open the way of invasion. MMP-2 can degrade type collagen and non collagen extracellular matrix than MMP-9. The aim of this study is to see the correlation between expression of MMP-2 and histopathology grading and other prognostic clinical variables
Methods: This study enrolled 39 cases of consisted of 19 low grade MPNST and 20 high grade MPNST. The case were stained for MMP-2 imunnohistochemistry and the expression of MMP-2 were scored. Analysis the correlation between over expression of MMP-2 and histopathology grading and other clinical variables , such as age, sex, size and location of the tumor.
Results:. Overexpression of MMP-2 was observed in 19 (95%) cases of high grade MPNST and 3 (15,8%) cases of low grade MPNST (p=0.000). There is a significant correlation between MMP-2 over expression and histopathology grade. There is no correlation between MMP-2 expression and age, sex, siize and location of tumor.
Conclusion: High expression of MMP-2 is in parallel with high histologic grade, therefore it may be of additional use as prognostic factor.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Erna Kristiani
Imunoekspresi braf V600E pada karsinoma papiler tiroid dan hubungannya dengan faktor-faktor prognostik serta varian histopatologik = Braf V600E immunoexpression in thyroid papillary carcinoma and its association with prognostic factors and histopathologic variants / Erna Kristiani
"[ABSTRAK
Latar Belakang: Karsinoma papiler tiroid (KPT) merupakan keganasan tersering
organ endokrin dengan prognosis yang sangat baik, namun pada beberapa kasus
dapat terjadi rekurensi dan mortalitas. Beberapa faktor prognostik dan mutasi Btype
rapidly accelerated fibrosarcoma V600E (BRAF V600E) dikatakan
berhubungan dengan prognosis yang lebih buruk. Pemeriksaan imunohistokimia
protein BRAF V600E dipercaya dapat mendeteksi adanya mutasi dengan
spesifisitas 100% dan sensitivitas 89%. Tujuan penelitian ini untuk mengetahui
imunoekspresi BRAF V600E dan hubungannya dengan faktor-faktor prognostik.
Bahan dan Cara: Penelitian dilakukan secara retrospektif, desain deskriptif
analitik studi potong lintang. Sampel penelitian berasal dari RSCM berjumlah 50
kasus KPT yang dinilai ulang untuk menentukan faktor-faktor prognostik secara
mikroskopik. Pemeriksaaan mutasi BRAF V600E menggunakan tehnik
imunohistokimia dan penilaian menggunakan H score.
Hasil: Nilai H score ³ 326,5 ditentukan sebagai mutasi BRAF V600E positif dan
< 326,5 sebagai mutasi BRAF V600E negatif. Terdapat 17 (34%) kasus positif
mengalami mutasi BRAF V600E. Rerata usia pada kasus dengan mutasi BRAF V600E
positif adalah 44,71 tahun. Ukuran tumor pada kasus dengan mutasi BRAF V600E positif
berkisar antara 0,1-4cm. Tujuh belas kasus yang mengalami mutasi, 6 dlaki-laki dan 11
perempuan. Tujuh kasus dengan perluasan keluar tiroid, 11 kasus dengan metastasis
kelenjar getah bening (KGB), dan 8 kasus dengan varian histopatologik tall cell.
Kesimpulan: Terdapat hubungan bermakna antara mutasi BRAF V600E dengan
perluasan keluar tiroid, metastasis kelenjar getah bening (KGB), dan varian
histopatologik tall cell. Tidak terdapat hubungan bermakna antara mutasi BRAF
V600E dengan usia, jenis kelamin, dan ukuran tumor.
ABSTRACT
Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant
neoplasm of the endocrine organ with an excellent prognosis, but in some cases
present with recurrency and mortality. There are prognostic factors and BRAF
V600E mutation that related to worse prognosis. Immunohistochemical
investigetion of BRAF V600E protein believe can detect mutation wth 100%
specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E
mutation do thyroidectomy with prophylactic lymph node dissection. BRAF
V600E specific inhibitor effective to the patient with advance stadium, patient
with metastases, and resistant to iodium radioactive. Aim of this study is to obtain
BRAF V600E and the relation with prognostic factors.
