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"[ABSTRAKOsteosarcoma adalah keganasan tulang tersering yang ditemukan pada usia muda. Terdapat beberapa faktor prognosis yang mempengaruhi, antara lain, staging, jenis kelamin dan usia. Pada osteosarcoma sel ganas menghasilkan alkaline fosphatase dan laktat dehidrogenase yang dihasilkan dari metabolisme sel kanker. Serum alkalin fosphatase (SAP) dan laktat dehidrogenase (LDH) dapat digunakan sebagai salah satu faktor prediktor prognosis.Tujuan dari studi ini adalah untuk mengetahui apakah SAP dan LDH dapat dijadikan faktor prediktor prognostik dan memperkirakan angka kesintasan pasien osteosarcoma.Penelitian ini dilakukan menggunakan metode potong-lintang untuk melihat hubungan antara usia, jenis kelamin, dan angka kesintasan 1 tahun dengan SAP dan LDH pada pasien osteosarcoma.Penelitian ini dilaksanakan di Departemen Orthopedi dan Traumatologi dan Departemen Patologi Anatomi FKUI/RSCM. Dari 303 pasien yang didiagnosis dengan osteosarcoma pada tahun 1995-2011, hanya 55 pasien yang memenuhi kriteria inklusi, terdiri atas 39 pasien laki-laki, 16 pasien perempuan dan umumnya berusia 20 tahun. Analisis dari penelitian ini menggunakan chi-square dan korelasi spearman. Dari hasil studi ini, tidak ditemukan asosiasi antara SAP dan LDH sebelum terapi dengan usia, jenis kelamin dan angka kesintasan 1 tahun.

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ABSTRACTOsteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival.;Osteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival.;Osteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival.;Osteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival.;Osteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival., Osteosarcoma is a bone malignancy that most commonly occurs in the young age. In this disease, there are many prognosis factor, hence, stage of the disease, gender and age.Alkaline phosphatase enzyme is produced by osteosarcoma cells and thus, increase in this malignancy. Whereas, LDH involve in cancer cell metabolism. Currently, the use of both Serum alkaline phosphatase (SAP) and lactate dehydrogenase (LDH) can be used as a prognostic factor.The research aims is to find out whether SAP and LDH, in addition to other prognostic factors, can be used to predict survivability of osteosarcoma patients. This research is a cross-sectional study and will discuss the association between age, gender, 1 year survival to the SAP and LDH in osteosarcoma patients.This study was conducted in the Department of Orthopaedic and Traumatology and Department of Pathology Anatomy FMUI/RSCM. There were 303 patients who are admitted to this hospital between the year 1995 to 2011, there were only 55 subjects included in this study that suit to the inclusion criteria. The analyses of this research was done using chi-square and spearman correlation.The sample were predominated by male (n=39), female (n=16) and the majority was the age of 20.In the results of this study, there were no association between pretreatment SAP and LDH with age, gender, and 1 year survival.]"

"Walaupun masih kontroversial, jenis kelamin dan umur diduga sebagai faktor prognostik yang mempengaruhi angka kesintasan osteosarkoma (suatu keganasan tulang yang umum terjadi pada anak-anak dan dewasa muda). Oleh karena itu, penelitian ini bertujuan untuk mengetahui angka kesintasan pasien osteosarkoma di RSCM selama periode waktu enam tahun (2006-2011) dan mengaitkannya dengan umur dan jenis kelamin. Studi potong-lintang ini menggunakan rekam medis 167 pasien osteosarkoma di Departemen Ortopedi dan Traumatologi Rumah Sakit Cipto Mangunkusumo (RSCM). Studi ini menunjukkan bahwa usia lebih muda saat didiagnosis berkaitan dengan respon yang lebih baik terhadap kemoterapi (p=0,028). Jenis kelamin perempuan berkaitan secara signifikan dengan stadium penyakit yang lebih rendah (p=0,04), respon yang lebih baik terhadap kemoterapi (p=0,016), dan berkurangnya risiko metastasis (p=0,008). Median waktu kesintasan pada studi ini adalah 12 bulan, yang disebabkan oleh pendeknya masa pemantauan pasien. Walaupun terdapat keterbatasan, angka kesintasan pasien perempuan lebih baik secara signifikan daripada pasien laki-laki. Angka kesintasan pada golongan usia yang lebih muda menunjukkan kecenderungan lebih baik, walau tidak signifikan secara statistik. Hasil uji multivariate tidak menunjukkan bukti tentang adanya keterkaitan stadium penyakit, respon kemoterapi, dan metastasis terhadap kesintasan. Sebagai kesimpulan, jenis kelamin perempuan berkaitan dengan tumor yang lebih favourable dan angka kesintasan yang lebih tinggi.

