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"Kanker kolorektal (KKR) adalah kanker tersering nomor tiga di dunia yang memiliki angka mortalitas tinggi terutama di negara berkembang, termasuk Indonesia. Angka mortalitas yang tinggi disebabkan penegakan diagnosis sudah pada stadium lanjut. Kolonoskopi merupakan baku emas diagnosis KKR, namun bersifat invasif, tidak nyaman, dan berisiko komplikasi. Inflamasi kronis diketahui terjadi pada KKR dan berperan pada perkembangan dan metastasis sel kanker. Parameter hematologi seperti red cell distribution width (RDW), Rasio Hemoglobin-RDW (RHR), dan Rasio RDW-Trombosit (RRT) memberi informasi yang bermakna pada pasien KKR. Penelitian ini bertujuan untuk menilai peran RDW, RHR, dan RRT dalam membedakan kelompok KKR dan non-KKR. Desain penelitian potong lintang dengan total 78 pasien tersangka KKR, terdiri dari 39 kelompok KKR dan 39 kelompok non-KKR yang dilakukan pemeriksaan kolonoskopi dan histopatologi. Didapatkan perbedaan bermakna nilai RDW, RHR, dan RRT pada kelompok KKR dan non-KKR. Titik potong nilai RDW, RHR, dan RRT untuk membedakan kelompok KKR dari non-KKR berturut-turut adalah 14,5 (sensitivitas 74,4% dan spesifisitas 66,7%), 0,77 (sensitivitas 76,9% dan spesifisitas 66,7%), 0,045 (sensitivitas 61,5% dan spesifisitas 66,7%). Berdasarkan analisis multivariat, model kombinasi parameter laboratorium RHR dan RRT dengan parameter klinis penurunan berat badan memiliki probabilitas 90,44% dalam diagnosis KKR pada pasien tersangka KKR.

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Colorectal cancer (CRC) is the third most common cancer in the world with high mortality rate, especially in developing countries including Indonesia. The high mortality rate is due to the late diagnosis at advanced stage. Colonoscopy is the gold standard for CRC diagnosis, but invasive, uncomfortable and carries a risk of complications. Chronic inflammation is known to occur in CRC and plays a role in the development and metastasis of cancer cells. Hematological parameters such as red cell distribution width (RDW), Hemoglobin-RDW Ratio (HRR), and RDW-Platelet Ratio (RPR) provide significant information in CRC patients. This study aims to assess the role of RDW, RHR, and RRT in differentiating CRC from non-CRC groups. Cross-sectional study was conducted in 78 suspected CRC patients, consisting of 39 CRC and 39 non-CRC subjects who underwent colonoscopy and histopathology examinations. Significant differences were found in RDW, HRR, and RPR between the CRC and non-CRC groups. The cut-off points for RDW, HRR, and RPR to distinguish the CRC from non-CRC groups were 14.5 (sensitivity 74.4% and specificity 66.7%), 0.77 (sensitivity 76.9% and specificity 66.7%), 0.045 (sensitivity 61.5% and specificity 66.7%), respectively. Based on multivariate analysis, a diagnostic model based on the combination of laboratory parameters such as HRR and RPR with clinical parameter of weight loss has a 90.44% probability in diagnosing CRC in suspected CRC patients."

