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"Blood vessels of tumors display many structural and functional abnormalities. Their unusual leakiness, potential for rapid growth and remodeling, and expression of distinctive surface molecules mediate the dissemination of tumor cells in the bloodstream and maintain the tumor microenvironment. Like normal blood vessels, they consist of endothelial cells, mural cells and their enveloping basement membrane. Common features, irrespective of their origin, size and growth pattern, are absent hierarchy, formation of large-caliber sinusoidal vessels, markedly heterogeneous density, increased permeability, decreased and abnormal pericyte-endothelial cell adhesion, irregular basement membrane structure, and the incorporation of bone-marrow-derived endothelial progenitor cells in the microvasculature. A number of specific tumor endothelial markers have been identified, as well as chromosomal abnormalities. These markers may be used to deliver drugs specifically and selectively to the tumor microvasculature."

"Tujuan: Insiden kanker prostat secara global terus meningkat. Meskipun dapat dilakukan deteksi dini kanker prostat, perlu dipahami bahwa progresivitas penyakit - menjadi metastasis - berbeda untuk setiap pasien. Penelitian ini bertujuan untuk mengamati aspek-aspek yang mungkin berperan sebagai faktor prediktif metastasis pada kanker prostat tidak terpalpasi. Material dan Metode: Data dikumpulkan dari Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dan Rumah Sakit Pusat Kanker Nasional Dharmais sejak tahun 1995-2013. Pasien dengan kanker prostat tidak terpalpasi kemudian dibagi menjadi dua kelompok: dengan metastasis dan tanpa metastasis. Usia, volume prostat, nilai prostate-spesific antigen (PSA), Gleason score sum group, stadium tumor, Karnofsky performance score (KPS), kadar hemoglobin, dan kadar kreatinin serum merupakan faktor yang dianalisis dalam penelitian ini. Data dianalisis menggunakan analisis bivariat dan uji regresi logistik. Hanya pasien dengan data lengkap yang dimasukkan dalam penelitian ini. Hasil: Didapatkan 91 pasien dengan data lengkap, 59 pasien (64,83%) tanpa metastasis dan 32 pasien (35,16%) dengan metastasis. Terdapat perbedaan statistik yang signifikan antara kelompok tanpa metastasis dan kelompok dengan metastasis, yakni untuk PSA (13.7ng / mL vs 71.5ng / mL; p = 0,001), kadar hemoglobin (13,60 g / dL vs 12,25 g / dL; p = 0,002), dan KPS (90 vs 90 ; p = 0,004). Perbedaan yang signifikan secara statistik juga didapatkan pada kelompok GSS (35 dan 24 pada kelompok tanpa metastasis vs 12 dan 20 pada kelompok dengan metastasis; p = 0,047). Usia, volume prostat, stadium tumor, dan kadar kreatinin antara kedua kelompok tidak memiliki perbedaan signifikan secara statistik (p> 0,05). Nilai pretreatment PSA adalah satu-satunya faktor prediktif untuk metastasis dengan odds ratio 1.014 (95% CI, 1,005-1,022; p = 0,002). Kesimpulan: Sebagian besar pasien kanker prostat tidak terpalpasi terdeteksi pertama kali tanpa metastasis. Nilai pretreatment PSA yang diperoleh pada kunjungan awal pasien dapat digunakan sebagai faktor prediktif metastasis di masa depan.

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Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.

Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.

Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).

Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future."

"Metastasis merupakan proses penyebaran sel induk kanker dari satu jaringan ke jaringan lain. Kejadian tersebut merupakan salah satu tanda utama kanker. Kanker yang dihasilkan dari metastasis disebut dengan kanker metastasis. Pertumbuhan kanker metastasis dapat dimodelkan ke dalam persamaan matematika. Pada pemodelan ini diasumsikan tubuh manusia sudah memiliki sebuah kanker yang akan memicu pertumbuhan kanker metastasis dan banyak niche (ruang dimana sel induk kanker melakukan segala aktivitasnya seperti proliferasi dan diferensiasi) yang ada dalam tubuh manusia adalah konstan. Metode kinetik Monte Carlo dapat digunakan untuk mensimulasikan pertumbuhan kanker metastasis sehingga dapat diestimasi waktu pertumbuhan kanker metastasis tersebut.

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Metastases is the spread of the cancer stem cells from one tissue to another. The occurence of the process is one of the major signs of cancer. The cancer resulting from metastases of cancer is called metastases. The growth of metastases cancer can be modeled into mathematical equation. On this modeling, the human body is assumed to already have a cancer that will trigger the growth of metastases cancers and the number of niches (the space where the cancer stem cells do all their activities such as proliferation and differentiation) in the human body is a constant. Kinetic Monte Carlo method can be used to simulate the growth of metastases cancer so that the estimation time of the growth can be found."