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In order to improve the plateaued average 70% survival of osteosarcoma patients, prognostic factors has to be identified to improve adjustment according to patient's characteristics. Female gender and younger age at diagnosis have been suggested as good prognostic factors though inconclusive. Therefore, this study aims to determine the survival rate of osteosarcoma patients admitted to Cipto Mangunkusumo Hospital from 2006 to 2011 and correlate it with age and gender. This cross-sectional study used the medical records of osteosarcoma patients admitted in the department of Orthopedics and Traumatology Cipto Mangunkusumo Hospital. Records of 167 patients were retrieved for this study.

This study shown that younger age was associated with better chemotherapeutic response (p=0,028). Meanwhile, female gender was associated with less advanced disease at presentation (p=0,04), better chemotherapeutic response (p=0,016), and less risk for metastasis (p=0,008). The median survival in this study was 12 months, an underestimation due to short followup duration. Still, female patients survived longer than males. We showed a trend of better survival for younger patients, however the result was not significant. Multivariate analysis failed to show any correlation between various tumor-related variables with survival."

"Pendahuluan: Osteosarkoma adalah tumor tulang ganas primer pada anak-anak dan remaja. Penelitian ini bertujuan untuk membandingkan hasil dan kelangsungan hidup pada pasien osteosarkoma pasca operasi di RSCM Jakarta dari tahun 2010 hingga 2022 dan faktor-faktor yang mempengaruhinya.Metode: Penelitian ini merupakan penelitian kohort retrospektif dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Subjek adalah pasien osteosarkoma femoralis distal yang menjalani disartikulasi pinggul atau amputasi transfemoral pada 2010-2020. Data yang dikumpulkan dan dianalisis meliputi karakteristik pasien, kelangsungan hidup, metastasis dan skor MSTS.Hasil: Jumlah subjek penelitian adalah 42. Subjek amputasi transfemoral lebih tua dibandingkan disartikulasi pinggul (p=0,048). Insiden metastasis lebih banyak pada amputasi dibandingkan dengan disartikulasi pinggul (p=0,001). Subjek disartikulasi pinggul memiliki diameter tumor yang jauh lebih besar daripada subjek amputasi transfemoral (p=0,031).Pembahasan: Hubungan yang signifikan antara diameter tumor dan kelangsungan hidup terjadi karena diameter tumor terkait dengan kejadian metastasis  dan kejadian metastasis terkait dengan kelangsungan hidup. Tidak ada perbedaan yang signifikan antara skor MSTS dan jenis amputasi karena kedua kelompok subjek menggunakan kruk, faktor sosial ekonomi untuk membuat prostesis, dan kesulitan dalam mencapai ukuran tunggul yang ideal dalam kasus tumor.Kesimpulan: Ada hubungan yang signifikan antara diameter tumor dan metastasis dengan kelangsungan hidup dan diameter tumor dengan metastasis.

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Pendahuluan: Osteosarkoma adalah tumor tulang ganas primer pada anak-anak dan remaja. Penelitian ini bertujuan untuk membandingkan hasil dan kelangsungan hidup pada pasien osteosarkoma pasca operasi di RSCM Jakarta dari tahun 2010 hingga 2022 dan faktor-faktor yang mempengaruhinya.

Metode: Penelitian ini merupakan penelitian kohort retrospektif dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Subjek adalah pasien osteosarkoma femoralis distal yang menjalani disartikulasi pinggul atau amputasi transfemoral pada 2010-2020. Data yang dikumpulkan dan dianalisis meliputi karakteristik pasien, kelangsungan hidup, metastasis dan skor MSTS.

