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"Kecemasan merupakan perasaan yang tidak jelas tentang keprihatinan dan kekhawatiran karena ancaman pada sistem nilai atau pola keamanan seseorang.Kanker kolorektal dapat dideteksi dengan beberapa pemeriksaan dan salah satunya adalah dengan kolonoskopi. Tindakan kolonoskopi menimbulkan keoemasan yang diakibatkan karena takut akan hasil dari kolonoskopi dan hasil patologi anatomi. Peneiitian deskripsi sederhana terhadap 33 responden ditujukan untuk mengetahui faktor-faktor yang mempengaruhi tingkat kecemasan pasien yang akan dilakukan kolonoskopi pada deteksi dini kanker kolorektal.Berdasarkan hasil kuesioner yang didapat, peneliti memperoleh hasil yang tinggi terhadap kecemasan karena takut akan hasil kolonoskopi dan kecemasan karena takut akan hasii patologi anatomi. Hasil penelitian menunjukkan bahwa faktor terbanyak yang mempengaruhi tingkat kecemasan pasien yang akan dilakukan kolonoskopi pada deteksi dini kanker kolorektal adalah nasil koionoskopi dan hasil patotogi anatomi. Kesimpulan yang diperoleh dari penelitian ini adalah kecemasan karena takut akan hasil kolonoskopi 90.9% dan kecemasan karena takut akan hasil patologi anatomi 9O,9%."

"Angka kejadian kanker rektal sekarang ini semakin meningkat. Semakin dini kasus ini dapat didiagnosis, maka prognosis pasien dengan kanker rektal akan semakin baik. Keterlibatan jaringan mesorektal yang ditemukan pada CT Scan abdomen-pelvis merupakan indikasi adanya metastasis pada kelenjar getah bening regional. Keterlibatan jaringan mesorektal pada CT Scan abdomen-pelvis mempengaruhi stadium dan penatalaksanaan pasien kanker rektal. Penelitian ini dilakukan untuk mengetahui hubungan keterlibatan jaringan mesorektal yang ditemukan pada Computed Tomography abdomen-pelvis pasien kanker rektal dengan metastasis kelenjar getah bening regional. Hasil penelitian ini menunjukkan tidak adanya hubungan antara keterlibatan jaringan mesorektal dengan metastasis pada kelenjar getah bening regional (pN) pada pasien kanker rektal.

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The incidence of rectal cancer is now increasing. The earlier cases can be diagnosed, the prognosis of patients with rectal cancer are better. Mesorektal tissue involvement were found in the abdominal-pelvic CT scan is an indication of the presence of metastases in regional lymph nodes. Mesorektal tissue involvement on CT scan of the abdomen-pelvis affect stage and management of rectal cancer patients. This study was conducted to determine the relationship of tissue involvement mesorektal found on abdominal-pelvic computed tomography rectal cancer patients with metastatic regional lymph nodes. The results of this study showed no correlation between tissue involvement mesorektal with metastasis in regional lymph nodes (pN) in patients with rectal cancer."