"Latar Belakang/Tujuan. Angka kematian dan kejadian metastasis kanker payudara cukup tinggi. Faktor metabolik termasuk resistensi insulin mempunyai peranan terhadap progresivitas kanker payudara namun terdapat hanya sedikit penelitian yang menilai hubungan resistensi insulin dengan kejadian metastasis kanker payudara. Terdapat hubungan yang erat antara beberapa variabel dalam kelompok pasca-menopause terhadap kejadian metastasis, pemberian terapi hormonal aromatase inhibitor dan kemoterapi terhadap nilai HOMA-IR. Mengetahui hubungan resistensi insulin yang dinilai menggunakan nilai homeostatic model assessment for insulin resistance (HOMA-IR) dengan kejadian metastasis kanker payudara.Metode. Studi potong lintang yang meneliti 150 pasien kanker payudara di Rumah Sakit Cipto Mangunkusumo (RSCM) dan Rumah Sakit Siloam Mochtar Riady Comprehensive Cancer Centre (MRCCC) Jakarta dalam rentang waktu agustus 2019-april 2020. Terdapat 150 subjek penelitian, nilai titik potong HOMA-IR ditentukan dengan kurva receiver operating curve (ROC). Dilakukan analisis subgrup kelompok pasca menopause terhadap metastasis, terapi hormonal dan kemoterapi terhadap HOMA-IR.Hasil. Tidak didapatkan nilai titik potong optimal HOMA-IR terhadap kejadian metastasis (Area under curve (AUC) 0,50, P : >0,05, interval kepercayaan (IK) 95% : 0,406-0,593). Tidak terdapat hubungan bermakna variabel pasca-menopause dengan kejadian metastasis dan kemoterapi terhadap nilai HOMA-IR. Terdapat hubungan bermakna pemberian terapi hormonal aromatase inhibitor terhadap peningkatan nilai HOMA-IR, P : <0,01Simpulan. Tidak terdapat hubungan yang bermakna antara resistensi insulin dengan kejadian metastasis pada pasien kanker payudara.

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Background/Purpose. Mortality and incidence rate of metastatic breast cancer is quite high.

Metabolic factors including insulin resistance have a role in the progression of breast cancer,

but there are only a few studies that assess the relationship of insulin resistance with the incidence of breast cancer metastases. There is a close relationship between variables in the postmenopausal group for the occurrence of metastases, administration of hormonal aromatase inhibitors and chemotherapy to the value of HOMA-IR. Knowing the relationship of insulin resistance which was assessed using the value of

the homeostatic model assessment for insulin resistance (HOMA-IR) with the incidence of metastatic breast cancer.

Method. A cross-sectional study examining 150 breast cancer patients at Cipto Mangunkusumo General Hospital and Siloam Hospital Mochtar Riady Comprehensive Cancer Center Jakarta in August 2019-April 2020. There are 150 subjects research, the HOMA-IR cutoff value is determined by the receiver operating curve (ROC) curve. Postmenopausal subgroups were analyzed for metastases, hormonal therapy and chemotherapy for HOMA-IR.

Results. There was no optimal HOMA-IR cut off value for metastatic events (Area under curve (AUC) 0.50,

P:> 0.05, 95% confidence interval (IK): 0.406-0.593). There was no significant relationship between postmenopausal variables with the incidence of metastasis and chemotherapy on the value of HOMA-IR. There was a significant

relationship between the administration of hormonal aromatase inhibitor therapy to the increase of HOMA-IR value, P: <0.01"