Hasil: Jumlah subjek penelitian adalah 42. Subjek amputasi transfemoral lebih tua dibandingkan disartikulasi pinggul (p=0,048). Insiden metastasis lebih banyak pada amputasi dibandingkan dengan disartikulasi pinggul (p=0,001). Subjek disartikulasi pinggul memiliki diameter tumor yang jauh lebih besar daripada subjek amputasi transfemoral (p=0,031).

Pembahasan: Hubungan yang signifikan antara diameter tumor dan kelangsungan hidup terjadi karena diameter tumor terkait dengan kejadian metastasis dan kejadian metastasis terkait dengan kelangsungan hidup. Tidak ada perbedaan yang signifikan antara skor MSTS dan jenis amputasi karena kedua kelompok subjek menggunakan kruk, faktor sosial ekonomi untuk membuat prostesis, dan kesulitan dalam mencapai ukuran tunggul yang ideal dalam kasus tumor.

Kesimpulan: Ada hubungan yang signifikan antara diameter tumor dan metastasis dengan kelangsungan hidup dan diameter tumor dengan metastasis."

"Osteosarkoma merupakan salah satu tumor ganas tulang primer yang paling sering ditemukan. Kemoterapi neoadjuvan merupakan salah satu alternatif terapi yang dapat meningkatan luaran dan kesintasan pasien. Studi ini dilakukan untuk menilai luaran klinis, histopatologis, dan radiologis pada pasien osteosarkoma yang menjalani kemoterapi neoadjuvan beserta faktor-faktor yang mempengaruhinya. Penelitian ini merupakan suatu studi potong lintang yang menggunakan data pasien dengan diagnosis osteosarkoma yang telah menjalani kemoterapi neoadjuvan di RSUPN dr. Cipto Mangunkusumo pada bulan Januari 2017 hinggal Juli 2019. Terdapat 58 subjek dalam penelitian ini. Sebanyak 38 (65,5%) subjek berjenis kelamin laki-laki dengan median usia seluruh subjek 16 (5 hingga 67) tahun. Sebanyak 10 (17,2%) subjek merupakan good responder kemoterapi neoadjuvan. Dari hasil analisis data didaapatkan perbedaan bermakna kadar laboratoris ALP (p=0,002), LED (p=0,002), dan NLR (p<0,001) sebelum dan sesudah kemoterapi. Derajat nekrosis berkorelasi negatif dengan perubahan nilai LDH sebelum dan sesudah kemoterapi (r=-0,354; p=0,006), namun tidak didapatkan hubungan yang bermakna dengan parameter lain seperti perubahan kadar ALP (r=-0,186; p=0,162) dan LED (r=-0,104;  p=0,437). Secara radiologis didapatkan peningkatan nilai ADC yang bermakna (p=0,028) setelah pemberian kemoterapi neoadjuvan, namun perubahannya tidak berhubungan dengan persentase nekrosis tumor (r=-0,300; p=0,433). Pada pasien osteosarkoma yang menjalani kemoterapi neoadjuvan di RSUPN dr. Cipto Mangunkusumo bulan Januari 2017 hingga Juli 2019, didapatkan perbedaan bermakna kadar penanda inflamasi dan parameter radiologis berupa ADC sebelum dan sesudah pemberian kemoterapi adjuvan.

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Osteosarcoma is one of the most prevalent primary tumors of the bone. Neoadjuvant chemotherapy has been administered in osteosarcoma cases to increase the survival rate and improve outcomes. This study is conducted to investigate the clinical, histopathological, and radiological outcome of osteosarcoma patients who underwent neoadjuvant chemotherapy, as well as the various factors that contributes to said outcome. This study is a cross-sectional study that involves the data of patients diagnosed with osteosarcoma who underwent neoadjuvant chemotherapy in RSUPN dr. Cipto Mangunkusumo from January 2017 up to July2019. A total of 58 subjects was admitted in this study. Thirty-eight (65,5%) subjects are male, with the median age of all subjects being 16 years old (5 to 67). We found that 10 subjects (17,2%) is a good responder to neoadjuvant chemotherapy. From the data analysis, significant differences were observed in ALP (p=0,002), ESR (p=0,002) and NLR (p=<0,001) levels before and after neoadjuvant chemotherapy. The degree of necrosis is inversely correlated with the change in LDH level before and after neoadjuvant chemotherapy (r=-0,354; p=0,006), however, no significant correlation was observed in ALP (r=-0,186; p=0,162) dan ESR (r=-0,104;  p=0,437). Radiologically, there is an increase in ADC value (p=0,028) after neoadjuvant chemotherapy. However, this is not correlated with the degree of necrosis (r=-0,300; p=0,433) observed pathologically. There is a significant difference in inflammatory markers and radiological parameter (ADC) pre and post neoadjuvant chemotherapy among osteosarcoma patients in RSUPN dr. Cipto Mangunkusumo from January 2017 up to July 2019."

