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"Pendahuluan: Kanker prostat merupakan jenis kanker yang paling sering kedua dan penyebab kematian kelima terbanyak di kalangan pria di seluruh dunia. Meskipun ada kemajuan dalam terapi, masalah kekambuhan dan resistensi terhadap pengobatan masih menjadi perhatian, seperti kanker prostat metastasis resisten kastrasi (MCRPC) yang tidak merespons terapi pengurangan androgen tradisional. Penghambat Poly ADP-ribose polymerase (PARP) dianggap sebagai pengobatan yang menjanjikan untuk pasien MCRPC. Oleh karena itu, kombinasi terapi PARP dan antiandrogen perlu dievaluasi.Bahan & Metode: Review sistematis dilakukan dengan mengikuti panduan Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Pencarian literatur dilakukan pada lima basis data yang berbeda dan disaring sesuai dengan kriteria PICO yang ditentukan. Pengambilan data dilakukan untuk membandingkan Kelangsungan Hidup Bebas Progresi (PFS), Kelangsungan Hidup Keseluruhan (OS), Kualitas Hidup Terkait Kesehatan (HRQOL), dan efek samping, dilanjutkan dengan analisis kuantitatif.Hasil & Diskusi: Sebanyak empat RCT yang memenuhi syarat, termasuk dua studi besar, dimasukkan dalam penelitian ini. Analisis PFS menunjukkan penurunan risiko yang signifikan dengan rasio bahaya (HR) sebesar 0.53 (95% CI 0.43-0.66;p<0.001). Hasil serupa juga ditemukan dengan penurunan risiko kematian dengan OS HR sebesar 0.75 (95% CI 0.58-0.97;p=0.03). Analisis HRQOL pada Functional Assessment of Cancer Therapy - Prostate (FACT-P) melaporkan hasil yang tidak signifikan [HR=0.97 (95% CI 0.80-1.17;p=0.72)], dengan hasil serupa pada skor rasa sakit terburuk BPI-SF [HR=0.66 (95% CI 0.32-1.35;p=0.26). Analisis efek samping cukup menarik dengan penurunan risiko pada efek samping ringan dan risiko lebih besar pada kejadian efek samping yang parah, dengan efek kumulatif perbedaan efek samping yang tidak signifikan antara kedua kelompok [HR=1.13 (95% CI 0.79-1.62;p=0.49).Kesimpulan: Penambahan penghambat PAPR pada pengobatan pasien mCRPC secara signifikan meningkatkan PFS dan OS tanpa memberikan dampak negatif pada HRQoL dan efek samping. Studi lanjutan harus dilakukan untuk menentukan manfaatnya dalam berbagai pengaturan.

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ntroduction: Prostate cancer is the second most common cancer and the fifth leading cause of death among men worldwide. Despite the advancement in therapy, recurrence and resistancy after treatment is still a concerning issue, such as metastatic castration-resistant prostate cancer (MCRPC) which is resistant to traditional androgen-deprivation therapy (ADT). Poly ADP-ribose polymerase (PARP) inhibitor is hailed as a promising treatment for MCRPC patients. Thus, combination therapy on PARP and antiandrogen should be evaluated.

Material & Methods: Systematic review was conducted by adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The literature search were conducted on five different databases and screened against the predetermined PICO criteria. Data extraction were completed to compare Progression-Free Survival (PFS), Overall Survival (OS), Health-Related Quality of Life (HRQOL), and adverse effects, continued by quantitative analysis

Results & Discussion: A total of four eligible RCTs, comprising of two large studies were included. The PFS analysis has reported significant risk reduction with hazard ratio (HR) of 0.53 (95% CI 0.43-0.66;p<0.001). Similar results are also found with reduced risk of death with OS HR of 0.75 (95% CI 0.58-0.97;p=0.03). The HRQOL analysis on Functional Assessment of Cancer Therapy - Prostate (FACT-P) reported insignificant results [HR=0.97 (95% CI 0.80-1.17;p=0.72)], with similar results with the BPI-SF worst pain score [HR=0.66 (95% CI 0.32-1.35;p=0.26). The adverse effects analysis was quite interesting with risk reduction on mild adverse effects and

greater risk in severe adverse events, with a cumulative effect of insignificant adverse events difference among the two group [HR=1.13 (95% CI 0.79-1.62;p=0.49).

