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"Latar Belakang: Limfadenektomi memainkan peranan penting dalam operasi surgical staging kanker ovarium. Limfadenektomi merupakan prosedur yang kompleks dan berpotensi menyebabkan berbagai komplikasi intra- dan pascaoperasi. Beberapa penelitian menunjukkan bahwa subtipe histologi dan derajat histopatologi kanker ovarium yang berbeda memiliki kejadian metastasis kelenjar limfe yang berbeda pula, sehingga dapat mempengaruhi pengambilan keputusan klinis.Tujuan: Mengetahui prevalensi metastasis kelenjar limfe pada pasien kanker ovarium tipe epitel stadium klinis 1 pada berbagai subtipe histologi dan derajat histopatologi.Metode: Penelitian menggunakan metode potong lintang pada pasien kanker ovarium tipe epitel stadium klinis 1 yang menjalani limfadenektomi di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada tahun 2014-2023. Data yang dikumpulkan mencakup karakteristik demografi, subtipe histologi, derajat histopatologi, dan status metastasis kelenjar limfe. Hubungan antar variabel dianalisis menggunakan uji chi-square atau uji Fisher's exact.Hasil: Terdapat 106 subjek yang memenuhi kriteria inklusi. Peningkatan stadium akibat metastasis kelenjar limfe ditemukan pada 6.6% subjek. Metastasis kelenjar limfe paling banyak ditemukan pada subtipe histologi serosum derajat tinggi (15.4%) dan derajat diferensiasi buruk (10.6%). Hubungan yang signifikan secara statistik ditemukan antara kejadian metastasis kelenjar limfe dengan derajat diferensiasi (P=0.043), namun tidak dengan subtipe histologi. Tidak terdapat subjek dengan derajat diferensiasi baik-sedang yang mengalami metastasis kelenjar limfe.Kesimpulan: Keputusan untuk melakukan limfadenektomi perlu dipertimbangkan kembali saat melakukan operasi surgical staging pada kanker ovarium tipe epitel stadium klinis 1 dengan derajat diferensiasi baik-sedang. Penelitian lanjutan dengan jumlah sampel yang lebih besar dibutuhkan untuk kesimpulan yang lebih kuat.

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Background: Lymphadenectomy plays an integral role in the surgical staging of ovarian cancer. However, it is a complex procedure that is potentially associated with intra- and post-operative complication. Some studies showed that distinct histologic subtype and grade have different frequencies of lymph node metastases and these might have potential implication for clinical decision making.

Objective: To evaluate the prevalence of lymph node metastasis in patients with clinically stage 1 epithelial ovarian cancer of various histologic subtype and grade.

Methods: This was a cross sectional study including clinically stage 1 epithelial ovarian cancer patient who underwent lymphadenectomy at Dr. Cipto Mangunkusumo Hospital, Jakarta, during the period of 2014-2023. Demographics, histologic subtype, tumor grade, and lymph node status were collected. Comparisons were made with Chi square or Fisher's exact test.

Results: A total of 106 subjects were included in the study. Upstaging due to lymph node metastases were found in 6.6% of subjects. Lymph node metastases were most common in high-grade serous histology (15.4%) and poorly differentiated tumor grade (10.6%). However, a significant association with lymph node metastases rate was found only on tumor grade (P=0.043) and not histologic subtype. Furthermore, no subjects with well-to-moderately differentiated tumor had lymph node metastases.

Conclusions: The decision to perform lymphadenectomy should be reconsidered when performing surgical staging in patients with well-to-moderately differentiated clinically stage 1 epithelial ovarian carcinoma. Additional studies with larger samples are needed for exact conclusion."

"ABSTRAKTUJUAN : Mengetahui insiden metastasis kanker ovarium epitelial yang dilakukan pembedahan primer pada kelenjar getah bening pelvik, paraaorta dan pelvik/paraaorta di RSCM periode Januari 2009 Desember 2015. LATAR BELAKANG : Tatalaksana mengenai limfedenektomi pada kanker ovarium masih merupakan kontroversi. Adanya kekurangan data penelitian prosfektif ataupun RCT tentang patologi antomi merupakan penyebab kontroversi tatalaksana limfedentomi. Namun sampai saat ini sejak 1998 FIGO mengatakan bahwa limfedenektomi pelvik dan paraaorta merupakaan bagian terintegrasi yang tidak dapat dipisahkan pada surgical staging kanker ovarium. Namun penelitian mengenai limfedenektomi masih terbatas, sampai saat belum menemukan adanya publikasi penelitian insiden metastasis kanker ovarium epitelial pada kelenjar getah bening di RSCM. METODE Penelitian ini menggunakan desain penelitian potong lintang, data diambil dari rekam medis, dari data kanker register didapatkan 1584 daftar rekam medik, namun didapatkan 401 pasien kanker ovarium, dan 306 yang ekslusi, didapatkan 55 data yang masuk kriteria inklusi. HASIL Dari 55 sampel yang dilakukan pembedahan primer pada kanker ovarium tipe epitel. Penyebaran kelenjar getah bening pada kanker epitel ovarium yang dilakukan pembedahan primer pada KGB paraaorta adalah 20 , pelvik 9.1 dan pelvik/paraaorta 23,6 . KESIMPULAN : 1. Insiden metastasis KGB kanker epitel ovarium pada paraaorta sebanyak 20 , pelvik 9,1 dan pada pelvik/paraaorta 23,6 di RSCM dari tahun 2009-2015.. 2. Semakin tinggi stadium, maka semakin tinggi keterlibatan KGB pelvik dan paraaorta . 3. Pada subtipe serosum lebih banyak menyebabkan keterlibatan pada KGB pelvik dan paraaorta . 4. Semakin buruk derajat differensiasinya, maka semakin tinggi keterlibatan pada KGB paraaorta . 5. Pada stadium I subtipe musinosum derajat difensiasi baik dengan keterlibatan pada KGB yang minimal sehingga dapat lebih selektif dalam mempertimbangkan risk dan benefit dari limfedenektomi