"[ABSTRAKPendahuluan Osteosarkoma adalah tumor ganas tulang paling sering ditemukan di RS Cipto Mangunkusumo (RSCM). Penatalaksanaan osteosarkoma dengan limb-salvage surgery (LSS) makin berkembang disamping tindakan amputasi. Penelitian ini bertujuan untuk mengetahui perbandingan luaran hasil LSS dan amputasi pada pasien osteosarkoma di RSCM.Metode Studi ini menggunakan desain kohort retrospektif pada pasien osteosarkoma periode tahun 1995-2014 di RSCM. Dilakukan evaluasi angka kesintasan, rekurensi lokal, metastasis, komplikasi, skor fungsional menurut Musculoskeletal Tumor Society Scoring system (MSTS) pada pasien yang dilakukan LSS dan amputasi. Metode Kaplan-Meier digunakan untuk mendeskripsikan kesintasan, sintasan bebas rekurensi lokal antara LSS dan amputasi. Hubungan karakteristik pasien dianalisis dengan uji log rank. Uji Kai kuadrat, Eksak Fischer dan Mann-Whitney U digunakan untuk menganalisis hubungan antara skor MSTS dan karakteristik pasien, angka rekurensi, metastasis serta komplikasi. Untuk melihat pengaruh katakteristik terhadap sintasan dilakukan analisis regresi Cox dan uji Wald serta analisis multivariat backward stepwise.Temuan Penelitian dan Diskusi Kesintasan 5 tahun pasien osteosarkoma 14,6%. Kesintasan 5 tahun LSS 34,8%, kesintasan 5 tahun amputasi 15,9%. Kesintasan bebas rekurensi lokal 5 tahun untuk LSS 96,2% dan untuk amputasi 86,5%. Kesintasan dipengaruhi metastasis, tipe operasi dan ukuran tumor. Metastasis merupakan faktor paling berpengaruh berdasarkan analisis multivariat. Metastasis terbanyak ditemukan di paru. Gejala awal dan staging Enneking mempengaruhi metastasis (p=0,02 dan 0,007). Infeksi adalah komplikasi tersering. Tipe biopsi FNAB memberi komplikasi yang paling sedikit. LSS memberi skor fungsional yang lebih tinggi (83,3%) daripada amputasi (61,7%). Pasien dengan rekurensi lokal cenderung mempunyai skor fungsional buruk (p=0,023).Kesimpulan Kesintasan paling tinggi pada pasien osteosarkoma RSCM yang dilakukan LSS. Luaran fungsional dengan skor MSTS baik (83,3%) didapatkan pada pasien yang dilakukan LSS dan bebas rekurensi lokal. Skor MSTS buruk dijumpai pada pasien amputasi dengan rekurensi lokal, komplikasi dan metastasis.