"ABSTRAKLatar Belakang: Kanker payudara sampai saat ini memiliki insiden dan prevalensi yangtertinggi dalam diantara penyakit kanker pada perempuan. Lokasi tersering metastasis kanker payudara adalah tulang dimana memiliki overall survival yang baik yang berakibat padapengeluaran biaya yang tinggi dibandingkan dengan metastasis organ viseral. CXCR4 dan RANK diketahui memiliki peran dalam homing sel kanker ke tulang.Dibandingkan dengan biomarker-biomarker yang lain, CXCR4 dan RANK berada padakaskade paling awal dari proses metastasis tulang. Aksis CXCR4 dengan SDF-1 sebagailigannya merupakan pengaturan utama dalam trafficking sel pada beberapa sel punca tubuhmanusia. Aksis RANK/RANKL/OPG mengontrol proses osteoklastogenesis dan resorpsitulang. Dari berbagai studi didapatkan CXCR4 dan RANK diekspresikan tinggi pada kankerpayudara dan berkaitan dengan metastasis tulang. Tujuan Penelitian: Mengetahui hubungan kombinasi ekspresi protein CXCR4 danRANK sebagai faktor prediktor metastasis tulang pada kanker payudara. Metode Penelitian: Jenis penelitian ini adalah case control, analitik, dengan observasional,untuk diagnostik dan prognostik. Penelitian ini dilakukan pada penderita kanker payudarastadium I-IV dengan jumlah sampel 58 pasien. Hasil Penelitian: Faktor Klinikopatologi stadium tumor, mempunyai hubungan yang signifikan terhadap ekspresi kombinasi CXCR4 dan RANK pada metastasis tulang padakasus kanker payudara. Pada penderita kanker payudara terdapat hubunngan yang signifikanantara nilai kombinasi ekspresi CXCR4 dan RANK tinggi dengan kejadian metastasis tulang. Kesimpulan: Faktor Klinikopatologi stadium tumor mempunyai hubungan yang signifikanterhadap ekspresi kombinasi CXCR4 dan RANK pada metastasis tulang pada kasus kankerpayudara. Kombinasi CXCR4 dan RANK dapat digunakan sebagai alat prediktor diagnostikuntuk mengetahui status metastasis tulang kanker payudara, sehingga dapat diberikan terapiawal yang dapat meningkatkan kualitas hidup dan menekan biaya kesehatan di kemudianhari.

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ABSTRACT<>br>Background Until recently, breast cancer has the highest prevalence and incidence offemale cancer. Breast cancer often metastasised to bone, which have better overall survival but consume more health cost than visceral metastasis. CXCR4 and RANK have been known for it's role in cancer cell homing to bone. Instead ofother biomarkers of bone metastasis, CXCR4 and RANK act in the early cascade of bonemetastasis process. CXCR4 SDF 1 axis plays a great role in cell trafficking of many types ofhuman stem cell. RANK RANKL OPG axis mediates osteoclastogenesis and boneresorption. In several studies, CXCR4 and RANK are highly expressed in breast cancer andcorrelate with bone metastasisAim To establish the combination, CXCR4 and RANK are highly expressed in breast cancer and correlate with bone metastasisMethods Case Control study, analytical, observational for prognostic and diagnostic byinvolving 58 patiens with stadium I,II,II,IV at breast cancer Result Clinic pathalogical factor, stadium had significant correlation with combination CXCR4 and RANK expression in breast cancer patients. The High combination CXCR4 and RANK expression in breast cancer patients had significant correlation with bone metastasis. Conclusion: Clinic pathalogical factor stadium tumor had significant correlation with combination CXCR4 and RANK expression in breast cancer patients. The high Combination of CXCR4 and RANK expression can act as a predictor for bone metastasis inbreast cancer, so the patient can start early therapy which increase the quality of life andreduce treatment cost."

"Latar belakang: Kanker payudara (KPD) mempunyai angka kejadian tertinggi pada wanita di dunia yang apabila tidak terdeteksi secara dini akan mengalami perkembangan menjadi stadium lanjut yang berujung pada metastasis ke organ-organ penting tubuh lainnya terutama di tulang. Keterlambatan pendeteksian akan meningkatkan kerusakan tulang secara permanen. Saat ini berbagai macam studi dilakukan untuk mencari parameter metastasis tulang secara dini dan salah satunya adalah keberadaan mikroklasifikasi pada mamografi sebagai salah satu parameters kejadian metastasis tulang.Tujuan: Penelitian ini bertujuan mencari hubungan gambaran mikrokalsifikasi pada mamografi KPD sebagai parameter terjadinya metastasis tulang dan faktor faktor yang memengaruhinya.Metode Desain studi ini adalah kasus kontrol menggunakan data sekunder pasien kanker payudara yang berobat di poli bedah onkologi RSCM dari Juni Tahun 2019 sampai dengan Juni Tahun 2021. Kelompok kasus adalah pasien KPD yang mengalami metastasis tulang dan kelompok kontrol adalah yang tidak mengalami metastasis tulang yang dilihat berdasarkan pemeriksaan Bone Scan, Ct Scan dan foto polos. Dilihat keberadaan mikroklasifikasi melalui mamografi. Dilakukan uji statistik univariat untuk melihat proporsi (%) dan dilanjutkan dengan uji bivariat yaitu chi square dan fisher jika syarat tidak terpenuhi. Hasil Didapatkan 81 subjek penelitian dengan kriteria inklusi dengan hasil 56,8% pasien dengan di atas 50 tahun, 86,4% IMT dibawah 30, 76,5% premenopause, 71,6% pada stadium lanjut, 70,4% dengan histopatologi NST, 58% luminal B, dan 30,9 % dengan metastasis tulang. Uji bivariat menunjukkan terdapat hubungan yang bermakna antara keberadaan mikroklasifikasi dengan metastasis tulang (OR 3,284 CI 95% 1,212-8,889 p=0,017cs) dan hubungan bermakna antara stadium lanjut dengan keberadaan mikrokalsifikasi (OR 3,74, CI 95% 1,28-10,86 p=0,012cs) .Kesimpulan Keberadaan mikrokalsifikasi pada penderita kanker payudara berhubungan secara bermakna dengan metastasis tulang dan stadium lokal lanjut memiliki hubungan yang bermakna dengan keberadaan mikroklasifikasi.

