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Abstrak :
Latar Belakang: Adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri, tanpa melihat gambaran episentrum tumor, sulit dibedakan secara histopatologi. Gejala klinis tidak spesifik sehingga kasus yang ditemukan seringkali tidak memenuhi kriteria resectable. Gambaran radiologi juga tidak spesifik, padahal terapi dan prognosis keduanya berbeda. Adenokarsinoma duktal pankreas memiliki angka kesintasan rendah dibanding adenokarsinoma ampula vateri. Penentuan asal tumor, berasal dari duktal pankreas atau ampula vateri, sangat penting. SMAD4 diduga dapat menjadi salah satu panel diagnostik imunohistokimia. Penelitian ini dilakukan dengan melihat perbandingan ekspresi SMAD4 di adenokarsinoma ampula vateri dan adenokarsinoma duktal pankreas. Tujuan: Mengetahui perbandingan ekspresi SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri. Metode: Penelitian analitik observasional, desain potong lintang pada sediaan reseksi adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri, periode Januari 2013 hingga September 2021. Pengambilan sampel dilakukan secara total sampling. Adenokasinoma ampula vateri dengan subtipe pankreatobiliar dieksklusi. Pemeriksaan imunohistokimia menggunakan antibodi primer SMAD4. Data imunohistokimia dianalisis untuk melihat adakah perbedaan ekspresi SMAD4 pada adenokarsinoma di ampula vateri dan adenokarsinoma duktal pankreas. Hasil: Loss of SMAD4 didapatkan pada 12 kasus (60 %) adenokarsinoma duktal pankreas dan 8 kasus (44,4 %) adenokarsinoma ampula vateri. Tidak didapatkan hubungan loss of SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri (p=0,338). Kesimpulan: Tidak terdapat hubungan bermakna loss of SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri. Namun terdapat trend loss of SMAD4 lebih tinggi pada adenokarsinoma duktal pankreas dibanding adenokarsinoma ampula vateri subtipe intestinal dan mixed type dominansi intestinal. ......ackground: Differentiating pancreatic ductal adenocarcinoma and ampullary adenocarcinoma without knowing the epicenter of the tumor is difficult. The clinical symptoms are non-specific. The cases found usually do not meet the operable criteria. Radiological examination is also non-specific, although the treatment and prognosis are different. Pancreatic ductal adenocarcinoma has lower survival rate than ampullary adenocarcinoma. It is very important to determine the origin of the tumor from pancreatic ductal or ampulla of Vater. SMAD4 is expected to be one of immunohistochemical diagnostic panel for the pancreatic ductal adenocarcinoma. This study compares the SMAD4 expression in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma. Objective: Knowing the comparison of SMAD4 expression in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma. Methods: Observational analytical study with cross sectional design, total sampling was performed on the resection specimens of pancreatic ductal adenocarcinoma and ampullary adenocarcinoma, period January 2013 to December 2021. Ampullary adenocarcinoma with pancreatobilliary subtype was excluded. Immunohistochemical examination using SMAD4 primary antibody. Immunohistochemical data will be analyzed to see SMAD4 expression difference between pancreatic ductal adenocarcinoma and ampullary adenocarcinoma. Results: Loss of SMAD4 was found in 12 cases (66,7 %) of pancreatic ductal adenocarcinoma and 6 cases (44,4 %) of ampullary adenocarcinoma. There was no significant relationship between loss of SMAD4 in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma (p=0,338). Conclusions: There was no significant relationship between loss of SMAD4 in pancreatic ductal adenocarcinoma and adenocarcinoma of the ampulla of vater. However, there was a trend of higher SMAD4 loss in pancreatic ductal adenocarcinoma than ampullary vater adenocarcinoma of intestinal subtype and mixed type with intestinal dominance.