"[Tujuan: Untuk mengetahui profil pasien kanker rektum di Departemen Radioterapi RSCM. Metode: Dilakukan penelitian restrospektif deskriptif analitik terhadap 144 pasien kankerrektum yang menjalani radiasi di Departemen Radioterapi RSCM periode Januari 2009Januari2014, dilihat karakteristik pasien dan tumor. Respons radiasi dinilai menggunakanmetode RECIST 1.1. Hubungan antara OTT dan DTT dengan respons radiasi dinilai dengankorelasi Spearman dan analisis kesintasan dihitung dengan kurva Kaplan Meier. Hasil: Pasien laki-laki sebesar 65.9%, median usia 53 (23-81) tahun dengan mayoritas beradapada kelompok usia 50-59 tahun. Tipe histopatologi terbanyak adalah adenokarsinoma(88.8%) dan pasien paling banyak datang dengan stadium IIIB (25.0%). Kemoradiasidilakukan pada 29.8% pasien, dengan toksisitas radiasi akut terbanyak adalah pada kulit(derajat I) sebesar 20.1%. Respons radiasi yang dinilai dengan metode RECIST 1.1menunjukkan respons terbanyak adalah stabil (71.4%). Tidak ditemukan korelasi antara OTTdan DTT dengan respons radiasi. Dari 118 pasien, didapatkan analisis kesintasan keseluruhan3 dan 5 tahun masing-masing adalah 65% dan 45% dengan median survival 59 bulan. Padakelompok pasien yang menjalani radiasi panjang, analisis kesintasan keseluruhan 3 dan 5tahun masing-masing adalah masing-masing 91% dan 78%. Kesimpulan: Karakteristik pasien rektum di Departemen Radioterapi RSCM yang berbedadengan berbagai studi sebelumnya hanya usia. Respons radiasi yang paling banyak dijumpai adalah stabil. Tidak ditemukan korelasi antara OTT dan DTT dengan respons radiasi.;Purpose: To obtain the profile of rectal cancer patients in Department of Radiotherapy, National General Hospital of Cipto Mangunkusumo.Method: A restrospective study was conducted over 144 rectal cancer patients undergone radiation therapy in Department of Radiotherapy, National General Hospital of CiptoMangunkusumo during period of January 2009 to January 2014. The characteristics ofpatients and tumour were assessed. The radiation response was evaluated with the RECIST1.1 method. The correlation between OTT and DTT with radiation response was analyzedwith Spearman?s correlation and the survival analysis was determined using Kaplan-Meiercurve. Result: The majority of patients were male (65.9%), with median age of 53 (23-81) years oldwhere most patients belonged to age group of 50-59 years old. The most frequenthistopathologic type found was adenocarcinoma (88.8%) with most patients were in stageIIIB (25.0%). Chemoradiation was performed in 29.8% of patients, and grade I skin toxicitywas the most frequent acute side effect of radiation found (20.1%). Radiation responseassessed with the RECIST 1.1 method showed stable disease as the mostly seen response(71.4%). There was no correlation found between OTT and DTT with radiation response.Overall survival from 118 patients for 3 and 5 years were 65% and 45%, respectively, withmedian survival of 59 months. In the group of patients underwent long-course radiotherapy,the overall survival for 3 and 5 years were 91% and 78%, respectively. Conclusion: The sole characteristic of rectal cancer patients in Department of Radiotherapy atCipto Mangunkusumo Hospital that is different from previous studies is the age group wheremost patients were in. Stable disease is the most frequent radiation response. There was no correlation found between OTT and DTT with radiation response., Purpose: To obtain the profile of rectal cancer patients in Department of Radiotherapy, National General Hospital of Cipto Mangunkusumo.Method: A restrospective study was conducted over 144 rectal cancer patients undergone radiation therapy in Department of Radiotherapy, National General Hospital of CiptoMangunkusumo during period of January 2009 to January 2014. The characteristics ofpatients and tumour were assessed. The radiation response was evaluated with the RECIST1.1 method. The correlation between OTT and DTT with radiation response was analyzedwith Spearman’s correlation and the survival analysis was determined using Kaplan-Meiercurve. Result: The majority of patients were male (65.9%), with median age of 53 (23-81) years oldwhere most patients belonged to age group of 50-59 years old. The most frequenthistopathologic type found was adenocarcinoma (88.8%) with most patients were in stageIIIB (25.0%). Chemoradiation was performed in 29.8% of patients, and grade I skin toxicitywas the most frequent acute side effect of radiation found (20.1%). Radiation responseassessed with the RECIST 1.1 method showed stable disease as the mostly seen response(71.4%). There was no correlation found between OTT and DTT with radiation response.Overall survival from 118 patients for 3 and 5 years were 65% and 45%, respectively, withmedian survival of 59 months. In the group of patients underwent long-course radiotherapy,the overall survival for 3 and 5 years were 91% and 78%, respectively. Conclusion: The sole characteristic of rectal cancer patients in Department of Radiotherapy atCipto Mangunkusumo Hospital that is different from previous studies is the age group wheremost patients were in. Stable disease is the most frequent radiation response. There was no correlation found between OTT and DTT with radiation response.]"