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ABSTRACTAIM To evaluate the incidence of pelvic and paraaortic lymph node metastasis of epithelial ovarian cancer underwent primary surgery in Cipto Mangunkusumo Hospital from Januari 2009 to December 2015. BACKGROUND The definitive objective of lymphadenectomy in ovarian cancer is still controversial due to the lack of prospective research or randomized controlled trial. Since 1998, FIGO has stated that pelvic and paraaorta lymphadenectomy are part of ovarian cancer surgical staging. But, there is still limited research and still not published the incidence of pelvic and paraaortic lymph node metastasis of epithelial ovarian cancer underwent primary surgery in Cipto Mangunkusumo Hospital. METHODS This research is cross sectional from medical records, the INASGO cancer registry. A hundred fifty four medical records were included but we found only 401 ovarian cancer, 306 data were excluded and 55 data were included. RESULTS From 55 epithelial ovarian cancer patients underwent the primary surgery, there are 20 metastasis to paraortic lymph node, 9,1 metastasis to pelvic lymph node, and 23,6 metastasis to both. CONCLUSION 1. Lymph node metastases incident of ovarian epithelial cancer in paraorta amounts 20 , pelvic 9.1 and pelvic or paraortic 23.6 2. Higher the stadium, the lymph node involvements will be higher as well pelvic and paraortic 3. In serous subtype, there is more incidents of lymph node involvements pelvic and paraaortic 4. If the differentiation type is worse, there will be higher rate of pelvic and paraaortic lymph node involvement. 5. In stadium 1 of mucinous subtype with well differentation has minimal lymph node involvement so we can be more selective in considering the risk and benefit of lymphadenectomy. The suggestion is the advanced research needs to be done prospectively by increase the number of samples for finding the metastatic factors to lymph node more accurately. "

"Latar Belakang : Sampai saat ini kanker ovarium masih menjadi salah satu kanker dengan angka mortalitas yang tinggi pada wanita dikarenakan tidak dijumpainya gejala yang khas sehingga lebih banyak kasus terdiagnosis pada stadium lanjut. Belum adanya metode skrining menjadikan pentingnya metode diagnostik yang mempunyai sensitivitas dan spesifisitas yang tinggi. Evaluasi biomarker yang baru diperlukan untuk dapat mendeteksi tumor ovarium ganas pada stadium awal.Objektif : Penelitian ini dilakukan untuk menilai ekspresi Immediate Early Response Gene X-1 (IEX-1) saliva sebagai prediktor keganasan pada tumor ovarium epitelial.Metode : Merupakan penelitian uji diagnostik pada pasien tumor ovarium yang direncanakan operasi elektif dengan mengambil 3-5 ml saliva pasien sebelum tindakan operasi. Subjek penelitian yang memenuhi kriteria inklusi dan eksklusi dibagi menjadi dua kelompok berdasarkan hasil histopatologi yaitu tumor ovarium epitelial jinak dan ganas. Dilakukan pemeriksaan ekspresi IEX-1 saliva dengan metode Real Time qPCR.Hasil : Hasil penelitian ini didapat dari 47 subjek, 22 subjek tumor ovarium epitelial ganas dan 25 subjek merupakan tumor ovarium epitelial jinak. Rerata ekspresi IEX-1 saliva lebih tinggi pada tumor ovarium epitelial jinak (1,976) dibandingkan ganas (0,554) (p<0,001). Didapatkan nilai AUC ekspresi IEX-1 0,949 (IK95% 0,894-1,000), nilai cut off point IEX-1 saliva ≥ 0.9115 dengan sensitivitas 84%, spesifisitas 86,4%, nilai duga positif 82,6% dan nilai duga negatif 87,5%. Terdapat hubungan yang signifikan antara ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas (OR 5,031, IK95% 2,039-12,41; p<0,001).Kesimpulan : Terdapat hubungan yang bermakna antara penurunan ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas dengan sensitivitas dan spesifisitas yang cukup baik.