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ABSTRACTIntroduction Osteosarcoma is the most common malignant bone tumor seen in Cipto Mangunkusumo Hospital (CMH). Treatment for osteosarcoma includes limb-salvage surgery (LSS), and it is increasingly more frequently performed compared to amputation. This study aims to analyze the outcome of LSS compared to amputation for osteosarcoma patients in CMH.Methods This is a retrospective cohort study to review osteosarcoma patients during 1995-2014 period in CMH. Analysis was performed on survival rate, local recurrence, metastasis, complication, and functional score according to Musculoskeletal Tumor Scoring System (MSTS) for patients underwent LSS or amputation. Kaplan-Meier method was used to determine survival rate, and disease-free survival rate between LSS and amputation. Log-rank analysis was used to determine relationship between patients characteristic. Chi-Square, Exact-Fischer, and Mann-Whitney U tests were used to analyze the correlation between MSTS score and patient characteristics, rate of recurrence, metastasis, and complication. To determine the influence of patient characteristics to survival, Cox regression analysis, Wald Test and backward stepwise multivariate analysis were performed.Results and discussion 5-year survival rate osteosarcoma patients was 14.6%, 5-year survival rate for LSS was 34.8% compared to 15.9% for amputation. Disease-free survival for LSS was 96,2%, while amputation was 86,5%. Survival were influenced by metastasis, type of surgical intervention, and tumor size. According to multivariate analysis, survival was most influenced by metastasis. Metastasis were found predominantly in lungs. Initial symptoms and Enneking stage were correlated to metastasis (p=0.02 and 0.007, respectively). Infection was the most common complication. FNAB gave the least complication compared to other types of biopsy. LSS gave the highest functional score (83.3%) compared to amputation (61.7%). Patients with local recurrence tend to have poor functional score (p=0.023).Conclusion The highest survival rate for osteosarcoma patients in CMH was found on patients who underwent LSS. Good functional outcome according to MSTS score (83.3%) were found on patients who underwent LSS and free of local recurrence. Poor MSTS score were seen on patients undergone amputation, patients who had had local recurrence, complication and metastasis, Introduction Osteosarcoma is the most common malignant bone tumor seen in Cipto Mangunkusumo Hospital (CMH). Treatment for osteosarcoma includes limb-salvage surgery (LSS), and it is increasingly more frequently performed compared to amputation. This study aims to analyze the outcome of LSS compared to amputation for osteosarcoma patients in CMH.Methods This is a retrospective cohort study to review osteosarcoma patients during 1995-2014 period in CMH. Analysis was performed on survival rate, local recurrence, metastasis, complication, and functional score according to Musculoskeletal Tumor Scoring System (MSTS) for patients underwent LSS or amputation. Kaplan-Meier method was used to determine survival rate, and disease-free survival rate between LSS and amputation. Log-rank analysis was used to determine relationship between patients characteristic. Chi-Square, Exact-Fischer, and Mann-Whitney U tests were used to analyze the correlation between MSTS score and patient characteristics, rate of recurrence, metastasis, and complication. To determine the influence of patient characteristics to survival, Cox regression analysis, Wald Test and backward stepwise multivariate analysis were performed.Results and discussion 5-year survival rate osteosarcoma patients was 14.6%, 5-year survival rate for LSS was 34.8% compared to 15.9% for amputation. Disease-free survival for LSS was 96,2%, while amputation was 86,5%. Survival were influenced by metastasis, type of surgical intervention, and tumor size. According to multivariate analysis, survival was most influenced by metastasis. Metastasis were found predominantly in lungs. Initial symptoms and Enneking stage were correlated to metastasis (p=0.02 and 0.007, respectively). Infection was the most common complication. FNAB gave the least complication compared to other types of biopsy. LSS gave the highest functional score (83.3%) compared to amputation (61.7%). Patients with local recurrence tend to have poor functional score (p=0.023).Conclusion The highest survival rate for osteosarcoma patients in CMH was found on patients who underwent LSS. Good functional outcome according to MSTS score (83.3%) were found on patients who underwent LSS and free of local recurrence. Poor MSTS score were seen on patients undergone amputation, patients who had had local recurrence, complication and metastasis]"

