Hasil Pencarian  ::  Simpan CSV :: Kembali

"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.

---

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."

"Latar Belakang Kanker adalah penyebab kematian secara global dan merupakan penyebab utama kematian pada anak. Dampaknya besar pada anak-anak di negara berpenghasilan rendah dengan tingkat kelangsungan hidup di bawah 30% akibat diagnosis terlambat, pengobatan yang tidak memadai, dan diagnosis tidak tepat. Hingga saat ini, belum ada publikasi terkait epidemiologi kanker anak pada pasien RSCM. Metode Penelitian ini adalah studi deskriptif mengenai epidemiologi kanker pada anak di Rumah Sakit dr. Cipto Mangunkusumo pada tahun 2017 sampai dengan 2022. Penelitian ini menggunakan rekam medis dari Departemen Ilmu Kesehatan Anak RSCM. Hasil Di RSCM, terdapat 1699 kasus kanker anak pada tahun 2017-2022. Sepuluh kasus kanker anak tertinggi adalah leukemia limfositik akut (630 kasus, 39,5%), diikuti oleh leukemia mieloid akut (311 kasus, 19,5%), retinoblastoma (221 kasus, 13,8%), tumor tulang (100 kasus, 6,3%), neuroblastoma (81 kasus, 5,1%), limfoma non-Hodgkin (73 kasus, 4,6%), rhabdomiosarcoma (70 kasus, 4,4%), leukemia mieloid kronik (54 kasus, 3,4%), hepatoblastoma (31 kasus, 2,0%), dan tumor otak (23 kasus, 1,5%). Pasien laki-laki memiliki kemungkinan 1,3 kali lebih tinggi untuk mengalami kanker (971 kasus, 57,1%). Pasien dengan kategori usia 0-5 tahun mempunyai prevelansi kanker paling tinggi (881 kasus, 51,9%), dan kebanyakan berdomisili di DKI Jakarta (552 kasus, 32,5%). Luaran pasien kebanyakan pada tahap loss-to-follow-up (664 kasus, 39,0%), dan 2021 adalah tahun dengan kasus terbanyak (335 kasus, 19,7%). Kesimpulan Dengan mengetahui epidemiologi kanker anak di RSCM, dapat dibuat sebuah strategi untuk prioritas penanganan kasus kanker tertinggi pada anak. Lalu, menjaga database yang terkini dengan melakukan follow-up secara berkala untuk mendapatkan data yang akurat mengenai relaps, kematian, penyembuhan, dan lost-to-follow-up dan dibutuhkan sebuah studi epidemiologi multi-senter yang mencakup prevalensi kanker anak di Indonesia untuk memperbaiki penanganan kanker anak.

---

Introduction Cancer is a leading global cause of death, particularly among children. Its impact is substantial in low-income countries, where survival rates are below 30% due to delayed diagnosis, inadequate treatment, and misdiagnosis. To date, there have been no publications regarding the epidemiology of childhood cancer in RSCM patients. Method This research is a descriptive study on the Epidemiology of Childhood Cancer at dr. Cipto Mangunkusumo Hospital from 2017 to 2022. This study utilizes medical records from the Department of Pediatrics at RSCM. Results At RSCM, there were 1699 cases of childhood cancer from 2017 to 2022. The top ten childhood cancer cases were acute lymphoblastic leukemia (630 cases, 39.5%), followed by leukemia mieloid akut(311 cases, 19.5%), retinoblastoma (221 cases, 13.8%), bone tumors (100 cases, 6.3%), neuroblastoma (81 cases, 5.1%), non-Hodgkin lymphoma (73 cases, 4.6%), rhabdomyosarcoma (70 cases, 4.4%), chronic myeloid leukemia (54 cases, 3.4%), hepatoblastoma (31 cases, 2.0%), and brain tumors (23 cases, 1.5%). Male patients have a 1,3 times higher likelihood of experiencing cancer (971 cases, 57.1%). Patients in the 0-5 age group have the highest cancer prevalence (881 cases, 51.9%), and most of them reside in Jakarta (552 cases, 32.5%). The majority of patients had an outcome classified as loss-to-follow-up (664 cases, 39.0%), and 2021 had the highest number of cases (335 cases, 19.7%). Conclusion By understanding the epidemiology of childhood cancer at RSCM, a strategy can be developed to prioritize the management of the highest cases of childhood cancer. Maintaining an up-to-date database by conducting regular follow-ups is essential to obtain accurate data on relapses, deaths, recoveries, and cases lost to follow-up. A multicenter epidemiological study that includes the prevalence of childhood cancer in Indonesia is needed to improve the management of childhood cancer."