Conclusion: The addition of PAPR inhibitor to the treatment of mCRPC patients has significantly improved the rPFS and OS with no negative impact on HRQoL and adverse effects. Further studies should be conducted to determine the benefits in various settings.

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"Pendahuluan: Kanker prostat adalah keganasan terbanyak pada pria, penyebab kematian kedua terbesar akibat keganasan. Colok dubur adalah pemeriksaan dasar dan deteksi dini untuk mendiagnosis kanker prostat. Saat ini pemeriksaan Prostate-Specific Antigen (PSA) dianggap sebagai tumor marker yang paling bermanfaat untuk mendeteksi kanker prostat. The American Cancer Society dan American Urologic Association merekomendasikan penyaringan kanker prostat setiap tahun dengan pemeriksaan colok dubur dan PSA. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan antara pemeriksaan colok dubur dan nilai PSA pada pasien kanker prostat di RSUP DR Sardjito Yogyakarta periode Januari 2011 sampai Desember 2011. Metode Penelitian: Penelitian ini adalah kasus kontrol. Data dikumpulkan secara retrospektif dari catatan medis RSUP DR Sardjito pada pasien dengan colok dubur yang abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl selama periode Januari 2011 sampai Desember 2011. Hasil pemeriksaan colok dubur dan nilai PSA didapatkan pada saat kunjungan pertama pasien ke rumah sakit. Analisis data nominal menggunakan Chi Square dengan SPSS 18. Hasil: Terdapat 87 pasien yang berhasil dikumpulkan selama periode Januari 2011 sampai Desember 2011 yang memiliki hasil pemeriksaan colok dubur abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl. Pasien memiliki usia rata-rata 70 tahun, nilai median PSA 10,9 ng/dl. Pada pasien ini ditemukan colok dubur abnormal 43 (49,4%), colok dubur normal 44 (50,6%), PSA ≥ 10 ng/dl 69 (79,3%) dan PSA < 10 ng/dl 18 (20,7%). Pemeriksaan colok dubur dan PSA dinilai signifikan secara statistik untuk mendeteksi kanker prostat, hasil secara berurutan 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002. Semua pasien dengan colok dubur abnormal dan PSA ≥ 10 ng/dl terdiagnosis kanker prostat (p < 0,001). Simpulan: Pemeriksaan colok dubur dan Prostate Specific Antigen (PSA) adalah prediktor terbaik untuk kanker prostat.

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Introduction: Prostate cancer is the most frequent form of cancer in males, being also second cause of death by cancer. Digital Rectal Examination (DRE) is the basic examination and early diagnosis for prostate cancer. The Prostate-Specific Antigen (PSA) assay is currently considered the most useful tumor marker for detecting prostate cancer. Both the American Cancer Society and American Urologic Association recommended annual cancer screening with both Digital Rectal Examination (DRE) and PSA.

Objective: The objective of this study is to understand the correlation between DRE and PSA level in prostate cancer at Sardjito General Hospital Yogyakarta during januari 2011 until december 2011.

Research Method: This is a case control study. The data were retrospectively collected from medical record in sardjito general hospital who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl during januari 2011 until December 2011. The DRE and PSA value were examined in the first time they came to the hospital. A chi-square was performed to analyzed the nominal data with SPSS 18.

Result: There are 87 patients were collected during januari 2011 until December 2011 who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl. The median age was 70 years, median PSA level was 10,9 ng/dl. Of these patient, we found abnormal DRE in 43 (49,4%), normal DRE in 44 (50,6%), PSA ≥ 10 ng/dl was 69 (79,3%) and PSA < 10 ng/dl was 18 (20,7%). Digital Rectal Examination and PSA was statistically significant to detected prostate cancer, 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002), respectively. All patient who had abnormal DRE and PSA ≥ 10 ng/dl were diagnosed with prostate cancer (p < 0,001).