"Colorectal cancer (CRC) is one of the top three leading causes of death in both men and women. However, screening can help detect and prevent CRC. Multiple guidelines recommend CRC screening using stool-based screening and direct visualization via colonoscopy. Anatomically, women have a longer total colonic length, especially in the transverse colon, which makes it redundant; thus it is more difficult to perform complete endoscopy in women. Women also have a higher risk of developing right-sided colon cancer of the flat and depressed type, which is harder to detect than the other types. Moreover, women are less likely to undergo colonoscopy due to embarrassment, especially when the procedure is performed by male gastroenterologists, and the lack of available female gastroenterologists further complicates the problem. The current COVID-19 pandemic also decreases patients’ willingness to undergo screening due to the fear of contracting the COVID-19. Delay in diagnosis leads to more advanced tumors upon detection and ultimately decreases the survival rate, especially in women, as they have lower 1-year survival rate when CRC is detected in its later stages than in men. Innovative options for CRC screening have recently emerged, including colon capsule endoscopy, which can be performed in a clinic and may reduce the need for colonoscopy. However, sex-specific CRC screening guidelines and tools are not available. The objective of this review is to identify the barriers and challenges faced when performing screening colonoscopy in women, especially during the pandemic and to encourage the development of sex-specific CRC screening."

"Kanker kolorektal (KKR) merupakan salah satu jenis keganasan dengan angka morbiditas dan mortalitas yang tinggi di seluruh dunia, termasuk di Indonesia. Kolonoskopi adalah baku emas dalam mendeteksi dan penapisan KKR. Inflamasi kronik dan respons imun pejamu diketahui berperan penting dalam proses tumorigenesis dan progresivitas sel kanker. Proses inflamasi tersebut mempengaruhi hasil pemeriksaan hematologi, sehingga parameter Rasio Hemoglobin-Trombosit (RHT), Rasio Trombosit-Limfosit (RTL), dan Rasio Limfosit-Monosit (RLM) diharapkan dapat memberikan informasi mengenai perkembangan sel tumor. Penelitian ini bertujuan untuk mengevaluasi peran RHT, RTL, dan RLM dalam membedakan kelompok KKR dan non-KKR. Penelitian dilakukan dengan menggunakan desain potong lintang dengan total 80 pasien tersangka KKR, 40 pasien KKR dan 40 pasien non-KKR yang menjalani pemeriksaan kolonoskopi dan histopatologi. Didapatkan perbedaan bermakna RHT, RTL, dan RLM pada kelompok KKR dan non-KKR. Titik potong RHT, RTL, dan RLM untuk membedakan kelompok KKR dan non-KKR adalah 0,26 (sensitivitas 77,5% dan spesifisitas 92,5%), 189,22 (sensitivitas 77,5% dan spesifisitas 72,5%), dan 2,864 (sensitivitas 77,5% dan spesifisitas 77,5%), secara berturut-turut. Berdasarkan analisis regresi logistik, kombinasi nilai RHT dan RLM lebih baik untuk mendeteksi KKR dibandingkan RHT atau RLM secara tunggal. Kombinasi RHT dan RLM dapat digunakan untuk mendeteksi KKR dengan skor 2 untuk RHT < 0,26 dan skor 1 untuk RLM < 2,864 dengan probabilitas 94,81%.

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Colorectal cancer (CRC) is a gastrointestinal malignancy with high morbidity and mortality rates worldwide, including in Indonesia. Colonoscopy remains the gold standard for CRC detection and screening. Chronic inflammation and host immune responses are known to play important roles in tumorigenesis and cancer progression. This inflammation affects the results of hematological examination. Therefore, parameters such as Hemoglobin-Platelet Ratio (HPR), Platelet-Lymphocyte Ratio (PLR), and Lymphocyte-Monocyte Ratio (LMR) are expected to provide information on tumor cell development. This study aims to evaluate the role of HPR, PLR, and LMR in distinguishing CRC and non-CRC. The study was conducted using a cross-sectional design with a total of 80 suspected CRC patients, with 40 CRC patients and 40 non-CRC patients undergoing colonoscopy and histopathology examinations. Significant differences were found in HPR, PLR, and LMR in the CRC and non-CRC groups. The cut-off points of HPR, PLR, and LMR to distinguish the CRC and non-CRC groups were 0.26 (sensitivity 77.5% and specificity 92.5%), 189.22 (sensitivity 77.5% and specificity 72.5%), and 2.864 (sensitivity 77.5% and specificity 77.5%), respectively. Logistic regression analysis showed that the combination of HPR and LMR values is better in detecting CRC compared to HPR or LMR alone. The combination of HPR and LMR can be used to detect CRC with a score of 2 for HPR < 0.26 and a score of 1 for LMR < 2.864 with 94.81% probability."