"Praktik residensi spesialis Keperawatan Medikal Bedah peminatan Onkologi berfokus pengaplikasian perawat dalam pemberi asuhan keperawatan, pendidik, dan peneliti. Peran sebagai pemberian asuhan keperawatan dilaksanakan dengan melakukan pengelolaan 30 pasien keganasan kanker dan satu kasus yang dijadikan kasus kelolaan pasien yang terdiagnosa kanker payudara metastase paru, hati dan tulang menggunakan pendekatan teori Peacefull End Of Life (PEOL). Pelaksanaan penerapan intervensi keparawatan berbasis bukti ilmiah merupakan perawat sebagai peneliti dalam bentuk ponerapan Progresif Muscle Relaxation (PMR) terhadap penurunan kecemasan dan nyeri pasca pembedahan abdomen. peran perawat sebagai pendidik dilaksanakan dalam bentuk implementasi penggunaan aplikasi J-Hati (jalan sehat berenergi) dengan memberikan latihan fisik walking exercise berbasis android kepada pasien kanker dengan masalah fatigue. Seluuruh rangkaian kegiatan praktek residensi ini mempunyai tujuan untuk meningkatkan kualitas dan profesionalitas keperawatan secara komprehensif.

---

Medical Surgical Nursing specialist residency practice with a specialization in Oncology focuses on the application of nurses in nursing care providers, educators, and researchers. The role as the provision of nursing care is carried out by managing 30 patients with cancer malignancy and one case which is used as a managed case for a patient diagnosed with metastatic breast cancer of the lung, liver and bone using the theoretical approach by Peaceful End Of Life (PEOL). The implementation of the application of scientific evidence-based nursing interventions is a nurse as a researcher in the form of Progressive Muscle Relaxation (PMR) application to reduce anxiety and pain after abdominal surgery. The role of nurses as educators is carried out in the form of implementing the use of the J-Hati application (healthy energy walking) by providing physical training of Android-based walking exercise to cancer patients with fatigue problems. The entire series of residency practice activities has the goal of comprehensively improving the quality and professionalism of nursing."

"ABSTRAK Profesi keperawatan untuk dapat memberikan layanan keperawatan yang berkualitas, diperlukan kemampuan perawat yang mampu mengintegrasikan ilmu pengetahuan dan seni dalam melakukan pelayanan keperawatan dan menjalankan peran perawat profesional. Spesialis keperawatan medikal bedah peminatan onkologi memiliki tanggung jawab sebagai pemberi asuhan keperawatan, peneliti, pendidik, advokat, dan inovator juga menjadi tuntutan penting untuk dijalankan. Peran pemberi asuhan keperawatan dilakukan pada pasien Kanker Nasofaring dengan faktor penyulit TB Paru dan Infeksi dengan menggunakan Model Adaptasi Roy. Disamping itu terdapat 30 pasien lainnya yang juga mendapat penerapan dari model keperawatan ini. Penerapan EBN yang dilakukan adalah akupresur P6 dan edukasi perawat untuk menagtasi mual muntah pasien kemoterapi. Program inovasi kelompok adalah penerapan terapi kombinasi Guided Imagery dan Progressive Muscle Relaxation untuk mengatasi nyeri pada pasien kanker.Kata kunci : akupresur, kemoterapi, mual muntah, Model Adaptasi Roy, nyeri ABSTRACT Nursing professions to be able to provide quality nursing services, nurses are required capable of integrating science and art in performing nursing services and perform the role of professional nurses. Specialized medical nursing specialist oncology specialists have responsibilities as nursing caregivers, researchers, educators, advocates, and innovators are also important demands to run. The role of nurse care caregivers is done in patients with Nasopharyngeal Cancer factors of Pulmonary TB and Infection by using the Roy Adaptation Model. In addition there are 30 other patients who also received the application of this nursing model. Implementation of EBN conducted is acupressure P6 and nurse education to mensing the nausea vomiting chemotherapy patients. Group innovation program is the application of combination therapy Guided Imagery and Progressive Muscle Relaxation to overcome the pain in cancer patients.Keywords acupressure, chemotherapy, nausea, pain, Roy 39 s Adaptation Model, vomiting "