Abstrak :
Kanker kolorektal merupakan jenis kanker terbanyak ketiga di Indonesia. Hal ini disebabkan oleh pola hidup yang tidak sehat seperti merokok, pola makan yang mengadopsi makanan cepat saji, kegemukan, dan kurangnya aktivitas fisik. Penatalaksanaan medis utama pada kasus kolorektal yaitu pembedahan dengan cara mereseksi kanker, kemudian membuat stoma, dan penyambungan kembali usus yang disebut anastomosis. Salah satu masalah utama pada pasien postoperasi adalah nyeri akut. Penelitian ini bertujuan untuk menyajikan hasil analisis asuhan keperawatan pada pasien post operasi close colostomy dan dan laparatomi adhesiolisis. Metode yang digunakan adalah studi kasus. Adapun intervensi berbasis bukti yang diterapkan yaitu intervensi manajemen nyeri berupa teknik relaksasi napas dalam guna menurunkan intensitas nyeri pada pasien post operasi close colostomy dan laparatomi adhesiolisis. Penerapan teknik relaksasi napas dalam diharapkan dapat diaplikasikan oleh perawat bedah di ruangan khususnya untuk mengurangi nyeri akut post operasi close colostomy dan laparatomi adhesiolisis. Kata kunci : kanker kolorektal, close colostomy, laparatomi adhesiolisis, nyeri akut, relaksasi napas dalam. ......Colorectal cancer is the third most common type of cancer in Indonesia. This is caused by unhealthy lifestyles such as smoking, eating patterns that adopt fast food, obesity, and lack of physical activity. The main medical management in colorectal cases is surgery by resecting the cancer, then making a stoma, and reconnecting the intestine which is called anastomosis. One of the main problems in postoperative patients is acute pain. This study aims to present the results of the analysis of nursing care in postoperative patients with close colostomy and adhesiolysis and laparotomy. The method used is a case study. The evidence-based intervention applied is pain management intervention in the form of deep breathing relaxation techniques to reduce pain intensity in postoperative close colostomy and adhesionic laparotomy patients. It is hoped that the application of deep breathing relaxation techniques can be applied by surgical nurses in the room especially to reduce acute pain after close colostomy surgery and adhesiolysis laparotomy. Keywords : colorectal cancer, close colostomy, laparotomy adhesiolisis, acute pain, deep breat relaxation.

Abstrak :
Keganasan pankreas merupakan keganasan dengan angka kematian yang tinggi, dengan Adenokarsinoma Duktal Pankreas/Pancreatic Ductal Adenocarcinoma (PDAC) mencakup 85-90% kasus. PDAC memiliki perjalanan penyakit yang sangat agresif, dan seringkali baru terdiagnosis pada stadium lanjut. Penegakan diagnosis pasti PDAC seringkali hanya dapat dilakukan melalui sediaan terbatas baik berupa biopsi maupun endoscopic ultrasound-guided fine-needle aspiration/EUS-FNA. Salah satu tantangannya adalah membedakan PDAC dari jaringan pankreas non-neoplastik/reaktif. Penelitian ini akan membahas mengenai peran von Hippel-Lindau gene product/pVHL dalam membedakan PDAC dengan jaringan pankreas non-neoplastik, serta hubungannya dengan profil klinikopatologiradira PDAC. Penelitian ini merupakan penelitian observasional analitik dengan desain cross-sectional pada kasus PDAC dan jaringan pankreas non-neoplastik yang dilakukan di RSCM pada sampel yang diperoleh pada bulan Januari 2012 hingga September 2023. Sampel penelitian dibagi menjadi 2 kelompok besar, yaitu kelompok PDAC dan pankreas non-neoplastik. Pemilihan sampel dilakukan dengan menggunakan simple random sampling dari kasus-kasus yang memenuhi kriteria inklusi dan tidak termasuk dalam kriteria eksklusi. Dilakukan pulasan imunohistokimia pVHL dan perhitungan Histoscore/H-score serta penentuan cut-offnya untuk membagi ekspresi pVHL menjadi tinggi dan rendah dan hubungannya dengan PDAC dan non-neoplastik, serta profil klinikopatologi pada kelompok PDAC. Penelitian ini menunjukkan tidak terdapat perbedaan ekspresi pVHL pada