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"Perjalanan penyakit Neoplasma Ovarium Kistik (NOK) disebut sillent killer karena seringkali terdeteksi saat sudah membesar. Kista ovarium seringkali muncul sepanjangsiklus hidup perempuan. Kelainan ginekologis dianggap sebagai kondisi yang secara signifikan mempengaruhi kehidupan sehari-hari perempuan, hubungan sosial, seksualitas dan kesehatan psikologis. Penatalaksaan NOK meliputi tindakan konservatif dan suportif dengan pemberian asuhan keperawatan yang komprehesif. Metode yang digunakan adalah studi kasus dengan fokus penerapan teori adaptasi Roy dan teori ketidakpastian Mishel. Aplikasi teori adaptasi Roy dan teori ketidakpastian Mishel efektif diterapkan pada kelima kasus yang berfokus pada kemampuan klien untuk beradaptasi dengan berbagai perubahan fisik maupun psikologis, serta melihat penilaian yang muncul dari kondisi penyakit dan tindakan yang dilakukan serta mampu mengeksplorasi bagaimana mekanisme koping yang digunakan serta respon adaptif yang digunakan oleh klien dengan menggunakan intervensi keperawatan yang sesuai.

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Cystic Ovary Neoplasm (NOK) disease is called the sillent killer because it is detected when it is enlarged. Ovarian cysts appeaed throughout the life cycle of women. Gynecological abnormalities are considered a condition that significantly affects women's daily lives, social relations, sexuality and psychological health. NOK's

management includes conservative and supportive interventions by providing comprehensive nursing care. The method used is a case study with a focus on applying Roy's adaptation theory and Mishel's uncertainty theory. The application of Roy's adaptation theory and Mishel's uncertainty theory is effectively applied to the five cases that focus on the client's ability to adapt to various physical and psychological changes, as well as see the evaluations that arise from disease conditions and actions and are able to explore how coping mechanisms are used and adaptive responses used by clients by using appropriate nursing interventions."

"Latar belakang: Kanker ovarium yang paling sering terjadi adalah jenis epitel, mayoritas terjadi pada perempuan usia lanjut namun ditemukan 3 - 17 wanita usia muda yaitu kurang dari 40 tahun. Meningkatnya angka survival dari keganasan ovarium maka mempertahankan fertilitas adalah hal yang sangat penting pada pasien usia muda. Prosedur diagnostik yang tepat diperlukan untuk oportunitas fungsi reproduksi pasien kedepannya, yaitu potong beku. Prosedur potong beku dapat mempertajam diagnosis dan penatalaksanaan yang terarah pada neoplasma ovarium suspek ganas dan mencegah terjadinya overprocedure maupun underprocedure. Tujuan : Mengetahui peran prosedur potong beku pada neoplasma ovarium suspek ganas pada usia dibawah 40 tahun di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini bersifat deskriptif dengan studi potong lintang yang dilaksanakan di RSUPN Dr. Cipto Mangunkusumo dengan menggunakan data rekam medik pada pasien neoplasma ovarium suspek ganas usia dibawah 40 tahun yang menjalani pembedahan dengan atau tanpa prosedur potong beku dari tahun 2013 hingga 2018. Hasil: Dari 109 subjek penelitian yang memenuhi kriteria inklusi didapatkan 62 kasus menjalani prosedur potong beku dengan hasil ganas (34,9%), borderline (14,7%) dan jinak (7,3%) sedangkan tanpa prosedur potong beku terdapat 47 kasus. Subjek yang menjalani potong beku didapatkan seluruh prosedur sesuai (100%) dengan kelengkapan prosedur pembedahan konservatif surgical staging, sedangkan tanpa potong beku didapatkan 4,8% outcome dengan hasil overprocedure. Kesimpulan: Tatalaksana konservatif menjadi prioritas utama dalam manajemen neoplasma ovarium suspek ganas usia muda, dengan adanya prosedur potong beku dapat menentukan tatalaksana lebih terarah secara intraoperatif.

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Background: The most common ovarian cancer is the type of epithelium, the majority occur in elderly women but found 3-17 young women that is less than 40 years. The increased survival rate of ovarian neoplasm is to maintain fertility is very important in young patients. Appropriate diagnostic procedures are needed for the future reproductive function of the patient, which is frozen section. Frozen section procedures can diagnose clearly and directed treatment of suspected malignant ovarian neoplasms and prevent overprocedure or underprocedure.

Aim: Knowing the role of frozen section procedures in suspected malignant of ovarian neoplasms under the age of 40 years at RSCM.