"ABSTRAKMenurut Jakarta Cancer Registry tahun 2012, kanker kolorektal merupakan kanker terbanyak kedua pada laki-laki dan terbanyak keempat pada perempuan di Indonesia. Pemeriksaan skrining kanker kolorektal yang saat ini tersedia memiliki berbagai keterbatasan. Matrix metalloproteinase-9 (MMP-9) adalah endopeptidase yang berperan dalam degradasi matriks ekstraseluler, dan disekresi oleh berbagai sel seperti sel tumor, sel radang, dan fibroblas. Penelitian ini bertujuan untuk mengetahui peran diagnostik MMP-9 feses dibandingkan dengan gambaran histopatologi sebagai baku emas. Desain penelitian adalah potong lintang. Penelitian dilakukan terhadap 52 subjek terduga kanker kolorektal yang menjalani kolonoskopi. Kadar MMP-9 feses diperiksa menggunakan kit MMP-9 dari R&D Systems dengan metode ELISA. Akurasi diagnostik kadar MMP-9 feses sebesar 0,855. Titik potong kadar MMP-9 feses didapatkan 1,237 ng/ml dengan sensitivitas 88,9%, spesifisitas 76,7%, nilai prediksi positif 44,4%, dan nilai prediksi negatif 97,1%. Pemeriksaan kadar MMP-9 feses dapat dipertimbangkan dalam skrining kanker kolorektal.

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ABSTRACT

According to Jakarta Cancer Registry 2012, colorectal cancer is the second most common cancer in men and fourth in women in Indonesia. Colorectal cancer screening tests currently available, have various limitations. Matrix metalloproteinase-9 (MMP-9) is endopeptidase which plays a role in the degradation of the extracellular matrix, and is secreted by various cells such as tumor cells, inflammatory cells, and fibroblasts. This is a cross sectional study aims to determine the diagnostic role of faecal MMP-9 compared to histopathological features as gold standard. The study was conducted on 52 subjects with suspected colorectal cancers who underwent colonoscopy. The levels of faecal MMP-9 were examined using MMP-9 kit from R&D Systems using ELISA method. Diagnostic accuracy of faecal MMP-9 levels is 0.855. The cutoff point was 1.237 ng/ml with sensitivity of 88.9%, specificity of 76.7%, positive predictive value of 44.4%, and negative predictive value of 97.1%. Faecal MMP-9 can be considered as a screening test in colorectal cancer."

"Pada kanker kolorektal dengan metastasis hati, pemilihan regimen kemoterapi memiliki peranan penting dalam manajemen penyakit. Cetuximab diberikan pada KKR dengan gen KRAS wild-type. Studi ini bertujuan untuk melihat faktor-faktor yang memengaruhi efektivitas Cetuximab pada KKR metastasis dinilai dari respon pengobatan berdasarkan CT-Scan dan kriteria RECIST. Studi ini merupakan studi deskriptif analitik retrospektif dengan desain potong lintang menggunakan data sekunder dari rekam medik pasien di RSCM dalam 3 tahun terakhir (januari 2015 – desember 2017). Dari 19 subjek, sebagian besar merupakan laki-laki dengan respon stabil pada seluruh variabel faktor (IMT normal, SGA B, tumor sisi kanan, hemikolektomi kanan, irinotecan-based agent, performance status karnofsky 80-90, derajat histologi diferensiasi sedang, dan WHO grade toxicity 0-1). Tidak didapatkan adanya respon komplit berdasarkan kriteria RECIST dan faktor yang bermakna secara statistik (p>0,05) terhadap pengaruh efektivitas Cetuximab pada kanker kolorektal metastasis hati. Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa faktor-faktor tersebut tidak memengaruhi efektivitas Cetuximab pada pasien kanker kolorektal metastasis hati.