kelompok PDAC dan non-neoplastik, dan staging pN memiliki hubungan bermakna dengan ekspresi pVHL pada PDAC. Ekspresi pVHL yang rendah lebih banyak ditemukan pada PDAC berdiferensiasi sedang, tidak ditemukan invasi limfovaskular maupun invasi perineural, memiliki batas sayatan yang tidak bebas, memiliki staging pT2, pN0, M0, dan kesintasan > 7 bulan. Sebaliknya, ekspresi pVHL yang tinggi juga lebih banyak ditemukan pada PDAC berdiferensiasi sedang, ditemukan invasi limfovaskular, tidak ditemukan invasi perineural, status batas sayatan yang bebas, staging pT2 dan pT3, pN1 dan pN2, M0, dengan kesintasan ≤ 7 bulan. Temuan ini berbeda dengan penelitian sebelumnya yang mendapati hilangnya ekspresi pVHL pada tumor PDAC, dan sebaliknya pada duktus pankreas non-neoplastik. Hal ini kemungkinan disebabkan oleh perbedaan klon antibodi yang digunakan pada penelitian ini dibandingkan dengan penelitian sebelumnya. Klon antibodi yang digunakan adalah VHL40, sedangkan penelitian-penelitian sebelumnya menggunakan klon FL-181 yang berikatan dengan asam amino yang berbeda dan memiliki klonalitas yang berbeda pula. Selain itu, pada PDAC dapat terjadi mutasi pada gen VHL yang menghasilkan protein VHL yang non-fungsional yang kemungkinan masih dapat terdeteksi dengan ikatan antigen-antibodi pada penelitian ini.  ......Pancreatic malignancy is a malignancy with a high mortality rate, with Pancreatic Ductal Adenocarcinoma (PDAC) accounting for 85-90% of cases. PDAC has a very aggressive disease course, and is often only diagnosed at an advanced stage. Establishing a definite diagnosis of PDAC can often only be done through limited sample from biopsy or endoscopic ultrasound-guided fine-needle aspiration/EUS-FNA. In such limited sample, differentiating PDAC from non-neoplastic/reactive pancreatic tissue can be challenging. This research will discuss the role of von Hippel-Lindau gene product/pVHL in PDAC and non-neoplastic pancreatic tissue, as well as their relationship with PDAC pathological factors. This research is an analytical observational study with a cross-sectional design on cases of PDAC and non-neoplastic pancreatic tissue conducted at RSCM on samples obtained from January 2012 to September 2023. The research samples were divided into 2 large groups, namely the PDAC and non-neoplastic pancreatic groups. Sample selection was carried out using simple random sampling from cases that met the inclusion criteria and were not included in the exclusion criteria. Immunohistochemistry of pVHL was performed along with calculation of Histoscore/H-score and determination of cut-offs to divide pVHL expression into high and low and its relationship with PDAC and non-neoplastic, as well as pathological factors in the PDAC group. This study shows that there is no difference in pVHL expression in the PDAC and non-neoplastic groups, and pN staging has a significant relationship with pVHL expression in PDAC. Low pVHL expression is more often found in moderately differentiated PDAC, no lymphovascular invasion or perineural invasion, non-free incision margins, staging pT2, pN0, M0, and survival > 7 months. In contrast, high pVHL expression was also found more frequently in moderately differentiated PDAC, lymphovascular invasion was found, no perineural invasion was found, free incision margin status, pT2 and pT3 staging, pN1 and pN2, M0, with survival ≤ 7 months. This finding is different from previous studies which found loss of pVHL expression in PDAC tumors, and vice versa. This difference in results is likely due to differences in the antibody clones used in this study compared to previous studies. The antibody clone used was VHL40, whereas previous studies used the FL-181 clone which binds to different amino acids and has different clonality. In addition, in PDAC there is a mutation in the VHL gene which may produce a non-functional VHL protein that still be detectable by antigen-antibody binding in this study.