Conclusion: Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) are the best predictor for prostate cancer. "

"Tujuan: Untuk mengetahui bagaimana upaya diagnosis kanker prostat yang dilakukan oleh spesialis urologidi Indonesia. Metode: Dilakukan pembagian kuesioner yang dirancang sendiri kepada Spesialis Urologi di Indonesia. Kuesioner berisi 11 pertanyaan tentang jenis dan indikasi pemeriksaan yang dilakukan, serta fasilitas yang tersedia di tempat responden dalam penegakan diagnosis kanker prostat. Hasil: Sebanyak 65 (36%) dari 182 (saat penelitian ini dilakukan) spesialis urologi di Indonesia mengembalikan formulir kuesioner. Dari jenis RS primer tempat bekerja terbanyak berasal dari RS swasta (35%), disusul RS pendidikan utama Fakultas Kedokteran (32%). Seluruh responden menjadikan lower urinary tract symptoms (LUTS) sebagai indikasi untuk melakukan pemeriksaan colok dubur. Selain itu 83% responden juga menjawab, peningkatan PSA sebagai salah satu indikasi pemeriksaan colok dubur. Pemeriksaan PSA dilakukan oleh 72% responden pada penderita dengan kecurigaan kanker prostat tanpa melihat usia. Sebanyak 66% responden mengerjakan sendiri pemeriksaan transrectal ultrasonografi (TRUS) dan biopsi, 18% merujuk pada sejawat lain di propinsi yang sama dan 15% tidak memiliki fasilitas TRUS dan biopsi di propinsi tempat bekerja. Sebanyak 75% responden memiliki fasilitas bone scan di Rumah Sakit primer, atau tersedia di RS pada propinsi yang sama. Indikasi tersering melakukan biopsi prostat adalah pada PSA lebih dari 10 ng/ml tanpa melihat usia. Sebanyak 86% responden melakukan biopsi pada kecurigaan kanker prostat melalui colok dubur tanpa melihat usia. Sembilan puluh persen responden menggunakan antibiotik profilaksis golongan Kuinolon untuk biopsi prostat. Sebanyak 46% menggunakan analgesia oral atau suppositoria atau kombinasi keduanya sebagai analgesia dalam biopsi prostat. Kesimpulan: Dalam mendiagnosis kanker prostat, spesialis urologi di Indonesia melakukan pemeriksaan colok dubur, PSA dan TRUS biopsi prostat, namun masih terdapat perbedaan pendapat tentang indikasi dan waktu dilakukannya masing-masing pemeriksaan. Ketersediaan fasilitas diagnostik juga berpengaruh dalam diagnostik kanker prostat di Indonesia. Belum tersedianya guideline Nasional pada saat penelitian ini dilakukandiduga menyebabkan perbedaan pendapat tersebut.

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Purpose: To get information on diagnosis of prostate cancer conducted by urologist in Indonesia.

Method: A self-constructed questionnare of 11 questions about the type and indication of the tests, as well as the available facilities at the place of the respondents to diagnose prostate cancer distributed to Indonesian Urologist.

Result: As much as 65 (36%) from 182 (when the survey was conducted) Indonesian Urologist returned the questionnare. Most of them worked in Private Hospital (35%), followed by Medical School Hospital (32%). All respondents performed DRE in patients with Lower Urinary Tract Symptoms (LUTS). Elevated PSA was also indication for conducting DRE in 83% respondents. PSA level was tested by 72% respondents in patients with suspicion of prostate cancer regardless of age. As much as 66% respondents did Trans Rectal Ultrasound (TRUS) and prostate biopsy by themselves, 18% referred to other urologists in the same province and 15% didn?t have TRUS and prostate biopsy facilities in their province. Bone scan was available in the Primary Hospital or another hospital in the province of 75% respondents. Main indication to perform prostate biopsy was elevated PSA level above 10ng/ml regardless of the age. Meanwhile, 86% respondents did prostate biopsy in suspiciousness of prostate cancer by DRE regardless of age. Most respondents (90%) chose Quinolon as prophylaxis antibiotic in prostate biopsy and 46% respondents used oral analgesia or suppository or both in prostate biopsy.