Material and Methods: This is a retrospective descriptive-analytic crosssectional
study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital
and reviewed to determine prognostic factors microscopicaly. BRAF V600E
mutation detected by immunohistochemical staining and assesed with H score.
Result: H score ³ 326,5 determined as positive BRAF V600E mutation and <
326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected
in 17 (34%) cases by immunohistochemistry. The mean age of the cases with
positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The
size of the tumor in cases with BRAF V600E mutation positive range between
0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex
male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases
with lymph node metastasis (KGB), and 8 cases with tall cell variant.
Conclusion: There are significant correlation between BRAF V600E mutation
with extrathyroidal extension, lymph node metastases, and tall cell variant. There
are no significant correlation between BRAF V600E mutation with age, gender,
and size of the tumor, Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant
neoplasm of the endocrine organ with an excellent prognosis, but in some cases
present with recurrency and mortality. There are prognostic factors and BRAF
V600E mutation that related to worse prognosis. Immunohistochemical
investigetion of BRAF V600E protein believe can detect mutation wth 100%
specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E
mutation do thyroidectomy with prophylactic lymph node dissection. BRAF
V600E specific inhibitor effective to the patient with advance stadium, patient
with metastases, and resistant to iodium radioactive. Aim of this study is to obtain
BRAF V600E and the relation with prognostic factors.
Material and Methods: This is a retrospective descriptive-analytic crosssectional
study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital
and reviewed to determine prognostic factors microscopicaly. BRAF V600E
mutation detected by immunohistochemical staining and assesed with H score.
Result: H score ³ 326,5 determined as positive BRAF V600E mutation and <
326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected
in 17 (34%) cases by immunohistochemistry. The mean age of the cases with
positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The
size of the tumor in cases with BRAF V600E mutation positive range between
0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex
male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases
with lymph node metastasis (KGB), and 8 cases with tall cell variant.
Conclusion: There are significant correlation between BRAF V600E mutation
with extrathyroidal extension, lymph node metastases, and tall cell variant. There
are no significant correlation between BRAF V600E mutation with age, gender,
and size of the tumor]"
2015
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Mangunsong, Maruli
Faktor faktor prognostik kematian dini pada perdarahan intraserebral primer di RSUD R. Syamsudin SR. Kota Sukabumi tahun 2005 - 2006 = Prognostic factors of early death on primary intra-cerebral hemorrhage at the district general hospital of R. Syamsudin SH (DGH-RS) of Kota Sukabumi, 2005-2006
"Latar belakang : Stroke masih merupakan penyebab kematian ketiga setelah penyakit jantung koroner dan kanker. Kematian karena perdarahan intraserebral dalam 7 hari pertama masih tinggi. Banyak faktor yang berpengaruh dan dapat dilakukan intervensi pada perawatan khusus.
Tujuan : Mengetahui faktor faktor prognostik kematian dini di RSUD R Syamsudin SH Sukabumi.
Bahan dan Cara : Pasien yang ikut penelitian ini adalah pasien stroke dengan perdarahan intraserebral yang dirawat di RSUD R Syamsudin SH yang memenuhi kriteria inklusi sejak 1 Januari 2005 sampai 30 Juni 2006.
Metode : Penelitian kohort prospektif dan dianalisis dengan analisis survival.
Hasil : Dari 117 pasien perdarahan intra serebral didapatkan kematian dini sebanyak 26,5%. Variabel yang sangat berpengaruh sebagai faktor prognosis kematian dini perdarahan intraserebral adalah gangguan kesadaran HR= 4,31 Interval Kepercayaan (2,0-9,19) p{1,000 sedangkan volume perdarahan HR=5,3 Interval Kepercayaan (2,34-11,9) p=0,000 serta kadar gula darah HR= 2,15 Interval Kepercayaan (0,99-4,65) p=0,051.
Kesimpulan : Kematian karena perdarahan intra serebral masih cukup tinggi yaitu 26,5%. Perlu penanganan segera faktor yang sangat berpengaruh terhadap terjadinya kematian dini yaitu gangguan kesadaran, gula darah, dan volume perdarahan sehingga dapat menurunkan angka kematian.