Abstrak :
CA 19-9 merefleksikan derajat keparahan adenokarsinoma kaput pankreas ditunjukkan oleh beberapa studi berhasil menemukan korelasi peningkatan CA 19-9 dengan resektabilitas adenokarsinoma kaput pankreas. Penelitian ini bertujuan melakukan evaluasi hubungan dan nilai diagnostik CA 19-9 dalam memprediksi resektabilitas adenokarsinoma kaput pankreas. Penelitian dilakukan secara potong lintang mengambil data dari rekam medis Rumah Sakit dr. Cipto Mangunkusumo tahun 2016–2019. Pasien terdiagnosis adenokarsinoma kaput pankreas secara histopatologis atau pencitraan abdomen, berusia ≤65 tahun, dan memiliki catatan pemeriksaan kadar CA 19-9 diikutsertakan dalam penelitian ini. Selain kadar CA 19-9, peneliti juga menilai factor terkait operabilitas. Tercatat 54 subjek dengan rerata usia 53,78±11,13 tahun. Ditemukan adanya korelasi positif (0,850) dan signifikan antara tingginya kadar CA 19-9 dengan resektabilitas tumor kaput pankreas. Untuk operabilitas, ditemukan perbedaan bermakna kadar CA 19-9, albumin, dan skor Karnofsky pada kelompok pasien tumor kaput pankreas resectable dan unresectable. Titik potong kadar CA 19-9 tercatat sebesar 140,65 U/mL, dengan sensitivitas sebesar 82,76% (64,23%–94,15%), spesifisitas sebesar 72,00% (50,61%–87,93%), dan AUC sebesar 0,784. CA 19-9 berhubungan secara signifikan dengan resektabilitas tumor kaput pankreas. CA 19-9 memiliki nilai diagnostik yang baik dalam mempredisksi resektabilitas tumor ini. ......This study would like to evaluate the relationship and diagnostic value of CA 19-9 in predicting the resectability of pancreatic head carcinoma. The cross-sectional study took data from the medical records at dr Cipto Mangunkusumo Hospital in 2015–2019. Patients diagnosed with pancreatic head carcinoma based on histopathologic or abdominal imaging, aged ≤75 years, and who had a recorded CA level of 19-9 were enrolled in the study. The investigators also assessed parameters of operability. Of 54 patients with similar characteristics were enrolled, with a mean age of 53.78 ± 11.13 years. It was found that there was a positive (0.850) and significant correlation between high levels of CA 19-9 and unresectable pancreatic head carcinoma. We found significant differences in levels of CA 19-9, albumin, and Karnofsky score in the resectable and unresectable groups of pancreatic head carcinoma. The cut-off point for CA 19-9 levels was 140.65 U / mL, with a sensitivity of 82.76% (64.23%-94.15%), specificity of 72.00% (50.61%-87.93 %), and AUC of 0.784. CA 19-9 was significantly associated with the pancreatic head carcinoma resectability. CA 19-9 has a good diagnostic value in predicting the resectability of these tumors.