"ABSTRAK Latar Belakang :Karsinoma kolorektal (KKR) merupakan penyebab kematian kedua di dunia dari seluruh jeniskanker. KKR dapat disebabkan oleh defek dari MMR DNA. Microsatellite instability (MSI)adalah penanda defek MMR DNA. KKR MSI-H memiliki gambaran karakteristik tertentu.Tumor-infiltrating-lymphocyte (TIL) merupakan faktor prognosis. Hilangnya ekspresi PMS2 danMSH6 dapat sebagai penanda MSI. Penelitian ini bertujuan untuk menilai terjadinya MSI padaKKR di sisi kiri dan sisi kanan kolon melalui Hilangnya ekspresi PMS2 dan MSH6, sertamengetahui hubungan antara TIL dengan MSI-H.Bahan dan Metode :Dilakukan pulasan IHK PMS2 dan MSH6, serta penghitungan TIL. Penilaian dilakukan denganmenghitung hilangnya ekspresi PMS2 dan MSH6 pada inti sel dan dikelompokkan ke dalamkelompok mutasi dan tidak mutasi .Penghitungan TIL juga dikelompokkan ke dalam TIL tinggidan rendah, berdasarkan nilai titik potong Hasil : Didapatkan 27,8% kasus menunjukkan hilangnya ekspresi PMS2 dan MSH6 dengan 14,4%kasus di distal kolon. TIL terbanyak di distal kolon 30% kasus. Tidak terdapat perbedaanbermakna antara mutasi PMS2 dan MSH6 dengan lokasi (p=0,829) dan TIL (p=0,187). Terdapatperbedaan bermakna antara usia dan lokasi (p=0,020) serta peningkatan ekspresi PMS2 denganMSH6 (p=0,06).Kesimpulan :MSI-H ditemukan pada 27,8% kasus. Penggunaan PMS2 dan MSH6 pada penelitian ini belumdapat menggantikan 4 panel IHK. Terdapat kecenderungan dimana adenokarsinoma NOSmemiliki frekuensi mutasi lebih tinggi dari adenokarsinoma musinosum.ABSTRACT Background : Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. ;Background :Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. ;Background :Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. "

"ABSTRAKKanker rektum merupakan salah satu penyakit keganasan saluran gastrointestinal yang banyak dialami masyarakat perkotaan. Salah satu tindakan pembedahan yang dapat dilakukan adalah operasi metode ultra low anterior resection. Berdasarkan jurnal terkait, pasien paksa operasi metode ultra low anterior resection memiliki risiko sebesar 10-20% terkena sindrom anterior resection dengan gejala kelemahan sfingter anal sehingga mengakibatkan inkontinensia fekal. Salah satu tindakan yang dapat dilakukan kepada pasien untuk mencegah masalah tersebut adalah dengan latihan kegel. Latihan kegel yang dilakukan secara rutin dapat membantu meningkatkan kontrol anus dan menguatkan sfingter anus. Latihan dilakukan secara bertahap sebanyak 4x10 set dalam sehari. Evaluasi latihan kegel dilakukan menggunakan colok dubur untuk mengevaluasi kekuatan kontraksi anus. Sebelum latihan kegel dilakukan, penanganan manajemen nyeri pada pasien paska operasi harus dilaksanakan dengan baik terlebih dahulu agar toleransi latihan kegel tinggi dan latihan dapat dilakukan segera setelah operasi.

