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"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. "

"Latar belakang: Pada kanker nasofaring, tingginya angka kegagalan metastasis jauh paska terapi masih menimbulkan masalah. Sehingga, penelitian mengenai penggunaan terapi sistemik novel pada kanker nasofaring seperti imunoterapi perlu dilakukan. Terdapat beberapa biomarker yang dapat diperiksa untuk dapat memprediksi respon dari pemberian imunoterapi, salah satunya adalah microsatellite instability (MSI). Mikrosatelit merupakan area pada DNA yang memiliki banyak pengulangan kodon, sehingga rentan terjadi gangguan coding dan mengakibatkan akumulasi mutasi. Pada keadaan normal, kerusakan ini akan diperbaiki dengan sistem mismatch repair. Namun, jika terdapat gangguan atau mutasi terkait sistem ini, atau yang disebut dengan deficient mismatch repair (dMMR), akan menghasilkan fenotipe MSI. Pada kanker kolorektal dan endometrium. Namun sampai saat ini, hanya terdapat 3 penelitian yang melakukan pemeriksaan status MSI pada kanker nasofaring. Penelitian ini bertujuan untuk melihat gambara status MSI pada pasien kanker nasofaring pada pasien di RSCM, Indonesia.Metode: Penelitian ini merupakan penelitian eksploratif dengan 36 subjek penelitian. Dilakukan pemeriksaan status instabilitas mikrosatelit menggunakan pemeriksaan berbasis polymerase chain reaction (PCR) Idylla MSI. Dilakukan pula pemeriksaan MMR menggunakan pemeriksaan berbasis imunohistokimia (IHK) menggunakan 4 antibodi untuk mendapatkan keselerasan antara pemeriksaan MSI dan MMR pada pasien kanker nasofaring di RSCM.Hasil : Menggunakan pemeriksaan Idylla MSI, ditemukan MSI pada 2 dari 36 pasien (5,6%) dan dMMR menggunakan pemeriksaan IHK pada 3 dari 36 pasien (8,34%). Hasil yang konsisten ditemukan pada 2 metode pemeriksaan sebesar 96,97%.Kesimpulan: Pada kanker nasofaring ditemukan frekuensi MSI yang rendah baik menggunakan pemeriksaan IHK dan Idylla MSI. Ditemukan keselerasan yang tinggi antara pemeriksaan berbasis IHK dan pemeriksaan berbasis PCR Idylla MSI.

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Background: Despite high probability of local control after treatment, high rate of distant metastases-failure still pose as problem in the management of locally advanced nasopharyngeal carcinoma. Thus, research for novel systemic therapies for nasopharyngeal cancer, such as immunotherapy, needs to be done. There are several biomarkers that may predict the response to immunotherapy, one of which is microsatellite instability (MSI) phenotype. Microsatellites defined by areas in DNA that are prone to mutations due to repetition of 1-3 nitrogen base. However, under normal circumstances, there are repair systems that can identify and correctly repairs DNA mutations in microsatellite area, a system called mismatch repair (MMR) system. Microsatellite instability is a condition of accumulating mutations in microsatellite area due to defect in MMR system. In colorectal and endometrial cancer, MSI are known as one of prognostic and predictive markers, especially with the usage of immunotherapy immune checkpoint blockade PD-1/PD-L1. To this date, only 3 studies are available in exploring the role of MSI in nasopharyngeal cancer, and no study was done in Indonesia. We conduct this study to assess the MSI status of Indonesia's nasopharyngeal cancer patients in Ciptomangunkusumo Hospital.

Methods: This is the first explorative study in exploring the role of MSI in Indonesia's nasopharyngeal cancer patients. A total of 36 subjects were recruited, and both MSI assessment using immunohistochemistry (IHC) and polymerase chain reaction (PCR) Idylla MSI was done on all study subjects.

Results: MSI was found in 2 patients (5,6%) using PCR based Idylla MSI, and dMMR was found in 3 patients (8,34%). Consistent results between IHC and PCR based MSI assessment was found in 32 patients (96,97%).

Conclusion: MSI was a rare event in Indonesia's nasopharyngeal cancer patients. High concordance was found between IHC and PCR MSI assessment in nasopharyngeal cancer."