"Latar Belakang: Kanker ovarium epitelial merupakan jenis keganasan ovarium yang paling sering ditemukan dan bersifat agresif. Upaya melakukan deteksi dini dilakukan dengan pemeriksaan ginekologi, dikombinasi dengan pemeriksaan ultrasonografi, advanced imaging (CT-Scan, MRI) dan pemeriksaan kadar serum CA-125, namun untuk menentukan diagnosis pasti diperlukan pemeriksaan histopatologi. Tujuan: Membandingkan temuan metastasis kelenjar getah bening pada advanced imaging (CT-Scan, MRI) dengan histopatologi pada kasus kanker ovarium epitelial.dan menentukan rentang waktu antara dilakukkan advanced imaging dengan tindakan operasi. Metode: Penelitian ini bersifat kohort retrospektif. Sampel penelitian adalah pasien dengan riwayat kanker ovarium epitelial stadium awal yang sudah dilakukan limfadenektomi di RSCM pada tahun 2017-2022 dengan teknik consecutive sampling. Pengumpulan data melalui data sekunder. Data dianalisis secara univariat dan bivariat dengan uji Mc Nemar atau Kappa. Hasil: Dari karakteristik didapatkan usia rata-rata 48 tahun, paling banyak dengan jenis clear cell carcinoma (36.7%), dan ditemukan paling banyak pada ovarium kanan (43.3%). Hasil advanced imaging tidak memiliki nilai kesepakatan yang berarti dengan hasil histopatologi (Kappa value -0.01, p >0.05). Hasil paling banyak ditemukan metastasis di pelvis kiri. Rentang waktu dilakukannya operasi setelah pemeriksaan advanced imaging, paling banyak dalam waktu kurang dari 3 bulan (50.0%). Kesimpulan: Semakin cepat waktu dilakukan tindakan operasi semakin tinggi survival rate. Tidak ada hubungan yang signifikan antara ditemukannya limfadenopati pada advanced imaging dan histopatologi.

---

Background: Epithelial ovarian cancer is the most common and aggressive type of ovarian malignancy. Efforts aimed at early detection are gynecological examination, combined with ultrasound examination, advanced imaging (CT-Scan, MRI) and CA-125 levels, but to determine a definite diagnosis a histopathological examination is needed. Objective: To compare the findings of lymph node metastases on advanced imaging (CT-Scan, MRI) with histopathology in cases of epithelial ovarian cancer. And to determine the time interval between advanced imaging and surgery. Methods: This study used a retrospective cohort. The sample of the study was patients with a history of early-stage epithelial ovarian cancer who had undergone lymphadenectomy at RSCM in 2017-2022 by consecutive sampling technique. Data collection through secondary data. Data were analyzed univariately and bivariately with the Mc Nemar or Kappa test. Results: The features revealed that the average age was 48 years, that clear cell carcinoma was the most prevalent form (36.7%), and that it was most frequently discovered in the right ovary (43.3%). According to the study's findings, there was no significant correlation between the outcomes of advanced imaging and those of histopathology (Kappa value: -0.01, p >0.05). The results showed that most metastases were found in the left pelvis. This study evaluated the length of surgery following enhanced imaging test revealed that 50% of patients underwent surgery in less than three months on average. Conclusion: The difference between preoperative and intraoperative findings will be minimized if surgery is conducted early. There was no significant correlation between lymphadenopathy findings on advanced imaging and histopathology."