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The choice of chemotherapy has an important role to manage a liver metastatic colorectal cancer (mCRC). Based on the newest recommendation, Cetuximab are suggestive to be given to mCRC patients with RAS wild-type. Therefore, the aim of this study is to investigate the contributing factors affecting the efficacy of Cetuximab in mCRC patients response based on CT-Scan and RECIST criteria. This study is a retrospective descriptive analtical study with cross sectional design using secondary data from RSCM’s medical records in the last 3 years (january 2015 – december 2017). From 19 subjects included in this study, most of the subjects are male with stabile disease (SD) response in all of the variable factors (normal BMI, SGA B, right-sided tumor, right-hemicolectomy, irinotecan-based chemotherapy agent, performance status Karnofsky 80-90, moderately-differentiated tumor, adn WHO grade toxicity 0-1). Complete response were not found in this study based on RECIST criteria. There were no significant factors (p>0.05) affecting the efficacy of Cetuximab in liver mCRC patients."

"Insiden kanker kolorektal di Indonesia adalah 10,5 per 100.000 penduduk dengan mortalitas 4,4% pada kanker kolon dan 3,3% pada kanker rektum. Penelitian oleh Sitorus dkk (2010) menunjukkan kesintasan kanker kolorektal di Indonesia adalah sebesar 31,34%. Identifikasi faktor-faktor prognostik yang berhubungan dengan kesintasan kanker kolorektal dapat digunakan sebagai acuan unutk meningkatkan pelayanan dalam tatalaksana kanker kolorektal. Studi ini menilai faktor-faktor yang memengaruhi kanker kolorektl di RSCM. Penelitian ini merupakan suatu penelitian kohort retrospektif dengan analisis faktor yang memengaruhi kesintasan. Data pasien yang mengalami kanker kolorektal diperoleh dari registrasi kanker kolorektal Divisi Bedah Digestif RSCM selama periode Januari-Desember 2014. Didapatkan sebanyak 142 subyek kanker kolorektal dengan kelompok usia terbanyak adalah usia ≥45 tahun. Sebanyak 52,1% subyek menderita kanker kolorektal stadium IV dengan lokasi tersering adalah rektum (47,2%). Adapun faktor-faktor yang memengaruhi kesintasan pasien kanker kolorektal antara lain ialah stadium (p=0,002; HR 2,09; 95%CI 1,32-3,29), terapi pembedahan definitif (p=0,000; HR 20,7; 95%CI 5,01-86,28), penyulit obstruksi atau perforasi (p=0,019; HR 9,99; 95%CI 2,42-41,08), invasi limfovaskular (p=0,000; HR 7,86; 95%CI 2,89-21,36), dan diabetes mellitus (p=0,048; HR 1,6; 95%CI 3,28-7,22). stadium, terapi pembedahan definitif, penyulit baik osbtruksi maupun perforasi, invasi limfovaskular, dan diabetes mellitus merupakan faktor-faktor yang memengaruhi kesintasan pasien kanker kolorektal