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Backgound: Ovarian cancer is still one of the cancers with a high mortality rate in women because there are no typical symptoms so that more cases are diagnosed at an advanced stage. The absence of a screening method makes the importance of a diagnostic method that has high sensitivity and specificity. Evaluation of new biomarkers is needed to detect malignant ovarian tumors at an early stage.

Objectives: This study was conducted to assess the expression of salivary Immediate Early Response Gene X-1 (IEX-1) as a predictor of malignancy in epithelial ovarian tumors.

Methods: This is a diagnostic test study in ovarian tumor patients who are planned for elective surgery by taking 3-5 ml of patient's saliva before surgery. Research subjects who met the inclusion and exclusion criteria were divided into two groups based on the histopathological results, benign and malignant epithelial ovarian tumors. The salivary IEX-1 expression was examined using the Real Time qPCR method.

Results: The results of this study were obtained from 47 epithelial ovarian tumors subjects, 22 malignant tumors and 27 benign tumors. The mean salivary IEX-1 expression was higher in benign epithelial ovarian tumors (1.976) than in malignant (0.554) (p<0.001). The AUC expression value of IEX-1 was 0.949 (95% CI 0.894-1,000), salivary IEX-1 cut off point value was 0.9115 with sensitivity 84%, specificity 86.4%, positive predictive value 82.6% and negative predictive value 87, 5%. There was a significant relationship between salivary IEX-1 expression and the event of malignant epithelial ovarian tumors (OR 5.031, 95% CI 2.039-12.41; p<0.001).

Conclusions: There is a significant correlation between decreased salivary IEX-1 expression and the event of malignant epithelial ovarian tumors with a good sensitivity and specificity."

"[ABSTRAKTujuan: Menentukan hubungan obesitas dengan proporsi ukuran tumor, keterlibatan KGB aksila dan derajat histopatologi pada pasien kanker payudara stadium I – IIIA di RSUPNCM, serta membantu meningkatkan kualitas tatalaksana bagi klinisi.Metode: Analisa menggunakan data sekunder pada pasien kanker payudara stadium I – III A. Dikatan obesitas bila indeks massa tubuh ≥ 25 kg/m2 dan non obesitas < 25 kg/m2. Hasil ukuran tumor dikelompokkan menjadi < 2 cm, 2-5 cm dan > 5 cm berdasarkan sistem staging TNM AJCC. Ukuran tumor diperoleh melalui pencitraan ultrasonografi payudara yang tersimpan pada sistem PACS. Keterlibatan KGB aksila serta derajat histopatologi diperoleh dari hasil ekspertise patologi anatomi.Hasil: Jumlah subyek penelitian sebanyak 52 pasien kanker payudara stadium I– IIIA tahun 2012 - 2014 di RSUPNCM terdiri dari 26 pasien obesitas dan 26 pasien non obesitas. Tidak ada hubungan yang bermakna antara ukuran tumor berdasarkan staging dengan obesitas (P= 0,795 (uji chi square)). Tidak terdapat hubungan yang bermakna antara obesitas dengan derajat histopatologi (P=0,610, (uji mutlak fisher)). Tidak terdapat hubungan yang bermakna antara obesitas dan keterlibatan KGB aksila (P =0,404 (uji chi square)). Median ukuran tumor pada pasien obesitas 2,95 cm dan pasien non obesitas 2,73 cm. Dari 26 pasien obesitas, 25 diantaranya memiliki derajat tinggi. Dari 26 pasien non obesitas, 14 memiliki keterlibatan KGB aksila.Kesimpulan: Pasien kanker payudara yang obesitas tidak berhubungan dengan besarnya ukuran tumor, keterlibatan KGB aksila dan derajat histopatologi yang tinggi. Namun terdapat kecenderungan pasien kanker payudara yang obesitas memiliki ukuran tumor yang lebih besar dan tingginya derajat histopatologi. Sedangkan keterlibatan KGB aksila lebih cenderung pada pasien yang non obesitas.