"[ABSTRAKTujuan: Menentukan hubungan ukuran tumor dan derajat histopatologi dengan metastasis tulang pada pasien kanker payudara berusia dibawah 40 tahun di RS Kanker Dharmais, membantu meningkatkan kualitas tatalaksana bagi klinisi.Metode: Analisa menggunakan data sekunder. Hasil ukuran tumor dikelompokkan menjadi ≤ 5 cm dan > 5 cm berdasarkan AJCC TNM staging system diperoleh melalui pencitraan radiologi payudara dari sistem PACS dan derajat histopatologi menurut derajat histopatologi Nottingham kombinasi diperoleh dari hasil ekspertise patologi anatomi, serta evaluasi metastasis tulang menggunakan skintigrafi tulang berdasarkan total populasi pasien kanker payudara berusia dibawah 40 tahun.Hasil: Jumlah subyek penelitian 32 perempuan kanker payudara berusia dibawah 40 tahun periode Januari 2011 hingga Juli 2014 di RS Kanker Dharmais. Tidak ada hubungan yang bermakna antara ukuran tumor dengan metastasis tulang (P= 0,715 (Fisher exact test), OR=1,71 (0,32-9,36)). Terdapat hubungan yang bermakna antara derajat histopatologi dengan metastasis tulang (P=0,010, P < 0,05).Dari 10 subyek derajat histopatologi tinggi, ternyata semua subyek mengalami metastasis tulang negatif. Pada subyek dengan derajat histopatologi sedang didapatkan 8 dari 15 subyek yang mengalami metastasis tulang. Pada subyek penelitian dengan derajat histopatologi rendah didapatkan 6 dari 7 subyek mengalami metastasis tulang negatif. Rerata usia 33,2 tahun dan simpang baku 3,7 tahun memiliki kejadian metastasis tulang lebih tinggi (P=0,024). Terdapat data tambahan dan ditemukan hubungan yang bermakna antara Cerb-b2/HER-2 positif dengan metastasis tulang (P=0,049 (P < 0,05), Odds Ratio=5,67 (0,84 ? 43,16)).Prevalensi metastasis tulang yaitu sebesar 28,1%.Kesimpulan: Pasien kanker payudara berusia dibawah 40 tahun dengan ukuran tumor besar tidak memiliki kejadian metastasis tulang lebih tinggi. Pasien dengan derajat histopatologi tinggi tidak memiliki kejadian metastasis tulang lebih tinggi, namun ditemukan angka kejadian metastasis tulang lebih tinggi pada derajat histopatologi sedang. Terdapat dua faktor lain yang juga mempunyai hubungan dengan kejadian metastasis tulang yaitu usia dan Cerb-br/HER-2. Rerata usia 33,2 tahun dengan simpang baku 3,7 tahun pada pasien kanker payudara berusia di bawah 40 tahun memiliki kejadian metastasis tulang lebih tinggi. Cerb-b2/HER-2 positif pada pasien kanker payudara berusia di bawah 40 tahun memiliki kejadian metastasis tulang lebih tinggi dengan resiko kejadian sebesar 5,67 kali. Prevalensi metastasis tulang cukup tinggi pada pasien kanker payudara berusia dibawah 40 tahun yaitu sebesar 28,1%.

---

ABSTRACTObjective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.;Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.;Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%., Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.]"