Abstrak :
[ABSTRAK
Latar Belakang: Kanker kolorektal merupakan tumor ganas ketiga di dunia. Sembilan puluh lima persen kanker kolorektal merupakan adenokarsinoma yang berasal dari lesi prekursor adenoma. Dilaporkan 15%-20% kanker terkait dengan infeksi virus. Virus yang diduga berhubungan dengan kanker kolorektal adalah human papilloma virus (HPV) dan tipe tersering adalah 16 dan 18. Hubungan antara HPV dan kanker kolorektal masih menjadi perdebatan. Penelitian ini bertujuan untuk mengetahui perbedaan prevalensi infeksi HPV pada adenoma dan adenokarsinoma kolorektal di Departemen Patologi Anatomik FKUI/RSCM Jakarta dengan menggunakan teknik polymerase chain reaction (PCR). Bahan dan Metode: Pemeriksaaan DNA HPV pada 33 kasus adenoma dan 33 kasus adenokarsinoma kolorektal dengan teknik nested PCR MY/GP dan elektroforesis. Pada kasus dengan hasil HPV positif, dilanjutkan PCR menggunakan primer spesifik HPV 16 dan HPV 18. Subjek penelitian berasal dari Departemen Patologi Anatomik FKUI/RSCM. Hasil: Satu dari 33 kasus (3,0%) adenoma dan 3 dari 33 kasus (9,1%) adenokarsinoma positif infeksi HPV. Satu kasus adenoma positif HPV bukan merupakan tipe 16 dan 18. Satu kasus adenokarsinoma dengan positif, HPV merupakan tipe 16, 2 kasus merupakan gabungan tipe 16 dan 18. Kesimpulan: Prevalensi infeksi HPV pada adenokarsinoma lebih tinggi dibandingkan adenoma kolorektal. Tipe HPV pada kasus adenokarsinoma kolorektal merupakan tipe 16 dan 18.

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ABSTRACT
Background : Colorectal cancer is the third malignant tumor in the world. Ninety-five percent of colorectal cancers are adenocarcinomas derived from precursor lesions adenoma. There are 15% -20% of cancers associated with viral infections. Virus are suspected associated with colorectal cancer is the human papilloma virus (HPV) and the most common types are 16 and 18. The relationship between HPV and colorectal cancer is still being debated. This study purpose to determine the prevalence differences of HPV infection in colorectal adenomas and adenocarcinomas in the Department of Anatomic Pathology, FKUI/RSCM Jakarta by using the polymerase chain reaction (PCR). Materials and Methods : HPV DNA examination on 33 cases of adenoma and 33 cases of colorectal adenocarcinoma by nested MY/GP PCR technique and electrophoresis. In the cases with positive HPV results, continue by specific primers HPV 16 and HPV 18 PCR. The subject of the study came from the Department of Anatomic Pathology, FKUI/RSCM. Result : One (3.0%) adenomas and 3 (9.1%) adenocarcinoma from 33 cases adenoma and adenocarcinoma are HPV positive. One case of HPV positive adenomas are not types 16 and 18. HPV positive adenocarcinoma, 1 case was type 16, two cases are combination of types 16 and 18. Conclusion : The HPV prevalence in adenocarcinoma was higher than colorectal adenoma. HPV types on positive colorectal adenocarcinoma cases are types 16 and 18., Background : Colorectal cancer is the third malignant tumor in the world. Ninety-five percent of colorectal cancers are adenocarcinomas derived from precursor lesions adenoma. There are 15% -20% of cancers associated with viral infections. Virus are suspected associated with colorectal cancer is the human papilloma virus (HPV) and the most common types are 16 and 18. The relationship between HPV and colorectal cancer is still being debated. This study purpose to determine the prevalence differences of HPV infection in colorectal adenomas and adenocarcinomas in the Department of Anatomic Pathology, FKUI/RSCM Jakarta by using the polymerase chain reaction (PCR). Materials and Methods : HPV DNA examination on 33 cases of adenoma and 33 cases of colorectal adenocarcinoma by nested MY/GP PCR technique and electrophoresis. In the cases with positive HPV results, continue by specific primers HPV 16 and HPV 18 PCR. The subject of the study came from the Department of Anatomic Pathology, FKUI/RSCM. Result : One (3.0%) adenomas and 3 (9.1%) adenocarcinoma from 33 cases adenoma and adenocarcinoma are HPV positive. One case of HPV positive adenomas are not types 16 and 18. HPV positive adenocarcinoma, 1 case was type 16, two cases are combination of types 16 and 18. Conclusion : The HPV prevalence in adenocarcinoma was higher than colorectal adenoma. HPV types on positive colorectal adenocarcinoma cases are types 16 and 18.]