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The incidence of colorectal cancer in Indonesia was 10,5 per 100.000 with mortality of 4,4% for patients with colon cancer and mortality of 3,3% in patients with rectal cancer. Research by Sitorus et al (2010) showed that the survival rate of patients with colorectal cancer in Indonesia was 31,34%. Identification of factors related to survival of colorectal cancer can be used to improve the management of patients with colorectal cancer. This study was a retrospective cohort with survival analysis. The patients data with colorectal cancer were from medical record from Digestive Surgery Division in RSCM from January - December 2014. Data selection was done based on inclusion and exclusion criterias. There were 142 patients with colorectal cancer included. Most of the patientes were ≥45 years old. There were 52,1% patients suffered from IV grade of colorectal cancer, and the most common location was rectum (47,2%). Factors affecting five years survival rate was stadium (p=0,002; HR 2,09; 95%CI 1,323,29), definitive treatment/surgery (p=0,000; HR 20,7; 95%CI 5,01-86,28), obstruction/perforation (p=0,019; HR 9,99; 95%CI 2,42-41,08), lymphovascular invasion (p=0,000; HR 7,86; 95%CI 2,89-21,36), and diabetes mellitus (p=0,048; HR 1,6; 95%CI 3,28-7,22). kanker (HR 1,842; 95%CI 1,244-2,729) were the factors that increased recurrence Stadium, definitive treatment/surgery, obstruction/perforation, lyymphovascular invasion, and diabetes mellitus were factors affecting fiver years survival rate of patients with colorectal cancer."

"Latar Belakang. Pemberian kemoterapi oxaliplatin sebagai salah satu modalitas terapi kanker kolorektal telah terbukti memperbaiki angka kesembuhan, ketahanan hidup maupun masa bebas penyakit dan kualitas hidup penderita. Namun, juga memberikan berbagai efek samping toksisitas hematologi anemia, leukopenia, dan trombositopenia yang paling sering ditemukan. Metode. Penelitian ini merupakan penelitian observasional dengan menggunakan rancangan hysterikal kohort. Penelitian dilakukan di Departemen Bedah Fakultas Kedokteran Universitas Indonesia Divisi Bedah Digestif RSCM, periode Januari 2016 - Desember 2016. Populasi sasaran adalah 65 pasien kanker kolorektal yang mendapat kemoterapi oxaliplatin adjuvan. Hasil. Usia pasien kanker kolorekta berkisar antara 18 tahun sampai dengan 73 tahun rata-rata 50,8 tahun, perbandingan pria 32 49,2 dan wanita33 50,8. dari 65 pasien kanker kolorektal distribusi lokasi tumor terbanyak pada rektum 39 60, sigmoid 11 16,9, kolon desenden 7 10,8, kolon tranversum 5 7,7, kolon asenden 2 3,1, dan pada caecum 1 1,5. Stadium terbanyak adalah stadium II dan tindakan pembedahan berupa Low Anterior Resction atau Anterior Perineal Resection. Terdapat penurunan rerata kadar hemoglobin yang bermakna dengan p

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Background. The administration of oxaliplatin chemotherapy as one of the therapeutic modalities of colorectal cancer has been shown to improve the rate of cure, survival and disease free and quality of life of patients. However, it also provides the most common side effects of hematologic toxicity anemia, leukopenia, and thrombocytopenia.

Methods. This research is an observational using hysterical cohort design. It was conducted in Department of Surgery Faculty of Medicine, University of Indonesia Division of Digestive Surgery RSCM, periode January 2016 December 2016. The target population is 65 patients of colorectal cancer receiving adjuvant oxaliplatin chemotherapy.

Results The age of colorectal cancer patients ranged from 18 to 73 years mean 50.8 years, male 32 49.2 and female 33 50.8. 65 patients of colorectal cancer distributed the most tumor sites in the rectum 39 60, sigmoid 11 16.9, descending colon 7 10.8, tranversum colon 5 7.7, ascending colon 2 3.1, and at caecum 1 1.5. Most stages are stage II and the operate type of Low Anterior Resction or Anterior Perineal Resection. There was a significant decrease in mean hemoglobin level with p "