"Latar belakang: Teknik radiasi ekstrakorporeal merupakan alternatif tindakan pembedahan penyelamatan ekstremitas pada kasus osteosarkoma khususnya di pusat layanan dengan keterbatasan endoprostesis dan alograf. Penelitian ini bertujuan untuk mengevaluasi hasil tindakan pembedahan penyelamatan ekstremitas dengan otograf yang diradiasi secara ekstrakorporeal pada pasien-pasien osteosarkoma yang datang ke RSCM.Metode: Studi ini menggunakan desain kohort retrospektif yang dilakukan pada 20 pasien osteosarkoma stadium IIB yang diterapi dengan pembedahan penyelamatan ekstremitas dengan otograf yang diradiasi secara ektrakorporeal selama periode 1995-2008. Dilakukan evaluasi terhadap angka kesintasan, rekurensi lokal, metastasis, komplikasi, lamanya unifi kasi, dan skor fungsional menurut sistem skor Musculoskeletal Tumor Society Scoring System (MSTS). Metode Kaplan-Meier digunakan untuk mendeskripsikan kesintasan, angka rekurensi lokal, kesintasan bebas tumor, dan kesintasan bebas metastasis. Hubungan variabel-variabel seperti usia, jenis kelamin, lokasi tumor, ukuran tumor, tipe osteosarkoma, kadar alkali fosfatase serum, jenis biopsi, dan klasifi kasi Huvos dianalisis dengan uji log rank. Uji chi-square digunakan untuk menganalisis hubungan antara skor MSTS dan karakteristik pasien, angka rekurensi, metastasis, serta komplikasi.Hasil: Kesintasan 5 tahun 54,97 ± 9,8%, kesintasan bebas rekurensi lokal 5 tahun 66,5 ± 7,6%, dan kesintasan bebas metastasis 5 tahun 57,13 ± 10,04%. Enam pasien meninggal dunia, lima disebabkan oleh metastasis ke paru dan satu karena toksisitas kemoterapi. Tiga pasien menjalani konversi amputasi karena rekurensi lokal. Kurva Kaplan-Meier menunjukkan Huvos (III,IV) selalu memberikan angka kesintasan, kesintasan bebas rekurensi lokal, dan kesintasan bebas metastasis yang lebih baik daripada Huvos (I, II). Kadar alkali fosfatase serum yang normal selalu memberikan kesintasan bebas rekurensi lokal yang lebih baik dibandingkan dengan kadar alkali fosfatase serum yang meningkat. Angka unifi kasi rata-rata 8,13 bulan. Skor MSTS dengan hasil baik (70,63%) dijumpai pada pasien yang bebas osteosarkoma pasca terapi, tetapi skor MSTS dengan hasil buruk dijumpai pada pasien dengan rekurensi lokal (p=0,025), metastasis (p=0,01), pasien dengan komplikasi (p=0,03), dan kombinasi ketiganya (p=0,001).Kesimpulan: Luaran fungsional dengan skor MSTS baik (70,63%) didapatkan pada pasien yang bebas osteosarkoma pasca terapi, skor MSTS buruk dijumpai pada pasien dengan rekurensi lokal, metastasis, pasien dengan komplikasi, dan kombinasi ketiganya. (Med J Indones 2011; 20:131-7).

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Background: Extracorporeally irradiated (ECI) technique is an alternative of limb salvage procedure in treating osteosarcoma regarding limitation of endoprosthesis and allograft. This study evaluated the outcomes of limb salvage surgery using extracorporeally irradiated (ECI) autograft and its correlation with patientâ??s characteristics.

Methods: Retrospective cohort design was performed to study 20 patients with stage IIB osteosarcoma treated by ECI autograft from 1995 to 2008. Survival, local recurrence, metastases, complications, union time and functional score based on Musculoskeletal Tumor Society scoring system-(MSTS) were evaluated. Kaplan-Meier method was used to describe survival, local recurrence free survival, and metastases free survival. The correlation among patientâ??s characteristics that were age, gender, duration, site of tumor size, type of osteosarcoma, SAP (serum alkaline phosphatase) level, type of biopsy, and type of Huvos were analyzed by Log rank test. Chi-square test was used to analyze the correlation between MSTS score and patientâ??s characteristics, local recurrence, metastases, complications.

Results: Five-year survival was 54.97 ± 9.8 %, fi ve-year local recurrence free survival was 66.5 ± 7.6%, and fi ve year metastasis-free survival was 57.13 ± 10.04%. Six patients died, fi ve were due to lung metastases and one due to complication of chemotherapy. Three underwent amputation after local recurrence. Kaplan-Meier curve showed that a good type of Huvos (III, IV) always gave better survival, local recurrence free survival, and metastases free survival than poor type of Huvos (I,II). Normal SAP level gave better local recurrence free survival compare to increased level of SAP. Mean of union rate was 8.13 months. MSTS mean score was good (70.63%) in patients with no evidence of disease. MSTS score was poor in patients with local recurrence (p=0.025), metastases (p=0.01), complications (p=0.03), and the combined of those three outcomes (p=0.001).