"Kaitannya dengan ekspresi protein MLH1, MSH2, dan SMAD4, dan membandingkannya dengan pasien kanker kolorektal usia di atas 60 tahun.Metode: Data rekam medis pasien kanker kolorektal usia di bawah 40 tahun dan usia di atas 60 tahun , dikumpulkan dari 3 rumah sakit: Jakarta, Makasar, dan Bandung. Kelompok etnis dipilih dari suku bangsa Jawa, Makasar (Sulawesi Selatan, dan Minangkabau (Sumatera Barat) yang dikonfirmasi berdasarkan kuesioner. Pada spesimen tumor dilakukan pemeriksaan histopatologi, gradasi tumor, serta pemeriksaan imunohistokimia untuk penentuan ekspresi protein MLH1 dan MSH2 untuk menilai mutasi instabilitas mikrosatelit. Ekspresi protein SMAD4 diperiksa untuk memastikan bahwa jaringan tumor tidak berasal dari instabilitas mikrosatelit.Hasil: Telah dikumpulkan 121 penderita kanker kolorektal dari etnis Sunda, Jawa, Makasar, dan Minangkabau. Derajad keganasan antara pasien muda dan pasien tua berbeda secara bermakna (p = 0.001). Pewarnaan imunohistokimia untuk protein MSH2 dan MLH1 yang dilakukan pada masing-masing 92 dan 97 pasien, menunjukkan tidak terdapat perbedaan bermakna dalam hal ekspresi MLH1 dan MSH2 dan gradasi tumor, yang berarti tidak ada hubungan antara instabilitas mikrosatelit dan derajad tumor.Kesimpulan: Karakter kliniko patologi kanker kolorektal pada penduduk asli Indonesia, tidak berbeda antara pasien usia muda (< 40 tahun) dan pasien usia tua (>60 tahun) pada kelompok etnis yang sama. Juga tidak terdapat perbedaan dalam ekspresi protein MSH2 dan MLH1, yang merupakan indikator instabilitas mikrosatelit.

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Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.

Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities ? Jakarta, Makassar, and Bandung - were reviewed. The ?native? ethnic groups were selected from those originating from Java, Makassar (South Celebes), Miinangkabau (West Sumatra). Ethnicity of 121 colorectal carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.

Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.

Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability."

"ABSTRAK Pembedahan terbuka kolorektal mempunyai morbiditas yang tinggi. Laparoskopi kolorektal pertama kali diperkenalkan pada tahun 1991 dengan hasil morbiditas pascabedah yang rendah. Penelitian ini mengambil total sampel subjek kanker kolorektal yang menjalani pembedahan laparoskopi pada tahun 2010 hingga 2015. Data ditabulasi dan dianalsis untuk mendapatkan hasil jangka pendek dan kesintasan lima tahun. Didapatkan 65 data dengan 21 kasus kolon 32,3 dan 44 kasus rektum 67,7 ; 34 pria 52,3 31 wanita 47,7 dengan rata ndash;rata usia 57,17 tahun SD 13.380 . Pada kelompok kolon didapatkan rata ndash;rata durasi bedah 216,75 menit SD 65,94 dan kehilangan darah 159,75 mL SD 125,47 . Median VAS adalah empat; diet, mobilisasi dan lama rawat pascabedah didapatkan pada dua, empat dan tujuh hari. Kesintasan lima tahun pasien didapatkan 83 . Tidak ada komplikasi, pembedahan ulang dan infeksi luka operasi ILO pada kelompok ini. Pada kelompok rektum rata ndash;rata durasi bedah adalah 305,97 min SD 94,23 dan perdarahan intra operasi 150 mL SD 50 . Median VAS pascabedah tiga, diet dan mobilisasi pascabedah dua hari dan empat hari. Lama rawat pascabedah delapan hari. Kesintasan lima tahun adalah 58,5 . Morbiditas pascabedah lebih rendah dengan pembedahan laparoskopi dengan hasil kesintasan keseluruhan yang tidak berbeda dengan kesintasan pasien kanker kolorektal yang ditangani sebelumnya. ABSTRACT Conventional colorectal cancer surgery is often associated with high post operative moribidities. Laparoscopic colorectal surgery has reduced post operative morbidities with same survival outcomes of open surgery. Retrospective data of laparoscopic colorectal cancer surgery from 2010 to 2015 were collected, tabulated and analyzed to get early results and five years survival rate. There were 65 data, 21 colon cancer 32.3 and 44 rectal cancer 67.7 . Higher incidence of male patients n 34, 52.3 than female n 31, 47.7 with mean age of 57,17 13.38 years. Length of operation for colon group was 216.75 SD 65.94 mins with intra operative blood loss 159.75 SD 125.47 mL and post operative pain, on visual analog score VAS , was 4 2 5 . Post operative diet, mobilization and length of stay were 2 1 3 days, 4 2 7 days and 7 4 12 days respectively. The five years survival rate was 83 . In rectal group, length of operation was 305,97 SD 94,23 mins with intra operative blood loss 150 SD 50 mL. Post operative VAS, diet, mobilization and length of stay were 3 2 5 , 2 1 4 days, 4 2 22 days and 8 5 36 days respectively. Five years survival rate was 58.5 . Post operative morbidities in colorectal cancer decreases with laparoscopic resection with satisfactory overall survival rate."

