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Abstrak :
Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 - 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 - 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 - 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 - 7,6). Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD. ......Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates morbidity and affect patient s quality of life and survival. This study uses cross sectional design with total sampling at one tertiary referral center. MBD patient during 2008 - 2018 were evaluated for characteristics, treatment received, and survival rate. Survived patients were evaluated for functional score with SF-36 and MSTS. From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 - 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 - 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 - 7,6). Surgery has a significant association with MBD patient survival.

Abstrak :
Pendahuluan: Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Metode: Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 – 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Hasil: Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 – 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 – 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 – 7,6). Kesimpulan: Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD. ......Introduction: Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates quite morbidity and in the end affect the patient’s quality of life and survival. Methods: This study uses cross sectional design with total sampling at Cipto Mangunkusumo Hospital. MBD diagnosed patient during 2008 – 2018 were evaluated for characteristics, survival rate. Survived patient will evaluated for functional score with SF-36 and MSTS. Results: From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 – 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 – 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 – 7,6). Conclusion: Surgery has a significant association with MBD patient survival.

Abstrak :
ABSTRAK
Latar Belakang: Simple bone cyst (SBC) adalah tumor tulang jinak, berisi cairan. Tujuan utama terapi SBC adalah mendapatkan penyembuhan tulang, mencegah fraktur patologis, dan manajemen gejala khususnya nyeri. Terdapat berbagai metode pengobatan SBC, namun saat ini masih kontroversial karena angka kesembuhan dan tingkat invasi operasi. Terapi injeksi perkutaneus steroid merupakan metode operasi dengan tingkat invasi rendah sehingga penyembuhan tulang dan luaran fungsional lebih baik. Metode: Total terdapat 10 pasien (6 laki-laki, 4 perempuan, rerata usia13 tahun) SBC yang terbagi dalam dua kelompok. 5 pasien (proksimal femur 3; proksimal humerus 1; calcaneus 1) dilakukan terapi injeksi perkutaneus steroid dan 5 pasien (proksimal femur 2; proksimal humerus 2, radius 1) terapi kurease dengan hidroksiapatit. Injeksi perkutaneus steroid dilakukan sebanyak tiga kali dengan interval waktu tiap satu bulan. Rerata follow up adalah 12-26 bulan. Evaluasi penyembuhan tulang dinilai secara radiologi dengan kriteria Chang dkk. Luaran fungsional dinilai berdasarkan skor MSTS. Hasil: Penyembuhan tulang komplit didapatkan pada kedua kelompok, namun solid union lebih cepat terjadi pada kelompok terapi injeksi perkutaneus steroid. Luaran fungsional didapatkan nilai yang lebih baik pada kelompok injeksi perkutaneus steroid terutama pada bulan ke-3 (55%) dan ke-6 (84%) pasca operasi berdasarkan skor MSTS dibandingkan terapi kuretase dengan hidroksiapatit (bulan ke-3 47% dan ke-6 69,3%). Simpulan: Terapi injeksi perkutaneus steroid masih tetap menjadi pilihan utama metode terapi SBC dengan solid union lebih cepat, tingkat prosedur operasi invasi rendah, lebih mudah, efektif, dan aman. ABSTRACT
Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main goals of the therapy are to get the bone healing, prevent pathological fractures, and management of pain symptom. There are various methods of the SBC treatment, however still remains controversial because of their healing rate and invasiveness of surgery. Steroid injection therapy is a surgical procedure with a low level of invasiveness so that better bone healing and functional outcomes. Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1) performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2 proximal humerus, radius 1) performed curretage with hydroxyapatite therapy. Percutaneous steroid injection was performed three times at intervals of each month. The mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by Chang criteria and the functional outcome by MSTS score. Results: Complete bone healing was found in both group, but solid union occurred faster in steroid injection theraphy group. The functional outcomes found better value in the steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post operation based on MSTS score. Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main goals of the therapy are to get the bone healing, prevent pathological fractures, and management of pain symptom. There are various methods of the SBC treatment, however still remains controversial because of their healing rate and invasiveness of surgery. Steroid injection therapy is a surgical procedure with a low level of invasiveness so that better bone healing and functional outcomes. Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1) performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2 proximal humerus, radius 1) performed curretage with hydroxyapatite therapy. Percutaneous steroid injection was performed three times at intervals of each month. The mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by Chang criteria and the functional outcome by MSTS score. Results: Complete bone healing was found in both group, but solid union occurred faster in steroid injection theraphy group. The functional outcomes found better value in the steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post operation based on MSTS score. Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main goals of the therapy are to get the bone healing, prevent pathological fractures, and management of pain symptom. There are various methods of the SBC treatment, however still remains controversial because of their healing rate and invasiveness of surgery. Steroid injection therapy is a surgical procedure with a low level of invasiveness so that better bone healing and functional outcomes. Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1) performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2 proximal humerus, radius 1) performed curretage with hydroxyapatite therapy. Percutaneous steroid injection was performed three times at intervals of each month. The mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by Chang criteria and the functional outcome by MSTS score. Results: Complete bone healing was found in both group, but solid union occurred faster in steroid injection theraphy group. The functional outcomes found better value in the steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post operation based on MSTS score. Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.