Conclusions: In diagnosing prostate cancer, Indonesian Urologists performed DRE, PSA serum analysis and TRUS biopsy of the prostate. But the Indonesian Urologists still had different opinions about the indications and timing of the procedure. The availability of diagnostic equipment and unavailability of National Guideline of Prostate Cancer when this study was conducted played a role of how the prostate cancer diagnosed in Indonesia."

"Kanker prostat adalah penyakit progresif yang menghasilkan moribiditas dan mortalitas yng tinggi. Penelitian ini berutujuan untuk menilai ketepatan dari Indonesian Prostate Cancer Risk Calculator IPCRC dalam memprediksi risiko kanker prostate. Data penelitian didapatkan secara retrospektif selama periode Agustus 2014 hingga Desember 2015 dari rekam medis pasien terduga kanker prostat. Pemeriksaan colok dubur, Prostate specific antigen PSA, dan volume prostat digunakan sebagai parameter prediktif dalam IPCRC. Biopsi prostat digunakan sebagai standar baku. Akurasi IPCRC divalidasi dengan menggunakan analisis ROC. Penelitian ini memiliki 127 subjek penelitian dengan median usia pasien BPH dan pasien kanker prostat adalah 66 52-85 dan 69.5 50-100 tahun. Pemeriksaan colok dubur yang tidak normal ditemukan pada 2 pasien 2. Median dari PSA dari pasien BPH dan kanker prostat dalah 10.2 1.6-203.1 dan 74.06 6.94-1412. Volume prostate pasien BPH memiliki median sebesar 47.9 13.774-108 dibandingkan 50.25 19.2-107 pada pasien kanker prostate. Area tersebesar dibawah kurva probabilitas kanker prostat adalah 0.907 95 CI 0.84-0.97. Jika probabilitas kanker prostate lebih dari 15 pada IPCRC, sensitivitas IPCRC mencapai 88.5 dan spesifitas IPCRC mencapai 81.8, dimana bila ditemukan probabilitas kanker prostate lebih dari 20 dengan menggunakan IPCRC, sensitivitasnya mencapai 80.8 dengan spesifitas sebesar 89.9. Dan bila probabilitas kanker prostate lebih dari 25 dalam IPCRC, sensitivitas sebesar 65.4 dan spesifisitas sebesar 89.9. Sehingga, dapat disimpulkan IPCRC merupakn perangkat yang akurat dalam prediksi kanker prosate pada populasi ini. Validasi lebih lanjut masih dibutuhkan pada populasi lain.

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Prostate cancer is a progressive disease resulting in morbidity and mortality. The aim of this study is to assess the accuracy of Indonesian Prostate Cancer Risk Calculator IPCRC in predicting prostate cancer risk. Data were obtained retrospectively during August 2014 to December 2015 from medical records of suspected prostate cancer patients. Digital rectal examination, Prostate Specific Antigen PSA, and prostate volume PV were used as predictive parameters in IPCRC. Prostate biopsy was used as the diagnostic gold standard. The accuracy of IPCRC was validated using the ROC analysis. Our study included 127 subjects. Median age of BPH patients and prostate cancer patients were 66 52-85 and 69.5 50-100. The digital rectal examination was found abnormal in 2 patients 2. Median of PSA of BPH patients and prostate cancer patients were 10.2 1.6-203.1 and 74.06 6.94-1412 respectively. The prostate volume of BPH patients 47.9 13.74-108 median compared to prostate cancer patients 50.25 19.2-107 median. The largest area under the curve of the probability of prostate cancer using IPCRC is 0.907 95 CI 0.84-0.97. If the probability of prostate cancer more than 15 using IPCRC, the sensitivity is 88.5 and specificity is 81.8, besides, if the probability of prostate cancer more than 20 using IPCRC, the sensitivity is 80.8 and specificity is 89.9 and if the probability of prostate cancer more than 25 using IPCRC, the sensitivity is 65.4 and specificity is 89.9 IPCRC is accurate for predicting prostate cancer in our population. Further validation is needed in other population. "