Abstrak :
Latar Belakang:Kanker prostat merupakan keganasan ketiga yang paling sering ditemukan di Indonesia. Sekitar 90-95% kanker prostat adalah adenokarsinoma asinar. Prognosis kanker prostat dan strategi tatalaksana didasarkan pada derajat keganasan. Tujuan penelitian ini untuk evaluasi rasio ADC dalam menentukan agresivitas kanker prostat. Metode:Sebanyak 32 sampel kanker prostat dari zona perifer yang terbukti dengan biopsi dan telah dilakukan pemeriksaan MRI 1,5T dengan body coil. Rasio ADC dihitung menggunakan nilai ADC tumor dengan urin di vesika urinaria, otot obturator, dan ramus pubis sebagai referensi. Analisis rasio ADC dengan hasil histopatologi grade group <2 dan >3 menggunakan student t. Kurva ROC digunakan untuk akurasi diagnostik rasio ADC dalam menentukan grade group. Hasil:Terdapat 12 dan 20 sampel grade group <2 dan >3. Rasio ADC tumor-urin 0,24, tumor-obturator internus 0,64, dan tumor-ramus pubis 0,85, lebih rendah dan bermakna pada pasien dengan grade group >3 (p <0,005). AUC dihitung menggunakan rasio ADC tumor-urin menunjukkan hasil tertinggi (0,988) di antara rasio ADC tumor-obturator internus (0,887) dan tumor-ramus pubis (0,783).Kesimpulan:Ketiga rasio ADC berbeda bermakna dalam membedakan grade group<2 dan grade group>3, serta merupakan prediktor signifikan dari kanker prostatgrade group >3. ......Background: Prostate cancer is the third most common malignancy in Indonesia. Approximately 90-95% of prostate cancers are adenocarcinoma acinar. Prostate cancer prognosis and treatment strategies are based on degree of malignancy. Objective of this study was to evaluate the ADC ratio in determining the aggressiveness of prostate cancer. Method: Thirty two prostate cancer samples from peripheral zones were proven by biopsy and 1.5T MRI examination was performed with body coil. ADC ratio was calculated using ADC value of tumor with urine in bladder, obturator muscle, and pubic ramus as a reference. Analysis ADC ratio with grade group <2 and >3 using a student T-test. The ROC curve is used for the accuracy of ADC ratio in determining the grade group. Results: Twelve and 20 samples of grade group <2 and >3. Three ADC ratio (0.24, 0.64, and 0.85, respecively) lower in grade group >3 (p <0.002). AUC was calculated, ratio ADC tumor-urine show the highest results (0.988) among tumor-internal obturator (0.887) and tumor-pubic ramus (0.783). Conclusion: Three ADC ratio have differed significantly in distinguishing grade group <2 and >3, and were a significant predictor of grade group >3 prostate cancer.