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Background: Breast cancer (BC) has the highest incidence in women in the world which if not detected early will develop into an advanced stage which leads to metastasis to other important organs of the body, especially in the bones. Delay in detection will increase morbidity in the form of permanent bone damage. Currently, various studies have been carried out to find parameters of early bone metastases and one of them is the presence of microclassification on mammography as one of the parameters for the incidence of bone metastasis

Objective: The design of this study is a case control using secondary data of breast cancer patients seeking treatment at the RSCM oncology surgery from June 2019 to June 2021. The case group was BC patients who had bone metastases and the control group was those who did not experience bone metastases taken from examination of Bone Scan, CT Scan and plain photo. Seen the existence of microclassification through mammography. Univariate statistical test was conducted to see the proportion (%) and continued with the bivariate test, namely chi square and fisher if the conditions were not met.

Methods The design of this study was a retrospective case-control study. Data were taken from breast cancer patients who were treated at the Oncology Surgery Clinic of RSCM who had undergone histopathological examination, mammography and imaging examinations such as bone prints or other additional investigations that confirmed whether the patient had bone metastases or not. Some of the data collected were age, body mass index, menopausal status, immunohistochemistry, tumor stage and histopathology.

Results There were 81 study subjects with inclusion criteria with results 56,7% of patients with over 50 years, 86,4% BMI below 30, 76,5% premenopausal 71,6% in advanced stages, 70,4% with NST histopathology, 58% luminal B, and 30,9% with bone metastases. The bivariate test showed a significant relationship between the presence of microclassification and bone metastases (OR 3.284 CI 95 1.212-8.899 p 0.017cs) and a significant relationship between the presence of advanced stage and the presence of microcalcifications (OR 3.74, 95% CI 1.28-10.86, p=0.012cs) .

Conclusion The presence of bone metastases in BC was significantly associated with the presence of microcalcification on mammography and locally advanced stages had a significant relationship with the presence of microcalcifications."

"Tujuan penelitian ini adalah untuk mengidentifikasi faktor prediktor metastasis kelenjar getah bening (KGB) pada pasien dengan kanker serviks stadium IB dan IIA. Penelitian dilakukan dari bulan Mei 1996 sampai bulan Desember 2001. Ada 183 pasien kanker serviks dengan stadium menurut FIGO IB dan IIA menjalani operasi histerektomi radikal dan limfadenektomi. Dari pasien tersebut 158 pasien yang dapat dinilai, terdiri dari 43 pasien dengan metastasis KGB dan 115 tanpa metastasis KGB. Rancangan penelitian adalah kasus-kontrol. Kasus adalah pasien dengan metastasis KGB dan kontrol pasien tanpa metastasis KGB. Analisis multivariat dilakukan setelah analisis bivariat. Pada analisis bivariat umur < 39 tahun, diameter lesi >4 cm, stadium IIA > 4 cm, histopatologi dengan diferensiasi sedang dan buruk, invasi ke pembuluh darah dan limfa merupakan variabel yang independen terjadinya metastasis KGB dengan nilai p ≤ 0,05. Tetapi pada analisis multivariat yang muncul sebagai variabel independen adalah umur muda, paritas > 4, diameter lesi, histopatologi adenoskuamosa, dan invasi limfo-vaskular dengan nilai p ≤ 0,05. Kesimpulan: Usia muda, paritas > 4, stadium IIA > 4 cm, diameter lesi, histopatologi adenoskuamosa, invasi limfa-vaskular merupakan faktor risiko terjadinya metastasis dan dapat dipergunakan sebagai faktor prediktor metastasis KGB. (Med J Indones 2004; 13: 113-8)

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The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors. (Med J Indones 2004; 13: 113-8)"