Background: Stroke is still known as the third leading cause of death after coronary heart disease and cancer. Death due to intra-cerebral hemorrhage in the first 7 days is having high rote. Many factors are able to influence the incidence, although it can he inter vent through special care.
Objectives: To find out prognostic factors on early death due to infra-cerebral hemorrhage at the District General Hospital of R. Syanisudin SH (DGH-RS) at Kota Sukabumi.
Objects and Technique: Respondents involved in the study are stroke patients that suffer with infra-cerebral hemorrhage. The patients are being treatment at the DGH-RS and have fulfilled the inclusion criteria of the study, from 1st `January 2005 until 30rd June 2006.
Method: The study is a prospective cohort study and is analyzed by using survival analysis.
Results: Of 117 patients with intro-cerebral hemorrhage, an early death has occurred at 26.5%. The most influence variables, as prognostic factor to early death of infra-cerebral hemorrhage, are: consciousness disorders HR= 4.31 Confidence interval (2.0 - 9.19) p= 0.000, blood depletion volume HR= 5.3 Confidence interval (2.34 - 11.9) p= 0.000, and blood sugar level l-IR= 2.15 Confidence Interval (0.9[9 - 4.65) p= 0.051.
Conclusion: The rate of death as a result of infra-cerebral is still high, i.e. 26.5%, There is an urgent need on controlling those factors affected the incidence of early death, namely consciousness disorders, blood sugar, and blood depiction volume, in order to decrease the death rate."
Depok: Universitas Indonesia, 2006
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Muhamad Reza Prabowo
Faktor-faktor Prognostik Progression-Free Survival Dua Tahun pada pasien Limfoma Hodgkin di Rumah Sakit Umum Pusat Nasional Dokter Cipto Mangunkusumo = Prognostic Factors of Two-Year Progression-Free Survival in Hodgkin's Lymphoma patients at Doctor Cipto Mangunkusumo National Central General Hospital
"Latar Belakang: Limfoma Hodgkin merupakan keganasan yang mencakup 1% kasus kanker keseluruhan. Adapun overall survival (OS) pasien limfoma Hodgkin dalam lima tahun mencapai 90%. Namun, progression-free survival (PFS) limfoma Hodgkin hanya mencapai 70-90% dalam kurun waktu 25 bulan. Setelah mengalami progresivitas, pasien mengalami penurunan PFS setelah mendapat terapi lini kedua. Sehingga, perlu diketahui faktor-faktor prediktor yang mempengaruhi PFS pasien limfoma Hodgkin.
Tujuan: Mengetahui faktor-faktor prognostik PFS dua tahun pasien limfoma Hodgkin. Metode: Penelitian ini menggunakan desain kohort retrospektif yang melibatkan pasien limfoma Hodgkin yang teregistrasi dari tahun 2011-2021 di Rumah Sakit Umum Pusat Nasional Dokter Cipto Mangunkusumo. Faktor-faktor prognostik yang diteliti adalah stratifikasi risiko, skor prognosis internasional, kadar trombosit, laktat dehidrogenase, indeks komorbiditas Charlson, dan waktu sejak diagnosis hingga terapi. Analisis multivariat terhadap PFS dua tahun dilakukan menggunakan model regresi Cox.
Hasil: Terdapat 115 subjek yang disertakan dalam penelitian dengan median usia 29 tahun, kadar trombosit 393.000 sel/L, LDH 340 IU/L, dan waktu sejak diagnosis hingga terapi enam minggu. Sebagian besar subjek penelitian adalah kelompok stadium lanjut (53,91%), total skor prognosis internasional 0-3 (69,57%), dan total skor indeks komorbiditas Charlson 0-1 (75,65%). Angka PFS dua tahun pasien limfoma Hodgkin di RSCM sebesar 59,13%. Hasil analisis bivariat menunjukkan waktu sejak diagnosis hingga terapi yang tidak memiliki kemaknaan secara statistik dengan HR 0,83 (IK 95% 0,42-1,59, p=0,57). Analisis multivariat menghasilkan tiga faktor prognostik independen, yakni stadium lanjut (HR 7,85 IK 95% 3,01-20,47, p<0,01), trombosit >450.000 sel/L (HR 2,77 IK 95% 1,49-5,16, p<0,01), dan LDH baik 250-500 IU/L (HR 2,57 IK 95% 1,01-3,63, p=0,04) maupun >500 IU/L (HR 3,06 IK 95% 1,20-7,82, p=0,02). Sistem skor berdasarkan ketiga variabel tersebut memiliki diskriminasi yang baik (AUROC 0,879, IK 95% 0,816-0,942, p <0,01).