"Latar belakang: Kanker kolorektal (KKR) menduduki peringkat keempat dengan persentase 8,6% dari total prevalensi kanker di Indonesia Namun, belum terdapat penelitian yang secara khusus mengevaluasi kualitas hidup penderita adenokarsinoma kolorektal pascaoperasi di Indonesia.Metode: Studi dilakukan dengan desain deskriptif, populasi penderita adenokarsinoma kolorektal pascaoperasi sejak Januari 2017-Desember 2020 dan bersedia serta mampu menjawab kuesioner diinklusi dalam penelitian. Luaran yang dievaluasi adalah kualitas hidup dihubungkan dengan usia, jenis kelamin, familial, stadium dan jumlah terapi adjuvant.Hasil: Terdapat 304 subjek penderita adenokarsinoma kolorektal pasca operasi , 123 pasien dinyatakan meninggal, 98 subjek yang menjawab kuesioner dalam penelitian ini, dengan 56 laki-laki dan 42 perempuan. 83 subjek (84.69%) tidak memiliki riwayat familial. Mayoritas penderita stadium IV sebanyak 71 subjek (72,44%), stadium III 23 subjek (23.46%) dan stadium II hanya 4 subjek (4.08%). Kualitas hidup menunjukkan sebaran data yang tidak normal dengan median 70 (50-90) pada semua domain. Ditemukan dua subjek yang menunjukkan nilai kurang pada domain kesehatan fisik. Pada domain psikologis, hubungan sosial dan lingkungan didapatkan seluruh subjek mendapatkan skor kualitas hidup diatas dari 60 dengan median secara berturut-turut 70(70-90), 70(60-90), dan 70(60-92). Didapatkan asosiasi yang bermakna secara statistik antara kualitas hidup dengan jenis kelamin, usia, stadium, dan jumlah terapi adjuvan yang memiliki p sebesar 0,011; 0,015; 0,002; dan 0,005. Tidak ditemukan asosiasi yang bermakna secara statistik antara kualitas hidup dengan familial.Simpulan: Terdapat hubungan antara kualitas hidup penderita adenokarsinoma kolorektal di RSUPN dr. Cipto Mangukusumo apabila dihubungkan dengan usia, jenis kelamin, stadium kanker, dan jumlah terapi adjuvan.

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Background: Colorectal cancer (CRC) is ranked fourth with a percentage of 8.6% of the total cancer prevalence in Indonesia. However, there are no studies that specifically evaluate the quality of life of postoperative colorectal adenocarcinoma patients in Indonesia.

Methods: The study was conducted with a descriptive design, patients with postoperative colorectal adenocarcinoma from January 2017-December 2020, willing and able to answer the questionnaire was included in the study. Outcomes evaluated were the quality of life related to age, sex, familial, stage and number of adjuvant therapy.

Results: There were 304 subjects with postoperative colorectal adenocarcinoma, 123 patients were declared dead, 98 subjects answered the questionnaire in this study. There were 56 men and 42 women, 83 subjects (84.69%) had no familial history. The majority of stage IV patients were 71 subjects (72.44%), stage III were 23 subjects (23.46%) and stage II only 4 subjects (4.08%). Quality of life showed an abnormal distribution of data with a median of 70 (50-90) in all domains. It was found that two subjects showed poor scores in the physical health domain. In the psychological domain, social relations and the environment, all subjects got a quality of life score above 60 with a median of 70 (70-90), 70 (60-90), and 70 (60-92). There was a statistically significant association between quality of life with sex, age, stage, and number of adjuvant therapy which had a p of 0.011; 0.015; 0.002; and 0.005. No statistically significant association was found between quality of life with familial."