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ABSTRAKRectal cancer is a malignancy of the gastrointestinal tract that is experienced by the urban community. One of the surgery choices is ultra low anterior resection method. Based on the relevant journal, patients were treated with this method have 10-20% higher risk of anterior resection syndrome, which symptoms is weakness of the anal sphincter, resulting in fecal incontinence. One of the interventions that can prevent patients from the fecal incontinence is Kegel exercises. Regular exercises can help improve and strengthen control of the anal sphincter. Exercises done gradually as 4x10 sets in a day. The evaluation of exercises using a rectal tusche to evaluate the strength of anus contraction. Before Kegel exercises is started, handling the management of pain post-surgery must be performed well so that patients have a higher tolerance of Kegel exercises and the exercises can be done soon after surgery.;"

"[ABSTRAKPendahuluan : Kanker kolorektal termasuk salah satu morbiditas terbanyak di Indonesia dengan hasil terapi yang cenderung memprihatinkan untuk stadium lanjut lokal. Oleh karena itu diperlukan kemoradiasi neoajuvan yang merupakan terapi standar sesuai guideline untuk kanker rektum stadium lanjut lokal, meskipun demikian espons yang dihasilkan sangat bervariasi dan dipengaruhi oleh berbagai faktor, termasuk hipoksia jaringan. Osteopontin adalah penanda hipoksia endogen yang berkorelasi signifikan dengan tekanan oksigen tumor. Osteopontin juga merupakan penanda hipoksia kronis yang lebih akurat dibandingkan Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), dan Lactate Dehydrogenase A (LDH A) tetapi belum pernah dilakukan penelitian yang mengukur kadar OPN secara kuantitatif pada jaringan kanker rektum serta mengkorelasikannya dengan respons pengecilan tumor pada kemoradiasi neoajuvan.Metode dan Materi: Dilakukan skrining data pasien dari Rekam Medis Departemen Radioterapi. Empat belas pasien yang memenuhi kriteria inklusi dan eksklusi dianalisis retrospektif dari bulan Februari sampai dengan bulan Mei 2015. Pencitraan radiologi pasca kemoradiasi dibandingkan dengan sebelum kemoradiasi, sementara jaringan rectum didapatkan dari blok parafin yang didapatkan dari biopsi sebelum kemoradiasi. Evaluasi radiologi diukur menggunakan kriteria RECIST 1.1. Kadar OPN diperiksa menggunakan metode ELISA dan diukur menggunakan spektrofometer.Hasil : Rerata kadar OPN adalah 0.5678 ± 0.26 ng/mL. Terdapat korelasi berbanding terbalik yang kuat (r= -0.630, p= 0.016) antara kadar OPN dan pengecilan tumor. Nilai ambang batas OPN ≥0.538 ng/mL memprediksikan ketidakresponsifan terhadap kemoradiasi neoajuvan dengan tingkat sensitivitas 100% dan spesifisitas 81,8%. Meskipun demikian, tidak terdapat korelasi antara kadar OPN dengan Hemoglobin.Kesimpulan : Penelitian ini menunjukkan bahwa hipoksia terdapat pada pasien dengan kanker rektum stadium lanjut lokal dan merupakan karakter yang menandai turunnya respons pengecilan tumor terhadap kemoradiasi neoajuvan. Kadar OPN yang makin tinggi menunjukkan kondisi hipoksia yang lebih buruk dan respons yang lebih buruk untuk pengecilan tumor.

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ABSTRACTIntroduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there's no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT.Methods and Materials: Patients? data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry.Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration.Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage., Introduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there’s no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT. Methods and Materials: Patients’ data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry. Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration. Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage.]"

"ABSTRAKUntuk memperbaiki survival dan angka rekurens dari karsinoma rekti, saat ini di Rumah Sakit Dr. Cipto Mangunkusumo sedang dilakukan penelitian prospektip penatalaksanaan karsinoma rekti dengan tehnik sandwich. Kasus dibagi dalam 2 golongan yaitu yang dapat direseksi dan tidak dapat direseksi. Kasus yang dapat direseksi diberikan radiasi pra bedah 1,000 cGy. dalam 1 minggu dan 5 FU lalu dibedah. Pasca bedah diberikan radiasi 4500 cGy. dalam 4,5 minggu dan 5 FU. Kasus yang tidak dapat direseksi pra bedah diberikan radiasi 4500 cGy./4,5 minggu dan 5 FU, pasca operasi diberikan radiasi 1.500 cGy. dan 5 FU. Sebagai laporan pendahuluan, sejak Januari 1988 sampai dengan Maret 1990 di RSCM/FKUI telah dilakukan penelitian terhadap 35 penderita yang datang ke UPF Radioterapi RSCM. Dari 5 orang yang tidak dapat dilakukan reseksi, 2 dapat dilakukan reseksi, 2 dapat direseksi tapi inoperable karena sudah ada metastase jauh. Didapatkan harapan yang menggembirakan dari kelompok tumor yang tidak dapat direseksi menjadi dapat direseksi setelah diberikan radiasi pra bedah yaitu sebesar 40%. "