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ABSTRACTObjective: Determine the relationship of obesity with tumor size proportion, axillary lymph node involvement and histopathological grading in breast cancer patients stage I-IIIA in Cipto Mangunkusomo hospital and to help improvement the quality of management by clinician.Methods: Analysis using secondary data of breast cancer patient stage I-IIIA. Obesity grouped if body mass index ≥ 25 kg/m2 and non obese < 25 kg/m2. The results of tumor size are grouped into 0-2 cm, 2-5 cm and > 5 cm based on the AJCC TNM staging system. Tumor size obtained through breast ultrasound imaging from PACS system. Axillary lymph node involvement and histopathological grading obtained from the anatomical pathology expertise.Results: The study subjects are 52 patients with stage I-IIIA breast cancer in 2012-2014 in Cipto Mangunkusumo consisted of 26 obese and 26 non-obese patients. There is no significant relationship between tumor size based on staging with obesity (P = 0.795 (chi square test)). There was no significant relationship between obesity and grading histopathology (P = 0.610, (absolute test fisher)). There was no significant relationship between obesity and the involvement of axillary lymph nodes (P = 0.404 (chi square test)). The median tumor size of 2.95 cm in obese patients and 2,73 cm in non-obese patients. From 26 obese patients, 25 of them had a high grading histopathology. From 26 non-obese patients, 14 of them had involvement of axillary lymph nodes.Conclusion: Breast cancer patients who are obese are not related to the larger tumor size , involvement of axillary lymph nodes and a high grading of histopathology. However, there is a tendency that breast cancer patients who are obese had larger tumor size and high grading of histopathology. Where as the involvement of axillary lymph nodes are more likely in non-obese patients., Objective: Determine the relationship of obesity with tumor size proportion, axillary lymph node involvement and histopathological grading in breast cancer patients stage I-IIIA in Cipto Mangunkusomo hospital and to help improvement the quality of management by clinician.Methods: Analysis using secondary data of breast cancer patient stage I-IIIA. Obesity grouped if body mass index ≥ 25 kg/m2 and non obese < 25 kg/m2. The results of tumor size are grouped into 0-2 cm, 2-5 cm and > 5 cm based on the AJCC TNM staging system. Tumor size obtained through breast ultrasound imaging from PACS system. Axillary lymph node involvement and histopathological grading obtained from the anatomical pathology expertise.Results: The study subjects are 52 patients with stage I-IIIA breast cancer in 2012-2014 in Cipto Mangunkusumo consisted of 26 obese and 26 non-obese patients. There is no significant relationship between tumor size based on staging with obesity (P = 0.795 (chi square test)). There was no significant relationship between obesity and grading histopathology (P = 0.610, (absolute test fisher)). There was no significant relationship between obesity and the involvement of axillary lymph nodes (P = 0.404 (chi square test)). The median tumor size of 2.95 cm in obese patients and 2,73 cm in non-obese patients. From 26 obese patients, 25 of them had a high grading histopathology. From 26 non-obese patients, 14 of them had involvement of axillary lymph nodes.Conclusion: Breast cancer patients who are obese are not related to the larger tumor size , involvement of axillary lymph nodes and a high grading of histopathology. However, there is a tendency that breast cancer patients who are obese had larger tumor size and high grading of histopathology. Where as the involvement of axillary lymph nodes are more likely in non-obese patients.]"

"Latar Belakang: CXCR4 adalah reseptor kemokin G-protein 7-transmembran yang diekspresikan pada beberapa sel kanker payudara manusia pada tumor payududara primer dan metastasis yang menyebabkan migrasi sel hematopoietik dari sumsum tulang belakang ke kelenjar getah bening perifer. Penelitian-penelitian sebelumnya menunjukkan bahwa CXCR4 berkaitan dengan metastasis kelenjar getah bening aksilla. Namun, sampai sekarang, tidak ditemukan penelitian yang mengevaluasi peran CXCR4 dalam metastasis kelenjar getah bening sentinel pada kanker payudara stadium dini.Tujuan: Menentukan peran reseptor kemokin CXCR4 pada migrasi sel kanker payudara ke kelenjar getah bening sentinel.Metode: Digunakan desain studi potong lintang dengan mengevaluasi ekspresi CXCR4 pada 32 pasien kanker payudara stadium dini yang menjalani mastektomi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM) pada periode Maret sampai Juni 2016. Pada seluruh kasus, ekspresi CXCR4 diperiksa dengan pemeriksaan imunohistokimia. Kemudian, dievaluasi hubungan antara ekspresi CXCR4 dengan metastasis kelenjar getah bening sentinel.Hasil: Ekspresi CXCR4 yang tinggi (cut off point ≥ 5) terdeteksi pada 19 dari 32 (59.4%) pasien kanker payudara stadium dini. Dari 19 pasien dengan metastasis kelenjar getah bening sentinel, 16 (84.21%) pasien memiliki ekspresi CXCR4 yang tinggi. Ekspresi CXCR4 berkorelasi signifikan dengan metastasis kelenjar getah bening (p < 0.01).Kesimpulan: Ekspresi CXCR4 yang tinggi berkorelasi signifikan dengan metastasis kelenjar getah bening sentinel pada pasien kanker payudara stadium dini.

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Background: CXCR4 is a 7-transmembrane G-protein chemokine receptor expressed in some human breast cancer cells in both primary breast tumors and metastases that allows for migration of hematopoietic cells from the bone marrow to the peripheral lymph nodes. Previous studies have shown that CXCR4 is associated with axillary lymph node metastases. However, up until now, no studies evaluating the role of CXCR4 in sentinel lymph node metastases in early stage breast cancer patients were found.

Aim: To determine the role of chemokine receptor CXCR4 in breast cancer cells migration to sentinel lymph nodes.

Methods: A cross sectional study design was used by evaluating CXCR4 expression of 32 early stage breast cancer patients that underwent mastectomy in Cipto Mangunkusumo Hospital during the period of March to June 2016. CXCR4 expression was assessed by immunohistochemistry in all cases. Associations between CXCR4 expressions and sentinel lymph node metastases were evaluated.