"Latar belakang: Masalah resistensi dan biaya pengobatan yang besar pada kanker kolorektal memicu penelitian lebih mendalam mengenai alternatif pengobatannya. Penelitian ini bertujuan untuk mengembangkan pengetahuan mengenai potensi sitotoksik Aloe vera, sebagai salah satu tanaman herbal, dalam mengatasi kanker kolon. Penelitian ini juga membandingkan dua ekstrak Aloe vera pada pelarut berbeda terhadap sel kanker kolon HT-29. Manfaat penelitian ini adalah mengembangkan penelitian dan pengembangan obat herbal, khususnya Aloe vera, untuk mengatasi kanker kolon HT-29. Metode: Penelitian yang dilakukan adalah penelitian analitik berbasis laboratorium dengan melakukan dua uji, yaitu uji fitokimia dan uji sitotoksisitas. Uji fitokimia dilakukan untuk mengetahui kandungan senyawa pada ekstrak Aloe vera. Uji fitokimia yang dilakukan adalah uji flavonoid, saponin, terpenoid, glikosida, alkaloid, fenol, dan tanin. Uji sitotoksisitas dilakukan untuk menilai inhibisi ekstrak Aloe vera terhadap sel kanker kolon HT29 menggunakan metode MTT assay. Jumlah sampel yang digunakan sebanyak 72 sampel. Metode analisis yang digunakan berupa uji normalitas shapiro wilk, uji komparatif One way Anova, dan uji komparatif post hoc bonferroni. Hasil: Uji fitokimia ekstrak etanol Aloe vera menunjukkan positif kandungan flavonoid, tanin, dan terpenoid. Hasil uji fitokimia ekstrak etil asetat Aloe vera menunjukkan hasil positif kandungan flavonoid, tanin, terpenoid, dan alkaloid. Uji sitotoksisitas menunjukkan hasil nilai IC50 ekstrak etanol adalah 22,62 µg/mL dan ekstrak etil asetat adalah 63,05 µg/mL. Hasil uji saphiro wilk menunjukan data bersifat normal. Hasil uji komparatif menunjukkan bahwa terdapat perbedaan yang signifikan antara kedua jenis ekstrak tersebut. Kesimpulan: Kandungan yang terdapat pada Aloe vera, baik ekstrak etanol maupun ekstrak etil asetat, adalah flavonoid, tanin, dan terpenoid, serta pada ekstrak etil asetat alkaloid juga terkandung yang mana kandungan-kandungan tersebut membuat ekstrak etanol dan etil asetat Aloe vera termasuk ke dalam kategori sitotoksik potensial (IC50< 100 µg/mL) dengan ekstrak etanol lebih poten dibanding dengan ekstrak etil asetat.

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Background: The problem of resistance and the high cost of treatment in colorectal cancer triggers more in-depth research on alternative treatments. This study aims to develop knowledge about the cytotoxic potential of Aloe vera, as an herbal plant, in treating colon cancer. This study also compared two Aloe vera extracts in different solvents against HT-29 colon cancer cells. The benefit of this research is to develop research and development of herbal medicines, especially Aloe vera, to treat HT-29 colon cancer.

Methods: The research conducted was a laboratory-based analytical study by conducting two tests, namely the phytochemical test and the cytotoxicity test. Phytochemical tests were carried out to determine the content of compounds in Aloe vera extract. The phytochemical tests carried out were tests on flavonoids, saponins, terpenoids, glycosides, alkaloids, phenols, and tannins. Cytotoxicity test was carried out to assess the inhibition of Aloe vera extract against HT29 colon cancer cells using the MTT assay method. The number of samples used was 72 samples. The analytical methods used are the Shapiro Wilk normality test, the One way Anova comparative test, and the Bonferroni post hoc comparative test.

Results: Phytochemical test of Aloe vera ethanol extract showed positive content of flavonoids, tannins and terpenoids. The phytochemical test results of Aloe vera's ethyl acetate extract showed positive results for the content of flavonoids, tannins, terpenoids, and alkaloids. The cytotoxicity test showed that the IC50 value of the ethanol extract was 22.62 µg/mL and that of the ethyl acetate extract was 63.05 µg/mL. The results of the Shapiro Wilk test show that the data is normal. The comparative test results showed that there were significant differences between the two types of extracts.

Conclusion: The ingredients contained in Aloe vera, both ethanol extract and ethyl acetate extract, are flavonoids, tannins, and terpenoids, and the ethyl acetate extract also contains alkaloids which make the ethanol and ethyl acetate extracts of Aloe vera included in the category of potential cytotoxic (IC50 < 100 µg/mL) with ethanol extract is more potent than with ethyl acetate extract."