"This study aimed to compare the efficiency of isosulfan blue (ISB) and colloid methods in determining metastatic conditions of axillary lymph node in sentinel lymph node biopsy (SLNB). this prospective study was performed between April 2005 and July 2009 at Gulhane Medical Faculty, Department of General Surgery. a total of 102 female patients diagnosed with breast cancer were enrolled in the clinic of Gulhane School of Medicine. According to the diagnostic protocols of SLN, the patients were divided into three groups as follows: ISB (group I), colloid (group II), and ISB and colloid (group III). SLN was identified in 49 of 52 patients (94.2%) in the ISB group; the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and false negativity (FN) ratio were found to be 90.9%, 75.8%, 96.1%, 55.5%, and 9.1%, respectively. On the contrary, the sentinel lymph node was identified in 38 of 38 (100%) patients in the colloid group; the sensitivity, specificity, PPV, NPV, and FN were found to be 88.2%, 100%, 100%, 91.3%, and 11.8%, respectively. In ISB and colloid groups; SLN was identified in 12 of 12 (100%) patients in the ISB and colloid groups; the sensitivity, specificity, PPV, NPV, and FN were found to be 100%, 100%, 100%, and 0%, respectively. this study showed that the combined methods applied to heterogeneous groups of patients for SLNB in breast cancer cases were minimally invasive and effective and hence could be used for evaluating nodal metastases."

"PURPOSE: To identify the possible roles of carcinoembryonic antigen (CEA) testing after liver resection for synchronous colorectal liver metastasis (CLM).METHODS: The subjects of this retrospective study were patients who underwent complete resection of primary tumors and synchronous CLM between 1997 and 2007 at 20 institutions in Japan. We studied the associations between perioperative CEA levels and the characteristics of recurrence.RESULTS: Recurrence was detected during the median follow-up time of 52 months in 445 (73.7%) of the total 604 patients analyzed. A postoperative CEA level >5 ng/ml was an independent predictor, with the highest hazard ratio (2.25, 95% confidence interval 1.29-3.91, P = 0.004). A postoperative CEA level >5 ng/ml had a specificity of 86.2% and a positive predictive value of 84.2% for recurrence. Patients with a high postoperative CEA level had a significantly higher recurrence rate, with a shorter time until recurrence and a higher frequency of multiple metastatic sites than those with a low postoperative CEA level. Among the patients with recurrence, 173 (52.7%) had an elevated CEA level (>5 ng/ml) when recurrence was detected.CONCLUSIONS: A postoperative CEA level >5 ng/ml was an independent predictor of recurrence; however, CEA testing was not a reliable surveillance tool to identity recurrence after liver resection."

"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh dunia setiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadap metastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakan salah satu penentu surgical staging. Surgical staging yang optimal merupakan sebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yang baik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitian ini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengan kanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiks yang dilakukan pembedahan primer di RSCM Metode: Penelitian ini merupakan studi potong lintang menggunakan data rekam medis pasien kanker ovarium epitelial yang menjalani pembedahan primer dan apendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhi kriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43 subjek (53,8%) sebagai stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek (37,5%) stadium III, dan tidak terdapat stadium IV (0%). Dari 80 subjek yang menjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19 subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar. Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4 musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjek terdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinis satu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuan histologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukan pembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atas jenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapat dipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadium lanjut.

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Background: Around 152,000 women were death every year because of ovarian cancer. Appendix is an intraperitoneal organ which prone to ovarian epithelial cancer metastasis. Appendix involvement is one of surgical staging scoring. Optimal surgical staging is one of key point to determine post operation treatment, accurate prognosis, and better chemotherapy response. This research was done to see appendix involvement from primary surgery in ovarian epithelial cancer at RSCM Aim: To determine prevalence of metastasis to the appendix from primary surgery in ovarian epithelial cancer at RSCM Method: This cross sectional study used ovarian epithelial cancer patient medical record which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutive random sampling were used. Result: Eighty subjects which were taken from inclusion and exclusion criteria has average age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadium I patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, and none of them as stadium IV. Appendectomy were done and eight subjects (10%) has metastasis to the appendix. On the other hand, 19 subjects (23.8%) have chronic appendicitis and 53 subjects (66.3%) doesn't have metastasis to the appendix. From eight subjects which has appendix involvement, four were defined have mucinous histology, two serous, and two endometrioid. Six out of eight were diagnosed at clinical stadium III and two were diagnosed at stadium I. These two stadium I subjects has mucinous histology. Conclusion: There are 10 percent appendix metastases from primary surgery in ovarian epithelial cancer at RSCM which consist of mucinous, serous, and endometrioid histological types. Based on this research, appendectomy can be considered done on surgery whether in early or late stadium."