Conclusions: Functional outcome was poor in patients with local recurrence, metastases, and complications. SAP level and type of Huvos could be studied further as predictive factors for the outcomes (survival, local recurrence, metastases). (Med J Indones 2011; 20:131-7)."

"PENDAHULUANMakalah ini dibuat untuk meninjau lebih jauh kepustakaan yang ada sampai saat ini, di mana dibicarakan mengenai terapi amputasi, limb salvage dan ajuvan terapi yang diberikan sebelum atau sesudah terapi bedah, di mana semua hal tersebut ditujukan untuk meningkatan survival rate pada penderita osteosarkoma. Seperti kita ketahui, amputasi sampai saat ini merupakan pilihan utama dalam terapi bedah. Beberapa penulis mengemukakan bahwa sejak dua dekade terakhir ini reseksi menjadi populer. Kemudian W. F. Enneking pada tahun 1980 mengajukan staging untuk neoplasms muskulo skeletal, di mana penyusunan staging tersebut mempunyai maksud untuk menggolongkan faktor-faktor prognosa yang berarti penyusunan implikasi spesifik untuk terapi pembedahan, dan petunjuk untuk melengkapi terapi tambahan. Makalah ini juga berisi ilustrasi penderita-penderita yang berobat di Bagian Bedah RSCM, periode Januari 1980 s/d Desember 1981, yang mempunyai masalah lain di samping masalah diatas. Bahan Dan Cara, Dikumpulkan status penderita osteo sarkoma yang berobat 1981 semuanya berjumlah delapan orang. Dikumpulkan kepustakaan yang ada, dan kemudian mencoba membandingkannya. Kepustakaan, Osteosarkoma merupakan tumor tulang primer, menurut klasifikasi AEGERTER (1968) digolongkan dalam " True neoplasma of bone ", jenis " Osteogenic sarcoma ". Neoplasma ini berasal dari sel mesensimal primitif, serf osteoblastik, di daerah metafisis tulang panjang. Etiologi neoplasma ini belum dapat dijelaskan secara pasti, akan tetapi ditemukan oleh pengarang-pengarang, bahwa neoplasma ini dapat terjadi pada satu keluarga, setelah radiasi, bersama neoplasma lain, timbul dari neoplasma lain, setelah trauma , dan oleh virus. Neoplasma ini umumnya menyerang penderita usia antara deka de 1-2 pada metafisis tulang panjang, dan penderita lakilaki lebih banyak dari pada wanita. Insidens di Amerika Serikat 1 : 100.000, dan di Inggris 1: 75.000. Di dalam deretan tumor tulang primer, menempati urutan kedua setelah plasma sel yeloma. Diagnosis ditegakkan dengan pemeriksaan klinis, radiologis dan patologi anatomis. "

"Periosteal osteosarkoma merupakan tumor ganas tulang yang jarang didapat, dibentuk dari sarkoma tulang dengan didominasi komponen tulang rawan yang berdiferensiasi dan tumbuh pada permukaan tulang. Penelusuran kepustakaan tidak banyak menyebutkan mengenai kasus ini. Laporan kasus ini terakhir dilaporkan oleh Klinik Mayo tahun 1999. Kami laporkan satu kasus periosteal osteosarkoma pada penderita laki-laki berusia 17 tahun. Penderita menjalani tindakan pembedahan berupa prosedur ?limb salvage?, dengan pra dan pasca bedah penderita mendapat kemoterapi (neo-ajuvan dan ajuvan). Tidak ditemukan rekurensi lokal dan metastasis di paru, pada follow up sampai dengan 14 bulan pasca bedah. (Med J Indones 2003; 12: 166-70)

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Periosteal osteosarcoma is a rare type of malignant bone neoplasm, with predominantly cartilaginous component and arising on the bone surface. Reports of the case in the literature were rare. Last case was reported by Mayo Clinic in 1999. We report a case of periosteal osteosarcoma in a 17-year-old male, who was treated surgically with a limb salvage procedure, neoadjuvant and adjuvant chemotherapy were also given to the patient. There was no local recurrence and lung metastases up to 14 months after surgery. (Med J Indones 2003; 12: 166-70)"