"Latar Belakang:Kegawatan onkologi pada pasien kanker paru berhubungan dengan angka kesintasan pasien kanker paru. Pasien kanker paru yang memiliki kegawatan akan meningkatkan angka morbiditas dan angka mortalitas. Penelitian ini bertujuan memberikan data angka kesintasan pada penderita kanker paru dengan kegawatan di RS Wahidin Sudirohusodo Makassar.Metode:Studi kohort retrospektif dengan menggunakan data sekunder rekam medis di RS Wahidin Sudirohusodo dari Januari 2016 sampai Agustus 2017. Semua data penderita kanker paru di ambil melaluielectronic medical record. Perhitungan angka kesintasan menggunakan analisis Kaplan Meier beserta kurva kesintasan. Uji kemaknaan menggunakan uji Mantel-Cox log-rank-test. Kriteria inklusi pada penelitian ini adalah pasien yang sudah tegak diagnosis kanker paru tanpa disertai dengan keganasan primer di organ lain.Hasil:Subjek penelitian 182 pasien kanker paru (122 laki-laki dan 60 perempuan). median. 135 pasien dengan kegawatan onkologi (74.18%). Usia median 55 (18-91 tahun). Jenis kegawatan pada pasien kanker paru yang paling sering ditemukan adalah efusi pleura masif. Angka kesintasan pasien kanker paru dengan tamponade jantung memiliki kesintasan paling rendah; angka tengah tahan hidup 0.6 bulan, dan angka kesintasan 1 tahun sebesar 0% (p<0.005). Pasien kanker paru yang memiliki lebih dari satu jenis kegawatan memiliki angka kesintasan yang lebih rendah dibandingkan dengan pasien kanker paru yang hanya memliki satu jenis kegawatan onkologi dengan nilai (p=0.002). Kesimpulan:Penderita kanker paru dengan kegawatan, terutama tamponade jantung dan jenis kegawatan lebih dari satu kegawatan memiliki angka kesintasan yang rendah.

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Background:

Oncological emergencies affect morbidity and mortality in lung cancer patients, which ultimately affects their survival. This study aims to estimate the survival rates of lung cancer patients with oncological emergencies treated at a general hospital in Indonesia.

Methods:

This retrospective study analyzed a cohort of lung cancer patients with oncological emergencies treated at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia, between January 2016 and August 2017. Subjects were patients without any primary malignancies in the other organs. Their survival rate was estimated from the Kaplan-Meier survival curve and was analyzed using the Mantel-Cox log-rank test.

Results:

This study involved 182 lung cancer patients (122 males and 60 females) as subjects, in which 135 subjects (74.18%) presented with oncological emergencies. Their median age was 55 (18-91) years old. Massive pleural effusion was the most common oncological emergency found (53%). The subject presented with a cardiac tamponade had the lowest survival rate; their median survival rate was 0.6 months, and their 1-year overall survival rate was 0% (p<0.005). Subjects presented with more than one oncological emergency had a lower survival rate compared to subjects with only one type of oncological emergency (p=0.002).

Conclusion:

Lung cancer patients with oncological emergencies, mainly presented with cardiac tamponade and more than one emergency, had a lower survival rate."