"Latar Belakang: Kanker payudara merupakan keganasan yang dapat bermetastasis ke kelenjar limfe aksila dan/atau organ jauh. Studi-studi sebelumnya menunjukkan terdapat kaitan antara sejumlah morfologi mamogram dan gambar ultrasonografi (USG) payudara dengan adanya metastasis kelenjar limfe. Seringkali pasien dengan kecurigaan kanker payudara diperiksakan di rumah sakit ketika sudah dalam stadium lanjut atau bahkan terdapat metastasis yang seharusnya dapat dideteksi lebih awal. Mamografi dan USG payudara merupakan modalitas radiologis yang mudah untuk dikerjakan untuk diagnosis kanker payudara dan tersedia di banyak rumah sakit. Sampai saat ini, belum ada penelitian mengaitkan secara langsung temuan morfologis mamografi dan USG payudara pada pasien kanker payudara yang mengalami metastasis. Tujuan: Mengetahui perbedaan temuan morfologis mamografi dan USG payudara pada pasien kanker payudara dengan metastasis dengan pasien kanker payudara tanpa metastasis di RSUPN Dr. Cipto Mangunkusumo (RSCM). Metode: Dilakukan pembacaan ulang hasil mamogram dan gambar USG payudara dari 112 pasien yang didapatkan dari sistem Picture Archiving and Communication System (PACS) di Departemen Radiologi RSCM dengan klinis karsinoma payudara berdasarkan patologi anatomi. Data riwayat pasien didapatkan dengan melihat catatan di rekam medis melalui Electronic Health Record (HER) atau Hospital Information System (HIS). Dilakukan analisis pada usia dan karakteristik morfologis lesi meliputi variabel bentuk lesi, ukuran terbesar lesi, jarak tumor ke kutis, adanya kalsifikasi, jenis kalsifikasi, distribusi kalsifikasi, dan adanya distorsi arsitektur pada mamogram, dan bentuk lesi, ukuran terbesar lesi, jarak tumor ke kutis, vaskularisasi lesi, adanya kalsifikasi, dan adanya distorsi arsitektur pada gambar USG payudara menggunakan uji Chi-Square atau Fisher. Dilakukan juga analisis multivariat regresi logsitik pada variabel yang signifikan secara statistik menggunakan metode backward yang disajikan dalam bentuk odds ratio (OR). Hasil: Terdapat perbedaan yang bermakna secara statistik pada variabel usia (p=0,032), ukuran terbesar lesi pada mamogram (p<0,001), jarak tumor ke kutis pada mamogram (p=<0,001), ukuran terbesar lesi pada gambar USG payudara (p<0,001), dan jarak tumor ke kutis pada gambar USG payudara (p=0,001) antara pasien kanker payudara dengan metastasis dengan tanpa metastasis. Pada analisis multivariat gabungan temuan morfologis mamogram dan gambar USG payudara, didapatkan perbedaan bermakna secara statistik pada ukuran terbesar lesi pada mamogram dengan nilai OR 3,73 (p=0,003) dan jarak tumor ke kutis pada mamogram dengan nilai OR 3,34 (p=0,006). Simpulan: Terdapat perbedaan bermakna temuan mamogram dan USG payudara yaitu masing-masing ukuran terbesar lesi>5 cm dan jarak tumor ke kutis ≤0,5 cm dengan adanya metastasis pada kanker payudara. Temuan ukuran terbesar lesi>5 cm dan jarak tumor ke kutis ≤0,5 cm pada mamogram dapat memprediksi kemungkinan terjadinya metastasis pada kanker payudara.

---

Background: Breast cancer is a malignancy that can metastasize to axillary lymph nodes and distant organs. Previous studies have shown an association between the morphological findings of mammograms and ultrasound images of the breast and the presence of lymph node metastasis. Patients with suspected breast cancer are often examined in the hospital when they are in an advanced stage or even have metastasis that should have been detected earlier. Mammography and breast ultrasound are radiological modalities that are easy to perform to diagnose breast cancer and are available in many hospitals. To date, no studies have directly compared the morphological findings of mammography and breast ultrasound in patients with metastatic breast cancer. Purpose: To identify the differences in the morphological findings of mammography and breast ultrasound in breast cancer patients with metastasis compared to those without metastasis at Dr Cipto Mangunkusumo General Hospital (RSCM). Methods: Mammogram results and breast ultrasound images from 112 patients diagnosed with breast carcinoma based on anatomical pathology were obtained from the Picture Archiving and Communication System (PACS) at the Department of Radiology RSCM. The images were then reviewed. Patient history is obtained from the Electronic Health Record (EHR) or Hospital Information System (HIS). Analyzes were performed on age and morphological characteristics of the lesion, including the shape of the lesion, the largest diameter of the lesion, the distance of the tumor to the skin, the presence of calcification, the type of calcification, the distribution of calcifications, and the presence of architectural distortion on mammograms, and the shape of the lesion, the largest diameter of the lesion, the distance of the tumor to the skin, the vascularity of the lesion, the presence of calcification, and the presence of architectural distortion on breast ultrasound images using Chi-Square or Fisher method. Multivariate logistic regression analysis was also conducted on statistically significant variables using the backward method, which was presented as an odds ratio (OR). Results: There was a statistically significant difference in age (p=0,032), the largest diameter of the lesion on the mammogram (p<0,001), the distance of the tumor to the skin on the mammogram (p<0,001), the largest diameter of the lesion on breast ultrasound (p<0,001), and the distance of the tumor to the skin on breast ultrasound images (p=0,001) between metastatic and non-metastatic breast cancer patients. In the multivariate analysis of the combination of morphological findings of the mammogram and breast ultrasound images, there were statistically significant differences in the largest diameter of the lesion on mammograms with an OR value of 3.73 (p=0,003) and the distance of the tumor to the skin on mammograms with an OR value of 3.34 (p= 0,006). Conclusion: There is a significant difference in mammogram and breast ultrasound findings, such as the largest diameter of the lesion >5 cm and the distance of the tumor to the skin ≤0,5 cm with the presence of metastasis in breast cancer. The findings of the largest diameter of the lesion >5 cm and the distance of the tumor to the skin ≤0,5 cm on the mammogram can predict the probability of metastasis in breast cancer."