Results: High CXCR4 expression (cut off point ≥ 5) was dectected in 19 of 32 (59.4%) primary early stage breast cancer patients. Of 19 patients with sentinel lymph node metastases, 16 (84.21%) had high expression of CXCR4. The expression of CXCR4 is significantly associated with sentinel lymph node metastases (p < 0.01).

Conclusions: High expression of CXCR4 was significantly correlated with sentinel lymph node metastases in early stage breast cancer patients."

"Kanker serviks merupakan jenis kanker terbanyak kedua pada wanita setelah kanker payudara namun menjadi penyebab kematian terbanyak pada wanita yang menderita kanker. Pada penderita kanker serviks gangguan psikiatri dapat terjadi karena berbagai faktor penyebab. Dari gangguan psikiatri yang terjadi pada penderita kanker serviks, depresi merupakan gangguan yang paling sering dijumpai. Penelitian ini bertujuan untuk mengetahui hubungan antara stadium klinis dan faktor-faktor sosio-demografi dengan derajat beratnya depresi pada pasien kanker serviks uteri.Metode: Penelitian ini berbentuk studi potong lintang dengan jumlah subjek 232 orang yang merupakan pasien kanker serviks uteri yang berobat ke Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (RSUPN Dr. Cipto Mangunkusumo) pada bulan November sampai Desember 2012. Seluruh subjek penelitian diminta untuk mengisi lembar kuesioner yang berisi identitas dan data sosio-demografi. Instrumen yang digunakan untuk penilaian depresi menggunakan Mini International Neuropsychiatric Interview ICD-10 (MINI ICD-10) dan untuk menilai derajat beratnya depresi dengan instrumen Hamilton Rating Scale for Depression (HRS-D).Hasil: Dari hasil analisis bivariat pada penelitian ini didapatkan hubungan yang bermakna antara stadium klinis kanker serviks uteri (p <0,001), umur (p = 0,005), dan lamanya diagnosis kanker serviks uteri ditegakkan (p <0,001) dengan derajat beratnya depresi yang terjadi, dan dari analisis multivariat didapatkan lamanya diagnosis merupakan variabel yang menjadi faktor dominan yang berhubungan secara statistik bermakna terhadap semua tingkatan depresi.Kesimpulan: Penelitian ini menjawab hipotesis penelitian dimana terdapat hubungan antara stadium klinis dan faktor-faktor sosio-demografi dengan derajat beratnya depresi pada pasien kanker serviks uteri.

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Cervical cancer is the second most types of cancer in women after the breast cancer, but it is the most frequent cause of cancer mortality in women. Patients with cervical cancer can occur psychiatric disorders due to various causes. Depression is the most common psychiatric disorder in cervical cancer patients. This study aims to determine the relationship between clinical stage and the factors of socio-demographic with the severity of depression in patients with cervical cancer.

Methods: This study was cross-sectional studies form 232 cervical cancer patients who went to the National Center Public Hospital Dr. Cipto Mangunkusumo (RSUPN Dr. Cipto Mangunkusumo) in November to December 2012. The whole subjects of the study were asked to fill out a questionnaire that contains the identity and socio-demographic data. The instrument used for the assessment of depression using the Mini International Neuropsychiatric Interview ICD-10 (ICD-10 MINI) and to assess the degree of severity of depression by the instrument Hamilton Rating Scale for Depression (HRS-D).

Results: From the results of the bivariate analysis in this study found a significant association between clinical stage of cervical cancer (p <0.001), age (p = 0.005), and duration of cervical cancer diagnosis is established (p <0.001) with the degree of severity of depression that occurs, and from the multivariate analysis found that the length of diagnosis is a dominant factor which is statistically significant related to all levels of depression.

Conclusion: This study answers the research hypothesis that there is a relationship between clinical stage and the factors of socio-demographic with the severity of depression in patients with cervical cancer."

"Kanker payudara merupakan salah satu jenis kanker yang paling umum. Sebagaimana diketahui, kanker suatu jaringan dapat menyebar atau bermetastasis ke jaringan lain sebagai kanker sekunder, di mana pada kanker payudara 90% kematian selama pengobatan dikaitkan pada metastasis. Penelitian ini fokus kepada karakteristik metastasis bone only sebagai subtipe metastasis tulang kanker payudara yang belum banyak diteliti walaupun angka kelangsungan hidup (survival)nya paling bagus dibandingkan bila metastasis ke organ/tempat lainnya. Gambaran karakteristik pasien KPD BMO yg berobat di RSCM juga belum pernah diteliti. Penelitian ini menggunakan desain penelitian observasional deskriptif dengan desain studi cross sectional dengan teknik sampel total sampling. Terdapat 1278 pasien KPD metastasis yg berobat di RSCM 2017-2022. Didapatkan 148 pasien KPD BMO, namun karena ketidak lengkapan informasi di hasil pemeriksaan penunjang maka yang masuk kriteria inklusi penelitian ini adalah 47 pasien. Dari 47 pasien, ditemukan karakteristik 100% perempuan, rentang usia terbanyak 45-64 tahun (70,2%), 46,8% bersuku Jawa, 85,1% dalam usia menopause, dengan sebagian besar kanker karsinoma duktal invasif (85,1%) grade 2 (68,1%) dan subtipe luminal A (42,6%). Kasus Denovo sebanyak 48,9%. Ditemukan metastasis multiple (91,5%) lesi osteolitik(29,8%) , dan berlokasi di Os. Vertebrae (31,7%). Sejalan dengan penelitian sebelumnya dan faktor risiko metastasis bone only, sehingga dapat dilakukan studi lanjutan berupa studi analitik maupun genomic untuk mengkonfirmasi hubungan kausalitas tiap variabel.