"ABSTRAKPenelitian ini dilakukan untuk meneliti apakah stadium lanjut pada kanker kolorektal berdasarkan Union for International Cancer Control Staging System, mempunyai pengaruh terhadap tingginya tingkat kebocoran anastomosis usus setelah operasi kanker kolorektal.Metode : Penelitian ini merupakan penelitian studi kohort retrospektif yang dilakukan pada 398 pasien kanker kolorektal yang datang ke RSUPN Cipto Mangunkusumo, Jakarta, Indonesia dari bulan Januari 2013 sampai Desember 2015, dari jumlah tersebut, terdapat 156 kasus yang menjalani tatalaksana pembedahan berupa operasi reseksi dengan anastomosis primer, ynag terdiri dari 110 pasien 70,5 kasus stadium II-III dan 46 pasien 29,5 kasus stadium IV. Tidak ditemukan pasien dengan stadium I yang datang ke RSCM. Data-data lain yang diketahui memiliki faktor risiko terhadap kebocoran anastomosis seperti jenis kelamin laki-laki, operasi elektif atau emergensi dan pengunaan ileostomi proteksi, dibandingkan antara kedua grup tersebut. Tidak ada perbedaan yang signifikan diantara kedua grup.Hasil penelitian : Tidak ada perbedaan yang signifikan pada jenis kelamin P = 0,755 , operasi emegensi atau elektif P = 0,089 , penggunaan ileostomy proteksi P = 1,00 dan stadium lanjut kanker kolorektal P = 0,084 dengan kebocoran anastomosis.Kesimpulan : Dari hasil penelitian didapatkan bahwa tidak ada hubungan yang bermakna antara stadium lanjut kanker kolorektal dengan kebocoran anastomosis pada operasi kanker kolorektal

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ABSTRACTThe objective of this study was to investigate whether advanced stages of colorectal cancer Union for international Cancer Control staging system correlates with higher risk of anastomotic leakage after colorectal cancer surgery.Method A retrospective cohort study was conducted on 398 colorectal cancer cases that was admitted at National Referral Hospital, Cipto Mangunkusumo, Jakarta, Indonesia from January 2013 until December 2015. Among these patients, 156 cases underwent surgical resections with primary anastomosis and consisted of 110 70,5 cases of stage II III and 46 29,5 cases of stage IV. No patients with stage I were found at the hospital. Demographic data and known risk factors for anastomotic leak were also recorded and compared between these groups, including male gender, elective or emergency surgery and use of protective ileostomy. There were no differences in these factors between the two groups.Results there were no significant differences with regards to gender P 0,755 , the type of operative setting elective or emergency with P 0,089 , use of protective ileostomy P 1,00 and advanced stages of colorectal cancer P 0,084 with anastomotic leak rate.Conclusion these results suggest there was no correlation between different colorectal cancer stages with anastomotic leak rate in colorectal surgery in National Referral Hospital, Cipto Mangunkusumo, Jakarta, Indonesia"

"Latar Belakang. Kanker kolorektal merupakan penyakit keganasan ketiga terbanyak di dunia dan memiliki mortalitas yang cukup tinggi terutama bila ditemukan pada stadium lanjut. Kesintasan pasien KKR stadium IV dan faktor yang berhubungan perlu diketahui untuk menentukan perbaikan pada tata laksana KKR. Tujuan. Mengetahui kesintasan satu tahun pasien kanker kolorektal stadium IV serta hubungan usia, lokasi tumor, lokasi metastasis, kemoterapi, terapi target, serta diferensiasi tumor dengan kesintasan dalam satu tahun Metode. Penelitian dilakukan dengan metode kohort retrospektif dengan subyek penelitian pasien kanker kolorektal stadium IV yang berobat ke RSCM sejak Januari 2018 hingga Mei 2020. Data pasien dan faktor yang berhubungan diambil dan dilakukan pengamatan selama 1 tahun sejak pasien pertama kali terdiagnosis stadium IV. Kesintasan dinilai dengan metode Kaplan-Meier dan dilanjutkan dengan uji log-rank untuk faktor yang berhubungan. Hasil. Penelitian ini berhasil mengumpulkan 214 subyek dengan kesintasan 1 tahun sebesar 43% dengan median kesintasan 11 bulan. Pasien yang memiliki berat badan kurang [HR 1,495; IK 1,028-2,173; (p=0,035)] dan tidak mendapatkan kemoterapi [HR 4,466; IK 3,027-6,588; (p=<0,001)] merupakan faktor yang bermakna secara statistic terhadap kesintasan satu tahun pasien KKR stadium IV di RSCM. Kesimpulan. Kesintasan satu tahun pasien KKR stadium IV di RSCM hampir sama dengan negara Asia lain. Pemberian kemoterapi dan berat badan kurang memiliki hubungan yang signifikan dengan mortalitas KKR stadium IV.