"Latar Belakang: Ketahanan hidup pasien kanker payudara di negara maju, seperti Amerika adalah sebesar 89,3% dan di Perancis adalah 82,3%. Di Rumah Sakit Cipto Mangunkusumo, sebagai salah satu rumah sakit rujukan terbesar di Indonesia, peringkat kedua untuk kasus rawat inap kanker selama tahun 2007 ? 2010 ditempati oleh kasus kanker payudara dengan ketahanan hidup yang belum diketahui.Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran ketahanan hidup lima tahun pasien kanker payudara berdasarkan karakteristik demografi dan fakrot klinis di RSCM tahun 2007 ? 2010.Metode: Populasi dan sampel penelitian adalah pasien rawat inap kanker payudara di RSCM yang memenuhi kriteria inklusi dan dipilih secara total sampling sebanyak 138 pasien yang diambil dari rekam medis. Analisis data dilakukan dengan uji univariat dan bivariat serta gambaran ketahanan hidup pasien berdasarkan cox regression.Hasil penelitian: Secara keseluruhan, ketahanan hidup relative 5 tahun pasien kanker payudara di RSCM tahun 2007 ? 2010 adalah sebesar 54,3%. Ketahanan hidup tertinggi berdasarkan karakteristik demografi adalah pasien yang didiagnosis pertama pada usia 31 ? 40 tahun (60,9%), berpendidikan menengah (70%), dan sudah menikah (85,7%). Sedangkan berdasarkan faktor klinis, ketahanan hidup tertinggi ditemukan pada pasien dengan ukuran tumor primer ≤ 5cm (71,9%), stadium klinis I (100%), jenis histology karsinoma payudara lainnya (85,7%), pasien dengan pengobatan yang lengkap (72,7%), derajat keganasan sel baik (83,3%), dan riwayat metastasis negatif (71,4%).Kesimpulan dan saran: Ketahanan hidup 5 tahun pasien kanker payudara di RSCM masih tergolong rendah. Oleh karena itu, penemuan kasus secara dini dan dan meningkatkan kesadaran wanita untuk melakukan berbagai skrining kanker khususnya pada mereka yang berusia lebih dari 30 tahun sangat penting untuk dilakukan.

---

Background: The 5-year survival rate of female breast cancer patients in developed country, such as America is 89,3% and France is 82,3%. At Cipto Mangunkusumo hospital, as one of reference hospital in Indonesia, second ranked in cancer patients admitted during the year 2007 ? 2010 is breast cancer with improved survival is unknown.

Objectives: This study is conducted for determine 5-year survival rate of breast cancer patients in the Cipto Mangunkusumo Hospital based on demographic characteristic and clinical factor during 2007- 2010.

Methods: Population and sample are breast cancer patients hospitalized in the Cipto Mangunkusumo hospital who met the inclusion criteria and were selected in total sampling as many as 138 patients and collected from medical record. Data analysis was performed with univariate and bivariate tests as well as an overview of survival of patients by Cox regression.