"Kematian yang disebabkan oleh kanker diperkirakan akan terus meningkat, terutama untuk kanker prostat. Penyakit ini adalah jenis kanker yang paling umum untuk pria di dunia. Jumlah kematian dapat dikurangi dengan deteksi dini menggunakan machine learning. Salah satunya adalah klasifikasi data kanker prostat. Data kanker yang digunakan memiliki berbagai fitur, tetapi tidak semua fitur adalah fitur penting. Dalam penelitian ini, kami menggunakan Support Vector Machine-Recursive Feature Elimination (SVM-RFE) dan One Dimensional Naïve Bayes Classifier (1-DBC) sebagai metode seleksi fitur. Dalam kedua metode itu akan mendapatkan peringkat untuk setiap fitur. Penggunaan kedua metode ini dalam klasifikasi data kanker prostat menghasilkan tingkat evaluasi yang tinggi. Kedua metode ini dapat menghasilkan tingkat akurasi 100%, precision 100%, dan recall 100% pada metode klasifikasi Random Forest. Dan menghasilkan tingkat akurasi 95%, precision 100%, dan recall 94,11% pada metode klasifikasi SVM. Dalam evaluasi tambahan, SVM-RFE memiliki running time lebih rendah dari 1-DBC.

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Death caused by cancer is expected to continue to increase, especially for prostate cancer. This disease is the most common type of cancer for men in the world. The number of deaths can be reduced by early detection using machine learning. One of them is the classification of prostate cancer data. Cancer data used has various features, but not all features are essential features. In this study, we use Support Vector Machine-Recursive Feature Elimination (SVM-RFE) and One Dimensional Naïve Bayes Classifier (1-DBC) as a feature selection method. In both methods, it will get a rating for each feature. The use of these two methods in the classification of prostate cancer data produces a high level of evaluation. Both of these methods can produce 100% accuracy, 100% precision, and 100% recall in the Random Forest classification method. And it produces 95% accuracy, 100% precision, and 94.11% recall in the SVM classification method. In the additional evaluation, SVM-RFE has a running time lower than 1-DBC."

"Kanker prostat merupakan kanker yang terdiagnosis kedua terbanyak dan mendudukiperingkat keenam dari penyebab kematian pada pria di seluruh dunia. Diperkirakan914.000 kasus ditemukan dan berperan dalam 6% (258.400) dari total angka kematiandi tahun 2008. Telah diciptakan Indonesian Prostate Cancer Risk Calculator (IPCRC)yang diperoleh dari penelitian multisenter sebelumnya, namun masih perlu dilakukanvalidasi eksternal untuk menguji validitas dari kalkulator tersebut. Kami inklusikanseluruh pasien pembesaran prostat jinak (BPH) dan kanker prostat (PCa) yangmenjalani biopsi prostat ataupun prostatektomi di RS Adam Malik Medan pada periode11 Agustus sampai 31 Desember 2014. Dilakukan analisis untuk membandingkanvariabel-variabel yang terkait resiko kanker prostat, termasuk: usia, kadar PSA, volumprostat, dan temuan pemeriksaan colok dubur (DRE). Kemudian resiko kanker prostatpada masing-masing pasien dihitung menggunakan IPCRC dan dianalisis hasilnyamenggunakan kurva receiver operating characteristic (ROC). Kami jugamembandingkan hasilnya dengan luas area di bawah kurva (AUC) untuk PSA. Padastudi ini dijumpai 21 pasien PCa dan 24 pasien BPH. Rata-rata umur, PSA, dan volumprostat secara berturut-turut adalah 66.8±7.3 tahun, 27.3±32.2 ng/ml, dan 64.9±38.1 ml.Temuan DRE abnormal dijumpai pada 6 pasien PCa dan 1 pasien BPH. Seluruhvariabel antara PCa dan BPH tidak berbeda signifikan (p>0.05). AUC dari IPCRCadalah 79.8% (95% IK= 66.2%-93.3%; p=0.001) dalam memprediksi kanker prostat.Analisis ROC IPCRC memiliki sensitivitas 85.7% dan spesifisitas 70.8%. AUC IPCRCini lebih tinggi daripada AUC PSA dengan selisih sebesar 11.4%. Indonesian ProstateCancer Risk Calculator (IPCRC) lebih baik daripada PSA tunggal dalam memprediksikejadian kanker prostat. Validasi dan studi prospective lebih lanjut dengan sampel yanglebih besar perlu dilakukan.