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Background. Colorectal cancer is the third most common types of cancer in the world. Colorectal cancer has high mortality especially when found in later stage. The survival and its associated factors should be known to improve the cancer treatment. Objective. This study was undertaken to document one year survival for colorectal cancer and whether age, tumor side, metastatic location, chemotherapy, targeted therapy, and tumor differentiation are associated with one year survival. Methods. This study is a retrospective cohort study. The subjects are stage IV colorectal cancer patients in RSUPN Dr. Cipto Mangunkusumo since January 2018-May 2020. Data of patients and its mortality status within one year is documented since the patients diagnosed with stage IV colorectal cancer. Survival was done using Kaplan-Meier method and continued with log-rank test. Result. We collected 214 subjects and 1 year survival rate is 43% with survival median of 11 months. Patients who are underweight [HR 1,495; 95% CI 1,028-2,173; (p=0,035)] and did not received chemotherapy [HR 4,466; 95% CI 3,027-6,588; (p=<0,001)] were associated with one year survival of mCRC in RSUPN Dr. Cipto Mangunkusumo. Conclusion. One year survival for mCRC in RSUPN Cipto Mangunkusumo is similar to other Asian countries. Chemotherapy and underweight were associated with survival in 1 year observation."

"Latar belakang: Kanker serviks adalah salah satu keganasan ginekologi yang paling umum di dunia, termasuk Indonesia. Kanker serviks menyebabkan 18,279  kematian per tahun di Indonesia dan menyebabkan beban fisik, mental, dan sosial ekonomi bagi pasien dan keluarga. National Comprehensive Cancer Network (NCCN) telah menerbitkan pedoman pengobatan pasien kanker serviks yang  selalu diperbarui (up-to-date) dengan tujuan agar pengobatan lebih terkoordinasi  dan efisien. Pedoman ini telah diadaptasi oleh Indonesia, namun keefektifannya belum dipertanyakan.Metode: Kami melakukan peninjauan sistematis sesuai dengan PRISMA  statement untuk menilai efektivitas kesesuaian pedoman. Pencarian dengan  strategi pada database PubMed, ProQuest, Scopus, dan Wiley menghasilkan tiga studi yang memenuhi semua kriteria, selanjutnya dinilai dengan skala NewcastleOttawa dan secara kualitatif.Hasil: Kami menemukan bahwa proporsi kesesuaian pedoman mulai dari 42% hingga 47% dengan faktor-faktor yang mendasarinya seperti jarak ke fasilitas  kesehatan, stadium kanker serviks, penggunaan asuransi, ras, dan faktor sosial  ekonomi lainnya. Kami juga menemukan bahwa terdapat kesintasan hidup lima tahun yang lebih baik dari pasien kanker serviks pada kelompok yang sesuai dibandingkan kelompok yang tidak sesuai. Selain itu, ditemukan lokalisasi dan  kualitas hidup yang lebih baik dari pasien kanker serviks pada kelompok yang sesuai terhadap pedoman. Ketiga studi menggunakan pedoman NCCN sebagai kontrol, sehingga studi-studi tersebut dapat digunakan.Kesimpulan: Tindakan harus diambil dengan tindakan multidisiplin untuk memastikan bahwa setiap pasien kanker serviks memiliki akses pengobatan yang sesuai terhadap pedoman.

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Background: Cervical cancer is the one of the most common gynecology malignancy in the world, including Indonesia. It has accounted for 18,279 deaths per year in Indonesia and caused physical, mental, and socioeconomic burden for patients and caregivers. National Comprehensive Cancer Network (NCCN) has published up-to-date guideline in-order to make more coordinated and efficient treatment for cervical cancer patients. This guideline has been adapted by Indonesia, however its effectivity is yet to be questioned,

Methods: we conducted systematic review according to PRISMA statement to assess effectivity of guideline adherence. Searching with strategy on PubMed, ProQuest, Scopus, and Wiley databases resulted in three studies that met all criteria, thus assessed further with Newcastle-Ottawa scale and assessed qualitatively.

Results: We found that proportion of guideline adherence ranging from 42% to 47% with factors underlying such as distance to health facility, cervical cancer stage, subscription to insurance, race, and other socioeconomic traits. We also found that there is better five-year survival of cervical cancer patients on guideline-adherent group versus non-guideline-adherent group. In addition, there is better cancer localization and life quality of patient in guideline-adherent group. All three studies were using NCCN guideline as control, thus applicable.

Conclusion: Actions should be taken by multidisciplinary action to ensure that every cervical cancer patient has access to guideline-adherent therapy."