"Latar Belakang: Penyakit kanker kolorektal (KKR) merupakan salah satu jenis penyakit kanker dengan insiden. prevalen serta mortalitas yang terns meningkat dewasa ini. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh. stadium klinik kanker terhadap katahanan hidup lima tahun penderita kanker kolorektal. Desain: Desaio penelitian adalah kohort retrospektif. Sarnpel sebanyak 1!6 orang penderita kanker kolorektal yang mendapat pengobatan pertama kali di RSKD dari tahun 1994 - 2004. Analisis bivariat dengan uji Lng rank test dan kurva probabilitas untuk ketahanan hldup menggunakan metode Kaplan Meier. Analisis seeara multivariat menggunakan Cox Proportional Hazard Regression. Hasil: Ditemukan penderita kanker kolorektal yang meninggal selarna lima tahun follow up adalah 46 orang (39, 7%). Probahilitas ketahanan hidup 5 tahtm penderita seeara keseluruhan adalah sebesar 42,23% dengan Median sehesar 36 bulan, Probabilitas ketahanan hldup 5 tahun menurut stadium adalah Dukes B sehesar 74,38%, Dukes C sebesar 37,28% dan Dukes D sehesar 22,28%. Menurut stadium awol sebesar 74,38% dan stadium !anjut sebesar 31,58%. Pada analisis Cox regresi stadium lanjut memiliki risiko kematian sehesar 4,83 kali (95%CI:1,72-13,60) dibandingkan stadium awal sebelum memperhitungkan variahel lain dan setelah memperhitungkan variabci derajat diferensiasi sel, umur, status perkawinan, jumlah sel darah putih sebelum operasi dan status pengobatan, risiko kematian stadium lanjut menjadi 9,37 kali(95%CI:2,88-30,48) dibandingkan stadium awal. Kesimpulan dan Saran : Stadium terbukti merupakan faktor prognostik yang kuat dan signifikan terhadap ketahanan hidup lima tahun penderita kanker kolorektaL Diharapkan kepada masyarakat terutama umur 40 tahun ke atas untuk segera memeriksakan diri hila ada keluhan pada saluran pencernaan sehingga kalaupun temyata kanker kolorektal maka akan ditemukan pada stadium lebih awal.

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Background: Colorectal cancer (CRC) disease is a kind of cancer disease with increasing incidence, prevalence, and mortality nowadays.

Objective: This research is aimed to know the effect of cancer clinical stadiums on five~ year survival of colorectal cancer patients.

Design: The design of this research is retrospective cohor4 using as sample 116 colorectal cancer patients who got their first treatment in RSKD from J 994 to 2004. Bivariate analysis was done with Log Rank Test and the probability curve of survival used Kaplan Meier method. Multivariate analysis was done with Cox Proportional Hazard Regression.

Result : It is found that the number of colorectal cancer patients' death during 5 years of follow up is 46 (39.7%). Patients' probability of 5-year survival as overall survival is 42.23% with a median of36 months. The probabilities of 5-year survival by Dukes' slage are Dukes B being 74.38%, Dukes C 37.28%, and Dukes D 22.28%. For early stadium it is 74.38% and advanced stadiwn 31.58%. Cox regression analysis reveals that advanced stadium has a death risk of 4.83 times (95%CI: 1, 72-13.60) higher than early stadium before controlling otller variables; and after controlling cell differentiation degree, age, marital status, preoperative amount of white blood cell, and treatment status, advanced stadiwn death risk becomes 937 times (95%C!: 2.88-30.48) than early stadium.