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Prostate cancer is the second most frequently diagnosed cancer and the sixth leadingcause of cancer death in men worldwide. It was estimated 914.000 new cases werefound and responsible for 6% (258.400) of total cancer deaths in men in 2008.Indonesian Prostate Cancer Risk Calculator (IPCRC) was developed from a multicentricstudy to predict the risk of prostate cancer in suspected patient. An externalvalidation is needed to c onfirm the validity of the calculator. We included all benignprostatic hyperplasia (BPH) and prostate cancer (PCa) patients who underwent prostatebiopsy and prostatectomy in Adam Malik Hospital between August 11th and December31st 2014. The relationship between variables affecting the percentage of prostatecancer risk were evaluated, including: age, PSA level, prostate volume, and digitalrectal examination (DRE) findings. We calculated the risk of prostate cancer for eachpatient using IPCRC and analyse the results using the receiver operating characteristic(ROC) curve. We also compared them with the area under curve (AUC) of PSA results.There were 21 PCa and 24 BPH patients in our study. The mean ages, PSA, and prostatevolume were 66.8±7.3 years old; 27.3±32.2 ng/ml and 64.9±38.1 ml, repectively.Abnormal DRE was found in 6 PCa and 1 BPH. Each variable didnt show significantdifference between PCa and BPH groups (p > 0.05). The AUC of IPCRC was 79.8%(CI 95%: 66.2%-93.3%; p=0.001) in predicting prostate cancer. The ROC analysis ofIPCRC had sensitivity of 85.7% and specificity of 70.8%. This AUC of IPCRC washigher than of PSA, with 11.4% difference. The Indonesian Prostate Cancer RiskCaluclator is better than PSA alone in predicting prostate cancer in this population.Further validation and future prospective study in larger population is needed."

"The volume provides an introduction to the concept of active surveillance in oncology in general and prostate cancer specifically. The primary focus is to provide a comprehensive guide to the management of patients on surveillance. The volume covers the many complexities and nuances to this approach including, patient selection, risk assessment, how to overcome 'cancer hysteria' when counseling patients, identifying appropriate triggers for intervention, use of PSA kinetics and MR imaging information, technique and frequency of biopsies, secondary prevention interventions, and the relative roles of surveillance and focal therapy."