Results: Overall, 5-year relative survival rate for breast cancer patients in the Cipto Mangunkusmo Hospital years 2007 to 2010 amounted to 54.3%. The highest of the 5-year survival rate based on demographic characteristic: age of first diagnosed between 31 and 40 years (60.9%), intermediate education (70%), married (58.7%). Then based on clinical factor: tumor size ≤ 5 cm (71.9%), clinical stage I 100% (n= 4) , another breast cancer histological type 85.7%, complete treatment (72.7 %), good grade (83.3%), and negative metastasis 71.4%.

Conclusions and suggestions: 5-year survival rates of breast cancer patients at RSCM is still low. Therefore, early case detection and increasing awareness of women to perform a variety of cancer screening, especially in those aged over 30 years is very important."

"Kanker payudara merupakan jenis kanker terbanyak diantara wanita Indonesia. Pada tahun 2013, belum diketahui faktor apa yang berhubungan dengan kanker payudara pada pasien di Rumah Sakit Umum Pusat Nasional (RSUPN) dr. Cipto Mangunkusumo. Tujuan penelitian ini adalah untuk mengetahui faktor apa saja yang berhubungan dengan kanker payudara. Desain studi yang digunakan adalah kasus kontrol. Data dikumpulkan dengan menggunakan kuesioner yang diambil dari pasien rawat jalan RSUPN dr. Cipto Mangunkusumo khususnya dari poli bedah. Sampel terdiri dari 117 kasus kanker payudara dan 119 kontrol (pasien lain di poli bedah yang tidak menderita kanker payudara). Hasil penelitian menunjukkan adanya peningkatan risiko kanker payudara pada umur 35-44 tahun (OR=3,370, 95% CI=1,390-8,170), dan 45-54 tahun (OR= 3,690, 95% CI=1,558-8,739) dibandingkan umur <35 tahun, umur menarche <12 tahun (OR=2,962, 95% CI=1,352-6,488) dibandingkan ≥12 tahun, adanya riwayat keturunan kanker payudara (OR=3,035, 95% CI=1,286-7,165) dan adanya keluarga tingkat 1 yang menderita kanker payudara (OR=3,854, 95% CI= 1,031-14,411) dibandingkan tidak ada riwayat keturunan kanker payudara sama sekali. Sementara itu efek protektif yang signifikan melindungi kanker payudara adalah menyusui anak selama ≥6 tahun (OR= 0,419, 95% CI=0,202-0,868) dibandingkan menyusui anak selama <2 tahun. Perlu adanya peningkatan promosi kesehatan mengenai faktorfaktor yang berhubungan dengan kanker payudara kepada masyarakat.

---

Breast cancer is the most common cancer among women in Indonesia. In 2013,it remains unknown factors that cause breast cancer on patients of Rumah Sakit Umum Pusat Nasional (RSUPN) dr. Cipto Mangunkusumo. The purpose of this study is to determine what factors are associated with breast cancer. Study design was case-control. Data were collected using questionnaires from the unhospitalized patients RSUPN dr. Cipto Mangunkusumo especially in Department of Surgery. Sample of 117 breast cancer cases and 119 control (other unhospitalized patients in Department of Surgery does not have breast cancer) were recruited. The results found increasing risk due to age of 35-44 (OR=3,370,95% CI=1,390-8,170), and age of 45-54 (OR= 3,690, 95% CI=1,558-8,739) compared to age of <35, age at menarche of <12 (OR=2,962, 95% CI=1,352-6,488) compared to age at menarche of ≥12, family history of breast cancer(OR=3,035, 95% CI=1,286-7,165) and family history of breast cancer in first degree relatives (OR=3,854, 95% CI= 1,031-14,411) compared to them with no family history of breast cancer. Meanwhile the significant protective effect that protect breast cancer is breastfeeding for ≥6 years (OR= 0,419, 95% CI=0,202-0,868) compared to breastfeeding for <2 years.There is need to increase health promotion regarding the factors associated with breast cancer to the public."