Abstrak :
Latar Belakang: Osteosarkoma merupakan jenis tumor tulang ganas paling sering pada anak dan remaja. Sejumlah faktor prognostik telah diketahui mempengaruhi luaran pada osteosarkoma pediatrik, termasuk lokasi dan ukuran tumor primer, adanya metastasis, resektabilitas, keadaan remisi, serta respons kemoterapi yang diperiksa dengan derajat nekrosis tumor. Penelitian ini bertujuan untuk mengetahui luaran osteosarkoma pada anak dan faktor-faktor yang mempengaruhinya. Metode: Penelitian ini merupakan studi observasional dengan desain cross sectional. Penelitian dilakukan di poliklinik Onkologi Orthopaedi Rumah Sakit Cipto Mangunkusumo, Jakarta pada bulan Januari 2020-Juni 2021. Pengambilan subjek penelitian dilakukan berdasarkan metode consecutive sampling. Data klinis, radiologis dan laboratorium diambil dari rekam medis, sementara skor MSTS diukur melalui wawancara terhadap subjek baik secara langsung atau pun melalui telepon. Data pasien dimasukkan ke dalam CRF (Case Report Form) untuk osteosarkoma dari Departemen Orthopaedi dan Traumatologi. Seluruh data dianalisis dan ditabulasikan ke dalam tabel. Hasil dan pembahasan: Pada penelitian ini, angka kesintasan keseluruhnan kasus osteosarkoma adalah 31,8%, dan rekurensi lokal terjadi pada 18,2% kasus pasien osteosarkoma anak. Metastasis terjadi pada 65,9% kasus dan sebagain besar metastasis ditemukan pada paru. Didapatkan jenis kelamin berhubungan dengan kesintasan pada pasien osteosarkoma (P<0,05). Hubungan kesintasan dengan usia sampel tidak bermakna, namun terdapat hubungan signifikan antara kesintasan dengan alkalin fosfatase, jenis biopsi, lokasi tumor, dan tipe HUVOS. Terdapat hubungan signifikan antara rekurensi lokal dengan nilai serum alkaline fosfatase, namun tidak terdapat hubungan signifikan antara rekurensi lokal jenis kelamin dan usia, jenis biopsi, tipe HUVOS, dan lokasi tumor. Rata-rata skor MSTS dari 14 subjek penelitian adalah 20,93 ± 3,63. Tidak terdapat perbedaan signifikan antara metastasis dengan jenis kelamin, usia, alkalin fosfatase, jenis biopsi, tipe HUVOS, dan lokasi tumor. Terdapat hubungan signifikan antara rekurensi lokal dan alkaline fosfatase (P < 0,05). Kesintasan dan metastasis memiliki perbedaan yang signifikan (P < 0,001). Kesimpulan: Terdapat hubungan yang bermakna antara kadar alkaline fosfatase terhadap rekurensi lokal pada anak dengan osteosarkoma. Terdapat hubungan yang bermakna antara metastasis dengan kesintasan 5 tahun pada anak dengan osteosarkoma. Hal ini menandakan bahwa angka kesintasan tinggi pada pasien yang tidak mengalami metastasis. ......Background: Osteosarcoma is the most frequent malignant bone tumor in children and adolescents. A number of prognostic factors have been known to affect the outcomes of pediatric osteosarcoma, including the location and size of the primary tumor, the presence of metastasis, resectability, remissions, and the chemotherapy response examined by the degree of tumor necrosis. This study aims to determine the outcomes of osteosaroma in children and the factors that influence it. Methods: This was an observational analytic study with a retrospective cross sectional design. The study was conducted at the Orthopedic Oncology Polyclinic Cipto Mangunkusumo Hospital, Jakarta in January 2020 – June 2021. The research sampling was carried out based on the consecutive random sampling method. Clinical, radiological and laboratory data were documented from medical records, while the MSTS score was measured through interviews on the subject both directly or by telephone. Patient data was inserted into the CRF (Case Report Form) for osteosarcoma from the orthopedic and traumatology department. All data were analysed and tabulated into the table. Results and Discussion: In this study, the overall 5 years survival rate of osteosarcoma was 31.8%, and the local recurrence is 18.2% of pediatric osteosarcoma patients. Metastases occurred in 65.9% of cases and most of the metastases were found in the lung. It was found that gender was significanced with survival in osteosarcoma patients (P<0.05). The relationship between survival and age was not significant, but there was a significant relationship between survival and alkaline phosphatase, type of biopsy, tumor location, and type of HUVOS. There was a significant relationship between local recurrence and serum alkaline phosphatase, but there was no significant relationship between local recurrence, gender and age, type of biopsy, HUVOS type, and tumor location. The mean of MSTS score of the 14 study subjects was 20.93 ± 3.63. There was no significant difference between metastases by sex, age, alkaline phosphatase, type of biopsy, type of HUVOS, and tumor location. There was a significant relationship between local recurrence and alkaline phosphatase (P < 0.05). There was a significant difference between survival and metastasis (P < 0.001). Conclusion: There was a significant relationship between alkaline phosphatase level and local recurrence in children with osteosarcoma. There was a significant association between metastasis and a 5-year mortality in children with osteosarcoma