Kesimpulan: Stadium lanjut, trombosit >450.000 sel/L, dan LDH 250 IU/L merupakan faktor-faktor prognostik PFS dua tahun pada pasien limfoma Hodgkin.
Background: Hodgkin's lymphoma is a malignancy that accounts for 1% of all cancer cases. The overall survival (OS) of Hodgkin's lymphoma patients in five years reaches 90%. However, progression-free survival (PFS) for Hodgkin's lymphoma only reaches 70-90% within 25 months. After experiencing progression, patients experienced a decrease in PFS after receiving second-line therapy. So, it is necessary to know the predictor factors that influence the PFS of Hodgkin's lymphoma patients.
Aim: To determine prognostic factors for two-year PFS in Hodgkin's lymphoma patients. Methods: This study used a retrospective cohort design involving Hodgkin's lymphoma patients registered from 2011-2021 at Dokter Cipto Mangunkusumo National General Hospital. The prognostic factors studied were risk stratification, international prognosis score, platelet levels, lactate dehydrogenase, Charlson comorbidity index, and time from diagnosis to therapy. Multivariate analysis of two-year PFS was performed using Cox regression models.
Results: There were 115 subjects included in the study with a median age of 29 years, platelet levels of 393,000 cells/L, LDH 340 IU/L, and time from diagnosis to therapy of six weeks. Most of the research subjects were in the advanced stage group (53.91%), the total international prognosis score was 0-3 (69.57%), and the total Charlson comorbidity index score was 0-1 (75.65%). The two-year PFS rate for Hodgkin's lymphoma patients at RSCM was 59.13%. The results of bivariate analysis showed that the time from diagnosis to therapy was not statistically significant with HR 0.83 (95% CI 0.42-1.59, p=0.57). Multivariate analysis yielded three independent prognostic factors, namely advanced stage (HR 7.85, 95% CI 3.01-20.47, p<0.01), platelets >450,000 cells/L (HR 2.77, 95% CI 1.49-5.16, p<0.01), and LDH either 250-500 IU/L (HR 2.57, 95% CI 1.01- 3.63, p=0.04) or >500 IU/L (HR 3.06 95% CI 1.20-7.82, p=0.02). The scoring system based on these three variables had good discrimination (AUROC 0.879, 95% CI 0.816- 0.942, p <0.01).
Conclusion: Advanced stage, platelets >450,000 cells/L, and LDH >250 IU/L are prognostic factors for two-year PFS in Hodgkin's lymphoma patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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Khaira Utia Yusrie
Faktor-faktor prognostik kematian 1 tahun pada pasien keganasan saluran cerna bagian atas di RSUPN Cipto Mangunkusumo Jakarta, Indonesia = Prognostic factors for one-year mortality in patients with upper gastrointestinal malignancy at Cipto Mangunkusumo Hospital Jakarta, Indonesia
"Latar Belakang: Keganasan saluran cerna bagian atas terutama esofagus dan gaster
merupakan penyebab kematian akibat kanker keenam dan ketiga di dunia. Beberapa
penelitian mengenai faktor-faktor yang mempengaruhi kesintasan pasien pada
pasien keganasan esofagus, gaster dan duodenum dalam studi yang terpisah telah
banyak dilakukan, namun saat ini belum diketahui sepenuhnya faktor-faktor apa
saja yang mempengaruhi kematian pasien keganasan saluran cerna bagian atas di
Indonesia dengan pengembangan model prognostik.