"[ABSTRAKTujuan: Insiden kanker prostat secara global terus meningkat. Meskipun dapat dilakukan deteksi dini kanker prostat, perlu dipahami bahwa progresivitas penyakit ? menjadi metastasis ? berbeda untuk setiap pasien. Penelitian ini bertujuan untuk mengamati aspek-aspek yang mungkin berperan sebagai faktor prediktif metastasis pada kanker prostat tidak terpalpasi.Material dan Metode: Data dikumpulkan dari Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dan Rumah Sakit Pusat Kanker Nasional Dharmais sejak tahun 1995-2013. Pasien dengan kanker prostat tidak terpalpasi kemudian dibagi menjadi dua kelompok: dengan metastasis dan tanpa metastasis. Usia, volume prostat, nilai prostate-spesific antigen (PSA), Gleason score sum group, stadium tumor, Karnofsky performance score (KPS), kadar hemoglobin, dan kadar kreatinin serum merupakan faktor yang dianalisis dalam penelitian ini. Data dianalisis menggunakan analisis bivariat dan uji regresi logistik. Hanya pasien dengan data lengkap yang dimasukkan dalam penelitian ini.Hasil: Didapatkan 91 pasien dengan data lengkap, 59 pasien (64,83%) tanpa metastasis dan 32 pasien (35,16%) dengan metastasis. Terdapat perbedaan statistik yang signifikan antara kelompok tanpa metastasis dan kelompok dengan metastasis, yakni untuk PSA (13.7ng / mL vs 71.5ng / mL; p = 0,001), kadar hemoglobin (13,60 g / dL vs 12,25 g / dL; p = 0,002), dan KPS (90 vs 90 ; p = 0,004). Perbedaan yang signifikan secara statistik juga didapatkan pada kelompok GSS (35 dan 24 pada kelompok tanpa metastasis vs 12 dan 20 pada kelompok dengan metastasis; p = 0,047). Usia, volume prostat, stadium tumor, dan kadar kreatinin antara kedua kelompok tidak memiliki perbedaan signifikan secara statistik (p> 0,05). Nilai pretreatment PSA adalah satu-satunya faktor prediktif untuk metastasis dengan odds ratio 1.014 (95% CI, 1,005-1,022; p = 0,002).Kesimpulan: Sebagian besar pasien kanker prostat tidak terpalpasi terdeteksi pertama kali tanpa metastasis. Nilai pretreatment PSA yang diperoleh pada kunjungan awal pasien dapat digunakan sebagai faktor prediktif metastasis di masa depan.

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ABSTRACTObjective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future., Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.]"

"ABSTRAKTujuan: Mengetahui batasan nilai PSA untuk memprediksi adanya metastasis tulang pada pasien kanker prostat di RS Sardjito. Metode: Penelitian retrospektif, dengan mengumpulkan rekam medis pasien kanker prostat telah dilakukan bone scintigraphy di RS Sardjito tahun 2006 - 2011.Hasil: Dari 83 pasien kanker prostat yang telah dilakukan bone scintigraphy, terdapat 55 pasien (66%) mengalami metastasis tulang dan terdapat 28 pasien (34 %) yang tidak mengalami metastasis tulang. Dari 55 pasien yang mengalami metastasis tulang, terdapat 11 pasien (20 %) dengan PSA kurang dari 20 ng/ml dan terdapat 44 pasien (80 %) yang memiliki PSA lebih dari 20 ng/ml. Cut-off point PSA 17.65 ng/ml memiliki sensitivitas terbesar yaitu 85.5% dan spesifisitas 53.6%.Kesimpulan: Pemeriksaan bone scintigraphy dianjurkan pada pasien dengan PSA > 17.65 ng/ml, sedangkan pada pasien dengan PSA < 17.65 dianjurkan pada pasien dengan gejala klinis nyeri tulang.

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ABSTRACTObjective: Prostate cancer shows a strong predilection to spread to the bones, with bone metastases identified at autopsy in up to 90 % of patients dying from prostate cancer. Serum prostate specific antigen (PSA) concentration has been widely applied as a biomarker to diagnose and monitor prostate cancer. Technetium-99m methylene diphosphate (Tc—99m MDP) whole body bone scintigraphy is currently a well-accepted diagnostic procedure for bone metastasis in malignancy. The aim of this study was to establish a useful serum PSA cut-off value to predict the presence of bone metastasis in men with prostate cancer. Material and Methods: Consecutive male patients diagnosed with prostate cancer were retrospectively analyzed. All of the subjects had received Tc-99m MDP whole body bone scintigraphy and had their serum PSA concentration measured at Sardjito Hospital, Yogyakarta. The proper cut-off value was established based on statistical analysis in order to predict the possibility of bone metastasis among prostate cancer patients.Results: In total, 83 consecutive male patients with prostate cancer were enrolled, and 55 patients (66 %) were confirmed by scintigraphic findings to have bone metastases. A serum PSA concentration of 17,65 ng/ml gave the best sensitivity (78,33 %) and specificity (65,21 %). The positive predictive value, negative predictive value were 85,45 % and 53,57 %, respectively (p<0,05).Conclusion: A cut-off value of 17,65 ng/ml appears to be an appropriate benchmark for stratifying metastatic bone disease in prostate cancer patients at Sardjito Hospital, Yogyakarta, such that if a patient with newly diagnosed prostate cancer and without any skeletal symptoms has a serum PSA concentration of less than 17,65 ng/ml,we suggest that they would not need to undergo bone scintigraphy."