Abstrak :
Latar Belakang: Kanker paru merupakan kanker terbanyak kedua yang terdiagnosis dan menjadi penyebab terbanyak kematian akibat kanker. Pemberian afatinb sebagai terapi target Epidermal Growth Factor Receptor (EGFR)-Tyrosine Kinase Inhibitor (TKI saat ini telah menjadi terapi standar untuk pasien adenokarsinoma paru dengan mutasi EGFR di Indonesia, termasuk di RSUP Persahabatan. Penelitian ini dilakukan untuk menganalisis pemberian terapi afatinib pada pasien adenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan. Metode: Desain penelitian ini adalah kohort retrospektif menggunakan data rekam medis fisik dan elektronik, dilakukan di Poli Onkologi RSUP Persahabatan, dengan teknik total sampling. Subjek penelitian adalah pasien adenokarsinoma paru dengan mutasi EGFR yang mendapatkan afatinib pada Januari 2018-Desember 2021 di Poli Onkologi RSUP Persahabatan yang memenuhi kriteria penelitian. Hasil: Didapatkan 116 subjek penelitian, pasien adenokarsinoma paru dengan mutasi EGFR yang mendapatkan afatinib di RSUP Persahabatan dengan karakteristik lebih banyak laki-laki (52,6%), kelompok usia <65 tahun (80,2%), suku Jawa (81,9%), tanpa faktor risiko keganasan di keluarga (82,8%). Saat terdiagnosis subjek penelitian lebih banyak dengan stage IVA (75%), metastasis pleura (59,5%), mutasi EGFR delesi ekson 19 (53,4%) status tampilan 0-1 (75,9%) dan metastasis otak didapatkan pada 19% subjek. Nilai median progression free survivival (PFS) subjek penelitian yang mendapat afatinib adalah 13 bulan (95%IK 10,5-15,5 bulan), dan nilai median overall survival (OS) adalah 17 bulan (95%IK 14,9-19,1 bulan). Angka tahan hidup satu tahun yang didapat 65,1% dan Objective Respons Rate (ORR) adalah 36,1%. Sebanyak 35,3% subjek mendapatkan penurunan dosis afatinib 20 mg atau 30 mg. Toksisitas nonhematologi tersering pada pada penelitian ini adalah diare (74,1%), diikuti oleh stomatitis (61,2%), ruam kulit (59,5%) dan paronikia (49,1%). Kesimpulan: Afatinib sebagai terapi lini pertama memberikan luaran yang cukup baik untuk pasien adenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan dengan efek samping samping nonhematologi yang dapat dikelola. Riwayat penurunan dosis afatinib tidak memengaruhi angka kesintasan. ......Background: Lung cancer is the second most diagnosed cancer and the most common cause of death from cancer. Afatinib as targeted therapy with Epidermal Growth Factor Receptor (EGFR)-Tyrosine Kinase Inhibitor (TKI) has now become standard therapy for lung adenocarcinoma patients with EGFR mutations in Indonesia, including at RSUP Persahabatan. This study was conducted to analyze the administration of afatinib therapy in lung adenocarcinoma patients with EGFR mutations at Persahabatan General Hospital. Metode: Design of the study was retrospective cohort using secondary data, physical and electronic medical records at Oncology Clinic Persahabatan Hospital with total sampling technique. Subject of this study were medical records of lung adenocarcinoma patients with EGFR mutation and received afatinib therapy by January 2018- December 2021 which met the inclusion criteria. Results: There were 116 subjects of lung adenocarcinoma with EGFR mutation and received afatinib at Persahabatan Hospital, with predominant of male (52,6%), age <65 years old (80,2%), Javanese (81,9%), without history of cancer in family (82,8%). Most of subjects are diagnosed as lung adenocarcinoma at stage IVA (75%), with most of them have pleural metastases (59,5%), EGFR mutation with exon 19 deletion (53,4%), performa status 0-1 (75,9%), and brain metastases were found in 19% of subject. The median progression free survival (PFS) of subjects was 13 months (95% CI 10.5-15.5 months), and the median overall survival (OS)was 17 months (95% CI 14.9- 19.1 months). The one-year survival rate was 65.1% and the Objective Response Rate (ORR) was 36,1%. As many as 35.3% of subjects had adjustment dose of afatinib to 20 mg or 30 mg The most common non-hematological toxicity found was diarrhea (74.1%), followed by stomatitis (61.2%), skin rash (59.5%) and paronychia (49.1%). Conclusion: Afatinib as a first-line therapy provides a good outcome for lung adenocarcinoma patients with EGFR mutations at Persahabatan General Hospital with manageable non-hematological adverse events. History of adjustment dose of afatinib did not affect survival rate.