Conclusion and Suggestion: lt. is proved that stadium is strong and significant prognostic !actor of colorectal cancer patients' 5 year-survival. It is hoped that all people especially those who are 50 years old up to gel themselves cheeked immediately when they have complaints about their digestive system."

"Kanker kolorektal (KKR) menempati urutan ketiga sebagai kanker penyebab kematian tertinggi di dunia. Diperkirakan sekitar 63% kematian akibat KKR terjadi karena kurangnya screening dan keterlambatan diagnosis. Saat ini metode standar yang digunakan dalam diagnosis KKR adalah kolonoskopi dan biopsi jaringan. Namun metode tersebut memiliki risiko yang tinggi, besifat invasif, serta tidak efisien untuk monitoring perkembangan tumor. Gen Epidermal Growth Factor Receptor (EGFR) telah umum digunakan sebagai marka prognostik KKR, salah satunya melalui studi ekspresi gen pada Circulating Tumor Cells (CTCs). Namun CTC memiliki beberapa kelemahan, seperti konsentrasi yang rendah dan heterogenitas yang beragam. Di sisi lain, serum darah penderita kanker mengandung cell-free Nucleic Acid (cfNA) yang membawa informasi genetik dari jaringan tumor asal. Hal tersebut menjadikan cfNA berpotensi untuk dikembangkan sebagai salah satu metode alternatif untuk diagnosis dan monitoring KKR. Penelitian ini bertujuan untuk mendeteksi gen EGFR dari CTC dan serum darah penderita KKR menggunakan metode quantitative PCR with Melting Curve Analysis (qPCR MCA). Penelitian dilakukan terhadap 4 pasien KKR dengan karakteristik dan stadium kanker yang bervariasi. Hasil penelitian menunjukkan gen EGFR terdeteksi pada seluruh sampel serum dan hanya terdeteksi pada 1 sampel CTC. Oleh karena itu, dapat disimpulkan bahwa deteksi biomarker EGFR pada serum memiliki efektivitas yang lebih baik dibandingkan CTC.<

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Colorectal cancer (CRC) ranks as the third leading cause of cancer death in the world. It is estimated that around 63% of deaths from CRC occur due to lack of screening and delay in diagnosis. Currently, the standard methods used in the diagnosis of CRC are colonoscopy and tissue biopsy. However, this method has a high risk, invasive, and inefficient for tumor monitoring. The Epidermal Growth Factor Receptor (EGFR) has been commonly used as a prognostic marker for CRC through gene expression analysis of Circulating Tumor Cells (CTCs). However, CTC have some limitations such as heterogeneity and low concentrations. On the other hand, the blood serum of cancer patients contains cell-free Nucleic Acid (cfNA) which carries genetic information from the original tumor tissue. Hence, cfNA have great potential to be developed as an alternative method for CRC diagnosis and monitoring. This study aims to detect the EGFR gene from CTC and blood serum of CRC patients using the quantitative PCR with the Melting Curve Analysis (qPCR MCA). The study was conducted on 4 CRC patients with various characteristics and stages of cancer. The results showed that the EGFR gene was detected in all serum samples and only in 1 CTC sample. Therefore, the results suggest that the detection of EGFR biomarkers in serum has better effectiveness than CTC."