Methods: This research is descriptive with a cross sectional study conducted at RSCM using medical record data on patients with suspected of malignant ovarian neoplasms age under 40 years who underwent surgery with or without frozen cut procedures from 2013 to 2018.

Results : 109 study subjects which were taken from the inclusion criteria, 62 cases underwent frozen section procedures with malignant results (34.9%), borderline (14.7%) and benign (7.3%) whereas without procedures frozen section there are 47 cases. Subjects who underwent frozen section obtained all procedures according to (100%) with complete conservative surgical staging procedures, whereas without frozen section obtained 4.8% outcome with overprocedure results.

Conclusions: Conservative management is the main priority in the management of young woman with ovarian neoplasms, with the presence of frozen section procedures can determine management more directed intraoperatively."

"Metode : Penelitian ini merupakan penelitian uji diagnostik dengan menggunakan metode potong lintang. Pengambilan sampel dilakukan secara konsekutif. Penelitian dilakukan di Poliklinik Obstetri dan Ginekologi RSCM Jakarta pada 31 Januari 2015 hingga 31 Januari 2020. Sebanyak 183 pasien wanita dengan kecurigaan neoplasma ovarium padat diikutsertakan dalam penelitian. Pasien dengan penyakit sistemik lainnya atau mengalami kehamilan dieksklusi dari penetlitian. Dilakukan uji kesesuaian dengan menggunakan uji Kappa. Didapatkan sensitivitas dan spesifisitas dari masing-masing penanda tumorHasil : AFP memiliki sensitivitas 1,92% dan spesifisitas 77,1% sebagai penanda disgerminoma. LDH memiliki sensitivitas 55,67% dan spesifisitas 65,65% sebagai penanda disgerminoma.. AFP memiliki sensitivitas 30,43% dan spesifisitas 85% sebagai penanda teratoma. LDH memiliki sensitivitas 30,43% dan spesifisitas 58,13% sebagai penanda teratoma . AFP memiliki sensitivitas 100% dan spesifisitas 88,89% sebagai penanda Yolk sac tumor. LDH memiliki sensitivitas 41,67% dan spesifisitas 59,65% sebagai penanda Yolk sac tumor. Kombinasi AFP dan LDH memiliki sensitivitas 100% dan spesifisitas 50,29% sebagai penanda Yolk sac tumor. Kombinasi tumor marker AFP dan LDH memiliki nilai sensitivitas yang lebih tinggi namun tidak memiliki akurasi yang lebih baik dibandingkan pemeriksaan menggunakan AFP atau LDH saja.Kesimpulan : AFP dan LDH merupakan penanda tumor yang dapat digunakan untuk deteksi dini maupun skrining pada kasus neoplasma padat ovarium.

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Background: Ovarian neoplasms are the most common malignancy experienced by women in Indonesia. Solid ovarian neoplasm is a form of ovarian neopalsma that has a low survival rate due to late diagnosis. Early detection using tumor markers is one of the focuses of researches on ovarian neoplasms, one of which includes AFP and LDH.

Objective : To determine the sensitivity and specificity of AFP, LDH, and the combination of the two tumor markers.

Method : This research is a diagnostic test using cross sectional method. Sampling is done consecutively. The study was conducted at the Obstetrics and Gynecology Clinic of RSCM Jakarta from 31 January 2015 to 31 January 2020. A total of 182 female patients with suspicion of solid ovarian neoplasms were included in the study. Patients with other systemic diseases or pregnant were excluded from research. Conformity test was performed using the Kappa test. Sensitivity and specificity of each tumor marker was obtained

Result : AFP has a sensitivity of 1.92% and specificity of 77.1% as a marker of dysgerminoma. LDH has a sensitivity of 55.67% and a specificity of 65.65% as a marker of dysgerminoma. AFP has a sensitivity of 30.43% and a specificity of 85% as a marker of teratoma. LDH has a sensitivity of 30.43% and specificity 58.13% as a marker of teratomas. AFP has 100% sensitivity and 88.89% specificity as a marker of Yolk sac tumor. LDH has a sensitivity of 41.67% and specificity 59.65% as a marker of Yolk sac tumor. The combination of AFP and LDH has a sensitivity of 100% and a specificity of 50.29% as a marker of Yolk sac tumor. The combination of AFP and LDH marker tumors has a higher sensitivity value but does not have better accuracy than examinations using AFP or LDH alone"

"Penelitian ini membahas perbandingan performa diagnostik sistem skoring International Ovarian Tumor Analysis (IOTA) dengan Risk of Malignancy Index-4 (RMI-4) dan indeks morfologi Sassone dalam memprediksi keganasan ovarium prabedah. Dilakukan uji diagnostik potong-lintang secara retrospektif dengan pasien neoplasma ovarium di RSUPN Dr. Cipto Mangunkusumo dari Januari hingga Desember 2013. Nilai diagnostik dari keempat metode skoring dihitung dengan luaran: sensitivitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, akurasi dan nilai AUC. Penelitian ini menyimpulkan IOTA simple-rules memiliki performa diagnostik lebih baik dibandingkan IOTA subgroup, RMI-4 dan indeks morfologi Sassone.