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Breast cancer is one of the most common types of cancer. As we know, cancer in one tissue can spread or metastasize to other tissues as secondary cancer, where in breast cancer 90% of deaths during treatment are attributed to these metastases. This study focuses on the characteristics of bone only metastases as a subtype of breast cancer bone metastases that has not been widely studied although its survival is better than breast cancer which metastases to other organs. This research uses a descriptive observational research design with a cross sectional study design with a total sampling technique. We found 1278 breast cancer with metastasis treated in RSCM within 2017-2022. There are 148 breast cancer bone metastasis only, but only 47 patients were included in the research due to the completed radiology data. Of the 47 patients, the characteristics of the 47 patients were 100% female; 70,2% aged 45-64 years-old ;46,8% Javanese ; 85,1% in menopausal age, 68,1% with grade 2 invasive ductal carcinoma and 42,6% luminal A subtype; 48,9% Denovo cases ; 91,5% suffered from Multiple osteolytic lesion metastases and 31,7% were located in Os. Vertebrae. In line with previous research and risk factors for bone only metastasis, further studies can be carried out in the form of analytical or genomic studies to confirm the causal relationship between each variable."

"Tujuan: Mengetahui pengaruh mutasi patogenik BRCA1/2 tumor terhadap kesintasan pasien advanced stage-high grade serous epithelial ovarian cancer di RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, dan RS MRCCC Siloam Jakarta.Metode: Sejumlah 68 sampel dari 144 pasien diagnosis high-grade serous epithelial ovarian cancer (HGSOC) stadium FIGO IIB-IV, periode 1 Januari 2015 sampai 31 Maret 2021, di RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, dan RS MRCCC Siloam Jakarta, menjalani pemeriksaan NGS mutasi patogenik BRCA1/2 tumor, dilibatkan dalam penelitian kohort historikal ini. Kami membandingkan karakteristik klinikopatologis pasien, dan hasil luaran kesintasan, setelah pasien menjalani tatalaksana primer, berdasarkan status mutasi patogenik BRCA1/2 tumor. Faktor terkait tatalaksana, yang diperkirakan berpengaruh terhadap hasil luaran kesintasan pasien, juga turut dianalisis dalam penelitian ini.Hasil: Angka kejadian mutasi patogenik BRCA1/2 tumor diketahui sebesar 27,94% (19/68). Antara kelompok mutasi patogenik BRCA1/2 tumor, dengan kelompok tanpa mutasi patogenik, tidak terdapat perbedaan statistik signifikan berdasarkan usia, paritas, indeks massa tubuh (kg/m2), riwayat kanker payudara, stadium FIGO 2014, kadar CA125 serum pre operatif (U/mL), volume cairan ascites intra operatif (mL), lesi residual pasca laparotomi debulking, pemberian neoadjuvant chemotherapy (NACT), pemberian kemoterapi adjuvant. Riwayat kanker keluarga terkait HBOC, merupakan variabel paling berpengaruh terhadap mutasi patogenik BRCA1/2 tumor. Kelompok dengan riwayat kanker keluarga terkait HBOC, berisiko 5,212 kali lebih besar mengalami mutasi patogenik BRCA1/2 tumor, dibandingkan dengan kelompok tanpa riwayat kanker tersebut (RR adjusted 5,212; 95%CI 1,495-18,167; nilai p=0,010).Pada kelompok mutasi patogenik BRCA1/2 tumor, kemungkinan meninggal 86% lebih rendah (RR adjusted 0,149; 95%CI 0,046-0,475; nilai p=0,001), dan median survival yang lebih baik (median 46 bulan; 95%CI 34,009-57,991; nilai p=0,001), apabila dibandingkan dengan kelompok tanpa mutasi patogenik (median 23 bulan; 95%CI 15,657-30,343; nilai p=0,001). Analisis multivariat menunjukkan mutasi patogenik BRCA1/2 tumor merupakan faktor prognostik independen yang baik terhadap hasil luaran kesintasan (RR adjusted 0,149; 95%CI 0,046-0,475; nilai p=0,001).Kesimpulan: Pasien advanced stage-high grade serous epithelial ovarian cancer, dengan mutasi patogenik BRCA1/2 tumor, memiliki kesintasan lebih baik, dibandingkan pasien tanpa mutasi patogenik BRCA1/2 tumor.