"Pendahuluan: Kualitas hidup pasien dengan kanker kolorektal di Indonesia saat ini dievaluasi oleh kuesioner yang tidak seragam. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ColoRectal 29 EORTC QLQ-CR29 , adalah sebuah kuesioner yang terstandarisasi untuk menilai kualitas hidup yang umum digunakan pada negara maju. Penelitian ini untuk membuktikan bahwa EORTC QLQ-CR29 adalah kuesioner yang valid dan reliabel untuk digunakan di Indonesia. Metode: Kuesiober EORTC QLQ-CR29 diterjemahkan kedalam bahasa Indonesia, dan diterjemahkan kembali ke bahasa Inggris. Dilakukan sebuah studi pilot terlebih dahulu, kemudian studi utama ke pasien kanker kolorektal pada poliklinik Bedah Digestif di RS dr.Cipto Mangunkusumo. Desain studi cross-sectional, digunakan intraclass correlation coeficient ICC untuk menilai test-retest reability. Konsistensi internal dievaluasi menggunakan Cronbach rsquo;s ? coefficient. Validitas konvergen dan diskriminan dianalisa dengan multi-trait scaling. Validitas klinis dievaluasi berdasarkan perbedaan klinis yang telah diketahui sebelumnya menggunakan known-group comparisons. Hasil: Sebanyak limapuluhdua pasien yang berpertisipasi pada penelitian ini. Proses penterjemahan membutuhkan sedikit perubahan akibat adanya perbedaan budaya. Uji test-retest dilakukan pada 17 subjek, yang menunjukan nilai yang dapat diterima 0.67-1.00 . Nilai Cronbach rsquo;s ? coefficient 0,77-0,86, nilai ini melebihi kriteria 0,7. Pada multi-trait scaling analysis menunjukan skala multi-item memenuhi standar validitas konvergen dan diskriminan. Pada uji known group comparison menunjukan kualitas hidup yang berbeda berdasarkan lokasi tumor. Kesimpulan: dibutuhkan adaptsi budaya dalam proses penterjemahan. Kuesioner EORTC QLQ-CR29 yang telah diterjemakan merupakan kuesioner yang valid dan reliabel untuk menilai kualitas hidup pasien kanker kolorektal di Indonesia.

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Background: Currently in Indonesia the quality of life QoL of colorectal cancer patients is evaluated by many questionnaire. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ColoRectal 29 EORTC QLQ CR29 , as a standardized objective method to assess QoL of colorectal cancer patients has been widely used in developed country. This research is to prove that EORCT QLQ CR29 is a reliable and valid questionnaire to be used in Indonesia.

Methods: The EORTC QLQ C29 was translated forward and backward into Indonesian language. A pilot study was firstly done then proceed with the main study towards colorectal patients in Digestive Surgery Clinic in Cipto Mangunkusumo Hospital. This is a cross sectional study, intraclass correlation coeficient ICC was used to assess the test retest reability. The Internal consistency reability was estimated using Cronbach rsquo s coefficient. Convergent and discriminant validity was analyzed with multi trait scaling. Clinical validity was assesed in terms of clinical difference using known group comparisons.

Result: Fifty two patients participated in this study. The translation proses require some adjusment due to cultural adaptation. Test retest was administered to 17 patient, showed acceptable reproducibility 0,67 1,00. The Cronbach rsquo s coefficient 0,77 0,86 exceeded the 0,7 criterion and multi trait scaling analysis showed that multi item scales met standards of convergent and discriminant validity. The known group comparisons showed QoL differences between groups of patients based on tumor location.

Conclusion: Some cultural adaptation is needed in the translation process. The translated EORTC QLQ CR29 is a reliable and valid questionnaire for assessing quality of life of colorectal cancer patients in Indonesia."