Tujuan: Mengetahui faktor-faktor prognostik kematian 1 tahun pada pasien
keganasan saluran cerna bagian atas di Indonesia.
Metode: Studi kohort retrospektif berbasis data rekam medis pasien keganasan
saluran cerna bagian atas di RSUPN Cipto Mangunkusumo (2015-2019). Analisis
bivariat dan multivariat dengan uji statistik Cox Proportional Hazards Regression
Model dilakukan untuk mengidentifikasi faktor-faktor independen yang
mempengaruhi kematian pasien keganasan saluran cerna bagian atas. Sistem skor
dikembangkan berdasarkan identifikasi faktor-faktor tersebut.
Hasil: 184 pasien dianalisis, sebagian besar laki-laki (58,7%), dengan rata rata
usia 54,5 tahun. Faktor-faktor independen yang berhubungan dengan kematian 1
tahun pasien keganasan saluran cerna bagian adalah usia > 60 tahun dengan HR
1,93 (IK95% 1,30-2,88), indeks massa tubuh < 20 dengan HR 2,04 (IK95% 1,25-
3,33), riwayat merokok dengan HR 1,77 (IK95%1,20-2,61), performa status ECOG
> 2 dengan HR 3,37 (IK95% 2,11-5,37), stadium tumor dengan stadium 4 dengan
HR 9,42 (IK95% 1,27-69,98) dan stadium 3 HR 9,78 (IK95% 1,31-72,69), dan
derajat diferensiasi tumor dengan HR 2,30 (IK95% 1,48-3,58) Kesintasan 1 tahun
adalah 39,7% dengan median survival 9 bulan. Skor prognotik kematian keganasn
saluran cerna bagian atas yang dikembangkan memiliki nilai AUC yang baik 0,918
Kesimpulan: Faktor-faktor independen yang berhubungan dengan kematian 1
tahun pasien keganasan saluran cerna bagian atas adalah usia, indeks masa tubuh,
riwayat merokok, performa status, stadium tumor, derajat diferensiasi tumor dan
keterlambatan intervensi. Kesintasan 1 tahun pasien keganasan saluran cerna bagian atas
adalah 39,7%. Telah dibuat sistem skor prediksi probabilitas kematian keganasan
saluran cerna bagian atas
Background: Upper gastrointestinal malignancy especially esophageal and gastric
cancer is the sixth and third leading cause of cancer-related deaths worldwide.
Some studies have been done separately to investigate factors which associated
with survival in patients with upper gastrointestinal malignancy, but not fully
evaluated which factors associated with mortality patients with upper
gastrointestinal malignancy regarding variables and prognostic score model.
Objective: To assess prognostic factors for one-year mortality in patients with
upper gastrointestinal malignancy in Indonesia
Methods: Retrospective cohort study using the hospital database of patients with
upper gastrointestinal malignancy at Cipto Mangunkusumo Hospital (2015-2019).
Bivariate and multivariate cox proportional hazards regression analysis were
performed to identify independent factors associated with mortality upper
gastrointestinal malignancy. Scoring system were developed based on the identified
factors.
Results: 184 patients were analyzed, mostly male (58,7%) with average ages 54,5
years old. Independent factors associated with one-year mortality were age > 60
years with HR 1,93 (95%CI 1,30-2,88), body mass index < 20 with HR 2,04 (95%CI
1,25-3,33), smoking history with HR 1,77 (95%CI 1,20-2,61), performance status
ECOG > 2 with HR 3,37 (95%CI 2,11-5,37), clinical stage which is 4th stage HR
9,42 (95%CI 1,27-69,98) and 3rd stage HR 9,78 (95%CI 1,31-72,69), and cellular
differentiation grade with HR 2,30 (95%CI 1,48-3,58). One-year survival rate was
39,7% with median survival was 9 months. The scoring system for predicting
mortality had AUC values of 0,918 respectively.
Conclusion: The independent factors associated with one-year mortality were age,
body mass index, smoking history, performance status, clinical stage of tumor,
cellular differentiation grade, and delay for start treatment. 1-year survival rate
was 39,7%. The mortality probability prediction scoring system has been developed
for upper gastrointestinal malignancy"
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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