"[ABSTRAKLatar Belakang: Kanker prostat adalah kanker yang paling umum pada pria. Kanker terjadi karena hilangnya kontrol atas proliferasi sel dan apoptosis sehingga sel berproliferasi terus menerus tanpa ada kematian sel. Apoptosis diregulasi oleh beberapa protein tertentu diantaranya protein keluarga Bcl-2 dan protein kanal. Perkembangan kanker prostat memerlukan transformasi dari sel epitel yang normal menjadi sel ganas yang kehilangan kemampuan untuk mengakumulasi zinc. Salah satu efek utama zinc adalah mencegah pertumbuhan sel kanker prostat dengan menginduksi apoptosis dengan memfasilitasi proses pembentukan pori Bax yang memulai apoptogenesis mitokondria. Selain keluarga Bcl-2, VDAC1 juga berperan penting dalam proses apoptosis. Beberapa penelitian menyatakan Bcl-2 mempunyai kaitan erat dengan VDAC1 terkait proses apoptosis dan protein pro-apoptotik Bax juga secara langsung berinteraksi dengan VDAC yang kemudian menginduksi keluarnya sitokrom c dari membran mitokondria.Tujuan: Mengevaluasi ekspresi mRNA dari gen mengkode keluarga protein Bcl-2 (Bax dan Bcl-2) dalam proses apoptogenesis pada galur sel kanker prostat yg diinduksi oleh zinc; Mengevaluasi ekspresi mRNA dari gen VDAC1 dalam proses apoptogenesis pada galur sel kanker prostat yang diinduksi oleh zinc; Menganalisis hubungan antara ekspresi VDAC1 dengan protein keluarga Bcl-2 pada apoptogenesis galur sel kanker prostat.Desain: Penelitian ini menggunakan eksperimental in vitro dan analisis statistikMetode: Untuk memperbanyak galur sel kanker prostat (PC3) dilakukan kultur sel, kemudian diberi perlakuan dengan tiga kelompok (kontrol, zinc 20 μM dan staurosporin 0,16 μM). Selanjutnya dilakukan isolasi RNA dan elektroforesis RNA untuk mengetahui keutuhan RNA. Terakhir dilakukan qRT PCR yang kemudian datanya dianalisis secara statistika.Hasil: Ekspresi Bax, Bcl-2 dan VDAC1 pada galur sel kanker prostat (PC-3) yang diberi perlakuan zinc mengalami penurunan dibandingkan dengan kontrol (tidak diberi perlakuan). Akan tetapi penurunan ekspresi tersebut tidak bernilai signifikan karena nilai p > 0,05 (nilai signifikansi Bax = 0,309; nilai signifikansi Bcl-2 = 0,236; nilai signifikansi VDAC1 = 0,437). VDAC1 mempunyai korelasi yang signifikan (p < 0,05) dengan Bax (p = 0,01) dibandingkan dengan Bcl-2 (p = 0,118).Kesimpulan: Terjadi perubahan ekspresi pada setiap gen (Bax, Bcl-2 dan VDAC1) pada galur sel kanker prostat yang diberi perlakuan zinc dengan yang tidak diberi perlakuan, akan tetapi tidak bernilai signifikan. VDAC1 mempunyai korelasi yang bermakna dengan Bax dan mempunyai korelasi yang tidak bermakna dengan Bcl-2.

ABSTRACT

Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2.;Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2., Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2.]"