"Latar BelakangKanker ginekologi dan infeksi COVID-19 memiliki tingkat insidensi dan mortalitas yang tinggi di Indonesia serta berdampak pada aspek kesehatan, sosial, dan budaya. Kanker ginekologi dan infeksi COVID-19 memicu inflamasi yang dapat mengakibatkan ganguan multi-organ. Pemeriksaan laboratorium dapat digunakan sebagai indikator keparahan untuk menilai inflamasi dan kerusakan organ. Oleh karena itu penelitian ini akan membahas mengenai analisis kakteristik klinis dan hasil laboratorium pasien kanker ginekologi dengan COVID-19.MetodeMetode yang akan digunakan di dalam penelitian ini adalah deskritif dan analitik dengan pendekatan potong lintang retrospektif.HasilTingkat insidensi pasien kanker ginekologi dengan COVID-19 2020-2022 sebesar 154 per 100.000. Kanker serviks (54,3%) menjadi diagnosis terbanyak diikuti dengan kanker ovarium (28,7%), kanker rahim (14,9%), kanker vulva (1,1%), dan kanker vagina (1,1%). Stadium III (37,2%) menjadi yang terbanyak diikuti stadium IV (26,6%), stadium I (20,2%), stadium II (16%). Karakteristik klinis dan hasil laboratorium yang memiliki hubungan signifikan dengan stadium kanker adalah obesitas (OR 0,321; CI 0,125-0,826; P value 0,018), neutrofil absolut tinggi (OR 5,006; Cl 95%, 1,307 – 19,176; P value 0,019), ureum tinggi (OR 3,977; Cl 95%, 1,112 – 14,224; P value 0,034), dan platelet to leucocyte ratio (PLR) tinggi (OR 7,379; 95% CI 2,067-26,466; P value 0,002). Karakteristik klinis dan hasil laboratorium yang memiliki hubungan signifikan dengan derajat keparahan COVID-19 adalah sesak napas (OR 12,364; Cl 95%, 4,148 – 36,848; P value <0.001) dan PLR tinggi (OR 6,787; 95% CI 1,103 - 41,774; P value 0,039).KesimpulanKarakteristik klinis dan hasil laboratorium yang dapat dikaitkan sebagai indikator keparahan berdasarkan stadium kanker ginekologi adalah obesitas, neutrofil absolut tingg, ureum dan PLR tinggi. Karakteristik klinis dan hasil laboratorium yang dapat dikaitkan dengan indikator keparahan berdasarkan derajat keparahan COVID-19 adalah sesak napas dan PLR tinggi.

---

Introduction

Gynecologic cancer and COVID-19 infection have high incidence and mortality rates in Indonesia and impact health, social and cultural aspects. Gynecological cancers and COVID-19 infections trigger inflammation that can lead to multi-organ disorders. Laboratory tests can be used as an indicator of severity to assess inflammation and organ damage. Therefore, this study will discuss the analysis of clinical characteristics and laboratory results of gynecological cancer patients with COVID-19.

Method

The method used in this study is descriptive and analytic with a retrospective cross- sectional approach.

Results

The incidence rate of gynecologic cancer patients with COVID-19 2020-2022 was 154 per 100,000. Cervical cancer (54.3%) was the most common diagnosis followed by ovarian cancer (28.7%), uterine cancer (14.9%), vulvar cancer (1.1%), and vaginal cancer (1.1%). Stage III (37.2%) was the most common followed by stage IV (26.6%), stage I (20.2%), stage II (16%). Clinical characteristics and laboratory results that had a significant association with cancer stage were obesity (OR 0,321; CI 0,125-0,826; P value 0,018), high absolute neutrophils (OR 5.006; 95% CI, 1.307-19.176; P value 0.019), high high ureum level (OR 3.977; 95% CI, 1.112-14.224; P value 0.034), and high PLR (OR 7.379; 95% CI 2.067-26.466; P value 0.002). Clinical characteristics and laboratory results that had a significant association with COVID-19 severity were shortness of breath (OR 12.364; Cl 95%, 4.148 - 36.848; P value <0.001) and high PLR (OR 6.787; 95% CI 1.103 - 41.774; P value 0.039).

Conclusion Clinical characteristics and laboratory results associated with gynecologic cancer stage were obesity, high absolute neutrophils, high ureum level, and high PLR. Clinical characteristics and laboratory results associated with COVID-19 severity were shortness of breath and high PLR."