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Objective: To evaluate the impact of pathogenic BRCA1/2 tumor mutational status on advanced stage- high grade serous epithelial ovarian cancer survival outcome at RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, and RS MRCCC Siloam Jakarta.

Methods: A total 68 of 144 patients diagnosed with FIGO 2014 stage IIB-IV high grade serous epithelial ovarian cancer (HGSOC) between January 1st, 2015 until March 31st, 2021, at RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, and RS MRCCC Siloam Jakarta, underwent NGS tumor BRCA1/2 gene testing, and were included in this cohort hystorical study. We compared patients clinicopathological characteristics, and survival outcomes after primary treatment, according to pathogenic BRCA1/2 tumor mutational status. Treatment-related factors that might affect patients’ survival outcome were also investigated.

Results: The BRCA1/2 pathogenic tumor mutations prevalence was observed in this study 27.94% (19/68). There were no significant statistical differences in age, parity, body mass index (kg/m2), previous breast cancer history, FIGO 2014 staging, pre-operative serum CA 125 level (U/mL), intra operative ascites volume (mL), post cytoreductive surgery residual lesion, neoadjuvant chemotherapy (NACT), and adjuvant chemotherapy administration, between the pathogenic tumor BRCA1/2 mutation, and no pathogenic tumor BRCA1/2 mutation groups. The hereditary breast ovarian cancer family history (HBOC) variable has the strongest correlation with pathogenic tumor BRCA1/2 mutation. The group with a family history of HBOC-related cancer had a 5.212 times greater risk of developing pathogenic BRCA1/2 tumor mutations, compared with the group without a history of those cancer (RR adjusted 5.212; 95%CI 1.495-18.167; p value=0.010).

The pathogenic BRCA1/2 tumor mutation group displayed better survival outcome. In the pathogenic BRCA1/2 tumor mutation group, the likelihood of dying was 86% lower (RR adjusted 0.149; 95%CI 0.046-0.475; p-value=0.001), and the median survival was better (median 46 months; 95%CI 34.009- 57.991; p value=0.001), than without pathogenic BRCA1/2 tumor mutations group (median 23 months; 95%CI 15.657-30.343; p value=0.001). The multivariate analyses identified pathogenic BRCA1/2 tumor mutation as an independent favorable prognostic factor for survival outcome (RR adjusted 0.149; 95%CI 0.046-0.475; p-value=0.001).

Conclusions: In advanced stage-HGSOC, patients with pathogenic BRCA1/2 tumor mutations have a better prognosis with longer survival outcome than those without pathogenic BRCA1/2 tumor mutations."

"Latar belakang: Kanker ovarium merupakan salah satu penyakit dengan tingkat mortalitas tertinggi dan memerlukan tindakan operatif sebagai penanganannya. Meskipun didapatkan manfaat yang besar dari tindakan operasi, tidak jarang tindakan operasi menimbulkan komplikasi pada pasien. Belum terdapat penelitian mengenai komplikasi akibat operasi pada kanker ovarium di Indonesia, oleh sebab itu penelitian ini bertujuan mengetahui proporsi komplikasi akibat operasi pada pasien kanker ovarium di Indonesia. Metode: Penelitian ini merupakan penelitian potong lintang untuk menganalisis proporsi komplikasi intraoperatif dan postoperatif pada pasien kanker ovarium yang menjalani operasi laparotomi di RSUPN dr. Cipto Mangunkusumo, Jakarta pada Januari 2018 hingga Desember 2019. Pasien kanker ovarium yang menjalani operasi laparotomi diikutsertakan dalam penelitian. Pasien dengan Riwayat kanker lainnya atau memiliki data tidak lengkap dieksklusi dari penelitian. Komplikasi intraoperatif pada penelitian ini adalah cedera usus,cedera ureter, dan cedera vesika. Komplikasi postoperatif pada penelitian ini adalah sepsis, ileus paralitik, dan infeksi luka operasi. Hasil: Sebanyak 78 subjek diikutsertakan dalam penelitian. Didapatkan proporsi komplikasi secara total sebesar 19,2%. Komplikasi intraoperatif terbanyak secara proporsi adalah cedera usus (12,8%), cedera vesika (2,6%), dan cedera ureter (1,3%). Komplikasi postoperatif terbanyak secara proporsi adalah infeksi luka operasi (5,2%), sepsis (3,9%), dan tidak terdapat pasien yang mengalami ileus paralitik.Kesimpulan: Didapatkan proporsi komplikasi pada operasi kanker ovarium di RSUPNdr. Cipto Mangunkusumo pada Januari 2018 – Desember 2019 sebesar 19,2%.