"ABSTRAKDiare telah menjadi salah satu penyebab meningkatnya kesakitan dan kematian pada anak. Diare biasanya disebabkan oleh infeksi. Sindrom Malabsorpsi dan beberapa enteropatogen bisa menyebabkan diare. Studi ini dilaksanakan untuk mencari prevalensi malabsorpsi laktosa dan malnutrisi pada pasien anak dengan diare dan mencari asosiasi malabsorpsi laktosa dan malnutrisi. Studi ini menggunakan studi potong lintang dengan menggunakan data sekunder. Jenis studi ini dipilih untuk mengetahui asosiasi malabsorpsi laktosa dan malnutrisi. Data yang dibutuhkan akan diperoleh dari profil analisis tinja dan rekam medis pasien anak yang dirawat di RSCM. Penelitian ini menemukan prevalensi malabsorpsi laktosa di pasien anak dengan diare sebanyak 18,2 . Prevalensi malnutrisi di pasien anak dengan diare sebanyak 38 . Hasil penelitian menunjukan bahwa tidak terdapat asosiasi malabsorpsi laktosa dengan status nutrisi p>0.05 . Perlu dilakukan penelitian lebih lanjut mengenai asosiasi malabsorpsi laktosa dan malnutrisi dengan sampel yang lebih besar.

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ABSTRACTDiarrhea remains as a leading cause of childhood morbidity and mortality in Indonesia. Diarrhea in children is usually caused by infection . However, numerous disorders could also result in diarrhea. It includes a malabsorption syndrome and various enteropathies. The study that we conduct is aimed to determine the prevalence of lactose malabsorption and malnutrition in pediatric patients with diarrhea and the association between lactose malabsorption. and malnutrition. The research design used for this study is a cross sectional using secondary data. This study is chosen to know the association between lactose malabsorption and malnutrition. The data in this study will be obtained from stool analysis profile and the medical record of pediatric patients that are treated in Cipto Mangunkusumo Hospital RSCM . This study found that the prevalence of lactose malabsorption in pediatric patients with diarrhea is 18.2 . This study also found that the prevalence of malnutrition is 38 .Moreover, the result of the study revealed that there is no association between lactose malabsorption and nutritional status P 0.05 . A further study is required to explored the association between lactose malabsorption and nutritional status with larger sample size "

"Keperawatan medikal bedah merupakan area praktik keperawatan pada orang dewasa yang mengalami perubahan fisiologis atau mempunyai resiko terjadi perubahan fisiologis, trauma atau kecacatan Tujuan dari penulisan Karya Ilmiah ini adalah menjabarkan analisis kegiatan praktik residensi keperawatan medikal bedah peminatan onkologi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dengan penerapan Model Keperawatan Adaptasi Roy dalam pemberian asuhan keperawatan pada kasus keganasan, melakukan aplikasi evidence based nursing (EBN), dan melaksanakan proyek inovasi. Praktik residensi dilaksanakan selama 2 semester dengan mengelola 30 kasus resume dengan berbagai jenis kasus keganasan dan 1 kasus utama (osteosarkoma). Penerapan evidence based nursing tentang auricular acupressure efektif untuk mengurangi konstipasi pada pasien kemoterapi dan pelaksanaan inovasi video edukasi meningkatkan pengetahuan pasien untuk manajemen mual muntah efek samping kemoterapi. Praktik residensi sangat bermanfaat untuk meningkatkan pengetahuan dan keterampilan klinik pada mahasiswa ners spesialis.

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Medical surgical nursing is an area of nursing practice in adults who have physiological changes or risk of physiological changes, trauma or disability. The aim of this writing is to describe the analysis of residency practice in medical surgical nursing especially oncology at Cipto Mangunkusumo National Center General Hospital with the application of Roys Adaptation Nursing Model in the provision of nursing care in malignancy cases, conduct evidence based nursing (EBN) applications, and implement innovation project. The residency practice is held for 2 semesters by managing 30 cases of resumes with various types of malignancy cases and 1 main case (osteosarcoma). The application of evidence based nursing auricular acupressure is effective for reducing constipation in chemotherapy patients and the implementation of innovative educational video projects increases the knowledge of patients to manage chemotherapy-induced nausea and vomiting. The residency practice is very useful for increasing clinical knowledge and skills of nursing specialist students"