"ABSTRAKKanker kolorektal menduduki peringkat ketiga jenis kanker yang paling sering terjadi di dunia. Data mengenai gambaran tatalaksana kanker kolorektal di RSUP Fatmawati belum pernah tercatat dan belum pernah dievaluasi keberhasilanya. Untuk itu kami mengumpulkan data penderita kanker kolorektal sehingga kami bisa menggambarkan profil penderita kanker kolorektal di RSUP Fatmawati.Metode : Penelitian ini dirancang secara potong lintang retrospektif analitik, di RSUP Fatmawati Jakarta dengan mencatat rekam medis penderita kanker kolorektal yang mendapatkan tatalaksana pembedahan dan terapi adjuvan pada tahun 2010 – 2012.Hasil : Selama 3 tahun periode Januari 2010 sampai dengan 2012, kami dapatkan 122 penderita kanker kolorektal yang di tatalaksana di Departemen Bedah RSUP Fatmawati Jakarta, yang sesuai kriteria inklusi 85 penderita. prevalensi dari tahun ke tahun semakin tambah, dengan jenis kelamin pria lebih banyak (55%) dan wanita (45%). Kelompok usia terbanyak pada penderita usia 50 tahun ke atas (55%), dan. lokasi tumor terbanyak pada kolon kanan (21%). Sebagian besar datang mencari pertolongan dengan keluhan utama buang air besar yang berdarah dan berlendir (47%). Stadium klinis penderita datang dengan stadium I (1%), stadium II (20%), stadium III (50%), stadium IV (28%). Sebagian besar temuan histopatologi adalah adenokarsinoma, dengan differensiasi baik (42%), differensiasi baik-sedang (8%), differensiasi sedang (24%), differensiasi sedang-buruk (4%), differensiasi buruk (10%), dan musinosum (12%). Hanya 68% penderita kanker kolorektal yang mendapatkan kemoterapi adjuvan.Simpulan : Berdasarkan penelitian ini kami menyimpulkan bahwa RSUP Fatmawati dengan jumlah insidensi kanker kolorektal bertambah tiap tahunnya. Rerata pasien yang berkunjung ke pelayanan kami adalah penderita pada stadium III. Kecenderungan insidensi pada usia muda semakin bertambah, kemoterapi adjuvan atau paliatif belum maksimal, neoadjuvan kemoradiasi atau radiasi tidak ada pada pelayanan kami. Sebagian besar penderita diberikan kemoterapi capecetabine oral. Sebagian besar terdapat ketidaksesuaian antara staging klinis dengan staging histopatologis. Data yang didapatkan ini merupakan data pertama yang kami buat di Departemen Bedah RSUP Fatmawati.

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ABSTRACTColorectal cancer was the third most frequent type of cancer that occurs in the world. Data of colorectal cancer management in Fatmawati hospital has not been recorded and has not been evaluated. we collected the data and we can describe the profile of colorectal cancer patients in Fatmawati hospital.Method : The study was designed as a cross-sectional retrospective analytic, in Fatmawati hospital Jakarta recorded base on colorectal cancer patient medical record who received surgery and adjuvant therapy in 2010-2012 .Result : During the 3 years, period from January 2010 to 2012, we got the 122 colorectal cancer patients in in the Department of Surgery Fatmawati hospital Jakarta, appropriate inclusion criteria 85 patients. Prevalence from year to year was increased, with more male gender (55%) and female (45%). The age group most in people aged 50 years and over ( 55 % ). Most tumor location in the right colon (21%). Most come for help with a chief complaint of bloody and mucus stool (47%). Clinical staging of patients with stage I came (1 %), stage II (20%), stage III (50%), stage IV (28%). Most of the findings histopathology is adenocarcinoma, with good differentiated (42%), well-moderate differentiated (8%), moderate differentiated (24%), moderate-poor differentiated (4%), poor differentiated (10%), and mucinous (12%). Only 68 % of patients with colorectal cancer who received adjuvant chemotherapy.Conclusion : Based on this study we conclude that the number of colorectal cancer patients in Fatmawati increased every each year. The most patients who visited our departement was in stage III. Tendency prevalence was increased at a young age, adjuvant or palliative chemotherapy is not maximized, neoadjuvant chemoradiation or radiation does not exist in our services. Most of the patients given oral chemotherapy capecetabine. Mostly there was a mismatch between clinical staging and histopathological staging. The data obtained was the first data that we created in the Department of Surgery Fatmawati hospital Jakarta ."