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This study compared diagnostic performance of scoring system of International Ovarian Tumor Analysis (IOTA) with Risk of Malignancy Index-4 (RMI-4) and Sassone morphology index to predict ovarian malignancy preoperatively. A retrospective study was done involving subject with ovarian neoplasm at National General Hospital Dr. Cipto Mangunkusumo on January to December 2013. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC value were calculated. This study concluded that diagnostic performance of IOTA simple-rules were significantly better than IOTA subgroup, RMI-4 and Sassone morphology index."

"Latar belakang: Kanker ovarium merupakan salah satu keganasan ginekologi dengan tingkat mortalitas tertinggi. Seiring dengan perubahan gaya hidup dan pola makan, khususnya konsumsi karbohidrat, terjadi peningkatan kejadian resistensi insulin yang berhubungan dengan kejadian berbagai kanker. Akan tetapi, belum terdapat perbandingan kejadian resistensi insulin antara pasien neoplasma ovarium jinak dan kanker ovarium di Indonesia. Tujuan: Mengetahui perbandingan kejadian resistensi insulin antara pasien neoplasma ovarium jinak dan kanker ovarium di Indonesia. Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang(cross sectional). Subjek dari penelitian ini semua pasien neoplasma ovarium jinak dan ganas yang berkunjung ke Rumah Sakit Cipto Mangunkusumo selama periode Oktober 2019-Oktober 2020.Pasien dengan kesadaran dan hemodinamik tidak stabil, penyakit ginjal, penyakit hepar kronik, dan pasien dengan diabetes melitus sebelumnya dieksklusi dari penelitian. Data karakteristik klinis dan profil gula darah dibandingkan antar kelompok neoplasma jinak dan ganas. Tingkat resistensi insulin dihitung menggunakan perhitungan homeostatic model assessment-insulin resistanceHOMA-IR. Hasil:Didapatkan sebanyak 58 subjek yang terdiri dari 28 subjek neoplasma ovarium jinak dan 30 subjek kanker ovarium selama periode penelitian. Didapatkan perbedaan usia, indeks massa tubuh, kejadian malnutrisi, kejadian menopause, riwayat kontrasepsi, dan riwayat keganasan ovarium keluarga yang berbeda antar kelompok (p < 0,05). Tidak didapatkan perbedaan gula darah puasa maupun kadar insulin antar kelompok. Tidak didapatkan perbedaan kadar HOMA-IR dan kejadian resistensi insulin antar kelompok (p > 0,05). Kesimpulan:Tidak didapatkan perbedaan kadar HOMA-IR dan kejadian resistensi insulin antara pasien dengan neoplasma ovarium jinak maupun kanker ovarium.

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Background:Ovarian cancer is one of thegynecologymalignancies with the highest mortality rate. Along with changes in lifestyle and diet, especially carbohydrate consumption, there is an increase in the incidence of insulin resistance, known to beassociated with incidence of various cancers. However, there is no comparison of insulin resistance incidence between patients with benign ovarian neoplasmand ovarian cancer in Indonesia.

Objective:To compareof the incidence of insulin resistance between benign ovarian neoplasm and ovarian cancer patients in Indonesia.

Methods:This study was an observational analytic study with cross sectional method. The subjects of this study were all patients with benign and malignant ovarian neoplasmas who visited Cipto Mangunkusumo Hospital during the period October 2019-October 2020. Patients with unstable hemodynamics, chronic kidney or liver disease, and diabetes mellitus previously were excluded from the study. Data on clinical characteristics and blood sugar profiles were compared between groups. Insulin resistance levels were calculated using the homeostatic model insulin resistance assessment calculation(HOMA-IR).

Results:There were 58 subjects consisting of 28 benign ovarian neoplasma subjects and 30 ovarian cancer subjects during the study period. There were differences in age, body mass index, incidence of malnutrition, incidence of menopause, history of contraception, and family history of ovarian malignancy between groups (p <0.05). There were no differences in fasting blood sugar and insulin level between groups. There was no difference in HOMA-IR level and incidence of insulin resistance between groups (p> 0.05).

Conclusion:There was no difference in HOMA-IR level and incidence of insulin resistance between patients with benign ovarian neoplasm andovarian cancer."