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Background: Ovarian cancer is one of the diseases with the highest mortality rate while requires operative action to treat. Despite the great benefits of surgery, complications are not uncommon adverse effects of it. There has been no research on complications of ovarian cancer in Indonesia, therefore this study aims to investigate complications associated with ovarian cancer surgery in Indonesia.

Methods: This study was a cross-sectional study to analyze reports of intraoperative and postoperative complications in ovarian cancer patients undergoing laparotomy at dr. Cipto Mangunkusumo National General Hospital, Jakarta from January 2018 to December 2019. Ovarian cancer patients undergoing laparotomy surgery were

included in the study. Patients with a history of other cancers or having incomplete data were not excluded from the study. The intraoperative complications in this study were intestinal injury, ureter injury, and bladder injury. Postoperative complications in this study were sepsis, paralytic ileus, and surgical wound infection. Results: A total of 78 subjects were included in the study. The total proportion of complications was 19.2%. The most prevalent intraoperative complications were intestinal injury (12.8%), bladder injury (2.6%), and ureter injury (1.3%). Most prevalent postoperative complications reported were surgical wound infection (5.2%), sepsis (3.9%), while none of the patients had paralytic ileus. Conclusion: The proportion of complications in ovarian cancer surgery at dr. Cipto Mangunkusumo National General Hospital on January 2018 to December 2019 was 19.2%."

"Latar belakang: Kanker ovarium merupakan penyebab kematian kelima terbanyak karena kanker pada wanita. Diperlukan uji diagnostik preoperatif dan intraoperatif yang tajam dan akurat untuk menurunkan morbiditas dan mortalitas karena kanker ovarium. Tujuan: Mengetahui nilai diagnostik RMI, Skor Purwoto, dan potong beku terhadap pemeriksaan histopatologi pada tumor ovarium suspek ganas. Metode: Penelitian ini menggunakan desain potong lintang (cross-sectional) dari data sekunder yang berasal dari 114 rekam medis pasien suspek keganasan ovarium yang menjalani pembedahan antara bulan Januari 2010 hingga Desember 2010 di RSCM. Hasil: Nilai diagnostik untuk RMI adalah sensitivitas 85%, spesifisitas 63%, NDP 68%, NDN 82%, RKP 2,29, RKN 0,23, akurasi 74%, dan AUC 0,800. Nilai diagnostik untuk Skor Purwoto adalah sensitivitas 80%, spesifisitas 59,3%, NDP 65%, NDN 76%, RKP 1.97, RKN 0,34, akurasi 69%, dan AUC 0,780. Nilai diagnostik untuk potong beku adalah sensitivitas 93%, spesifisitas 98%, NDP 98%, NDN 94%, RKP 54,7, RKN 0,07, akurasi 96%, dan AUC 0,968. Kesimpulan: RMI dan skor Purwoto dapat digunakan untuk evaluasi diagnostik keganasan ovarium praoperatif. Meskipun telah dilakukan evaluasi kemungkinan keganasan praoperatif, tetap diperlukan pemeriksaan potong beku. Hasil evaluasi RMI dan Skor Purwoto jinak dapat ditatalaksana di pusat pelayanan dengan fasilitas yang tidak memerlukan surgical staging. Meskipun hasil evaluasi RMI dan skor Purwoto jinak sebaiknya tetap dilakukan pemeriksaan potong beku untuk menyingkirkan kemungkinan keganasan yang masih belum dapat dibuktikan dengan pasti melalui evaluasi praoperatif.

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Introduction: Ovarian cancer is the fifth leading cause of death from cancer in women. The sharp and accurate preoperative and intraoperative diagnostic tests are needed in reducing morbidity and mortality due to ovarian cancer.

Purpose: This study aims to determine the diagnostic value of RMI, Purwoto Score, and frozen section compared to histopathologic examination in suspected malignant ovarian tumors.

Methods: This study used cross-sectional design of secondary data from the medical records of 114 patients with suspected ovarian malignancy who underwent surgery between January 2010 and December 2010 at Cipto Mangunkusumo Hospital.

Results: The diagnostic value for RMI are sensitivity 85%, specificity 63%, PPV 68%, NPV 82%, positive likelihood ratio 2.29, negative likelihood ratio 0.23, accuracy 74%, and AUC 0,800. Diagnostic value for Purwoto Score are sensitivity 80%, specificity 59.3%, PPV 65%, NPV 76%, positive likelihood ratio 1.97, negative likelihood ratio 0.34, accuracy 69%, and AUC 0.780. Diagnostic value of frozen section are sensitivity 93%, specificity 98%, PPV 98%, NPV 94%, positive likelihood ratio 54.7, negative likelihood ratio 0.07, accuracy 96%, and AUC 0.968.

Conclusion: RMI and Purwoto Score can be used for preoperative diagnostic evaluation of ovarian malignancies. Although it has been performed preoperative evaluation of malignancy, is still required frozen section examination. Benign case of RMI and Purwoto Score can be managed at the service center with facilities that do not require surgical staging and still need to be confirmed with frozen section examination to rule out malignancy that still has not been proven with certainty through preoperative evaluation."