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"Latar Belakang Pada tahun 2020, ditemukan total kasus kanker serviks mencapai 36.633 kasus dengan 21.003 di antaranya adlaah kasus kematian di Indonesia. Pasien kanker serviks stadium awal diberikan pilihan tatalaksana pembedahan umumnya berupa histerektomi. Pilihan terapi ajuvan juga diberikan guna mengurangi risiko terjadinya kekambuhan. Dengan tingginya kasus kematian kanker serviks di Indonesia, diperlukan penelitian lebih lanjut terkait angka kesintasan pasien kanekr serviks yang dilakukan histerektomi radikal di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo pada tahun 2010-2018 dengan memerhatikan dilakukan atau tidaknya terapi ajuvan dan ada tidaknya kekambuhan yang terjadi pada pasien. Metode Penelitian ini adalah penelitian deskriptif analitik dengan desain penelitian kohort retrospektif. Data diambil dari rekam medik dan dianalisis kesintasannya dengan metode Kaplan-Meier. Hasil Didapat sebanyak 9,1% (7 orang) pasien mengalami kematian (event) dan 90,9% (70 orang) pasien bertahan hidup dalam kurun waktu tiga tahun dari tanggal tatalaksana histerektomi radikal dilakukan. Pada analisis bivariat antara variabel usia, stadium, terapi ajuvan, dan kekambuhan terhadap kesintasan tidak ditemukan adanya P Value < 0,05 sehingga tidak ada perbedaan ataupun hubungan yang bermakna. Kesimpulan Kesintasan tiga tahun pasien kanker serviks yang dilakukan histerektomi radikal di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo pada tahun 2010-2018 sebesar 90,9%.

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Introduction In 2020, the total number of cervical cancer cases was found to reach 36,633 cases with 21,003 of them being deaths in Indonesia. Patients with early stage cervical cancer are given surgical treatment options, generally in the form of hysterectomy. Adjuvant therapy options are also given to reduce the risk of recurrence. With the high number of cervical cancer deaths in Indonesia, further research is needed regarding the survival rate of cervical cancer patients who undergo radical hysterectomy in National Referral Hospital Cipto Mangunkusumo in 2010-2018 by paying attention to whether or not adjuvant therapy was carried out and whether or not there was a recurrence. Method This research is a descriptive analytical study and using a retrospective cohort design. Data were taken from medical records and analyzed for survival using the Kaplan-Meier method. Results It is found that 9.1% (7 people) of patients experienced death (event) and 90.9% (70 people) of patients survived within three years from the date the radical hysterectomy was carried out. In the bivariate analysis between the variables such as age, stage, adjuvant therapy, and recurrence, there is no P value < 0.05 was found (no significant difference). Conclusion Three-year survival of cervical cancer patients who undergo radical hysterectomy in National Referral Hospital Cipto Mangunkusumo in 2010-2018 was 90.9%."

"Latar Belakang: Kanker serviks menduduki peringkat ke tiga di seluruh dunia sebagaipenyebab kematian perempuan dan merupakan penyebab kematian utama perempuan dinegara berkembang. Diperlukan evaluasi kesintasan berkala yang secara tidak langsungmenjadi cermin tatalaksana.Tujuan: Mengetahui kesintasan pasien kanker serviks di RSCM.Metode: Penelitian ini menggunakan desain kohort retrospektif terhadap data rekammedis pasien kanker serviks pada tahun 2012-2014 dengan metode total populationsampling. Analisis data dilakukan menggunakan kurva Kaplan Meier, uji Log Rank dan Regresi Cox untuk mencari kemaknaan hubungan antarvariabel.Hasil: Terdapat 1.303 subjek penelitian dengan angka kesintasan kanker serviks hingga tahun ke-5 sebesar 76%, 66%, 60%, 43% dan 36% dengan median kesintasan sebesar 1355 hari secara keseluruhan. Terdapat perbedaan hazard bermakna pada variabel stadium kanker (p<0,001). Analisis regresi cox menunjukkan faktor yang berpengaruh terhadap kesintasan adalah stadium kanker. Kesimpulan: Kesintasan 5 tahun kanker serviks di RSCM tahun 2012-2014 sebesar 36%.

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Background: Cervical cancer is ranked third as female cause of death worldwide and isthe leading cause of death of women in developing countries. A periodic survivalevaluation is required that implies the treatment implicitly.Objective: To know the survival rate of cervical cancer patients at CiptoMangunkusumo Hospital.Methods: This retrospective cohort study used medical records data of cervical cancerpatients in 2012- 2014 using total population sampling method. Data analysis was doneusing Kaplan Meier curve, Rank Log test and Cox Regression to find the associationbetween variables.Results: There were 1.303 subjects with overall kesintasan rates of cervical cancer up tothe fifth year of 76, 66, 60, 43 dan 36 with a median survival 1355 days. There were significant hazard differences in cancer stage variables (p <0.001). Cox regression analysis showed that factors affecting survival were cancer stage. Conclusion: The 5-year kesintasan rate of cervical cancer at Cipto Mangunkusumo hospital in 2012-2014 is 36%."

"Tujuan penelitian ini adalah untuk memperoleh informasi tentang survival kanker servik stadium lanjut dengan gangguan fungsi ginjal (KSSLGFG) serta faktor-faktor yang mempengaruhinya. disamping itu diharapkan dapat ditemukan sistem scoring untuk prediksi kematian pasien KSSLGFG. Rancangan studi yang digunakan adalah retrospektif kohort. Data yang dikumpulkan berasal dari rekam medik penderita KSSLGFG dari 1 januari 1998 sampai 31 Desember 2003 di Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Jakarta, dengan jumlah sampel 70 kasus. Hasil penelitian menunjukkan rerata Survival secara keseluruhan pasien KSSLGFG 8,2 bulan, survival bulan ke-6 sebesar 39%, survival 1 tahun sebesar 3,2%. Median survival 5,3 bulan. Faktor-faktor yang berpengaruh terhadap survival pasien KSSLGFG adalah gambaran histopatologik (sel adenoskuamosa dan diferensiasi sel), ketebalan korteks ginjal < 1 cm dan nefrostomi. (Med J Indones 2005; 14: 173-8)

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The objective of this study was to obtain information on the survival rate of advanced cervical cancer patients with renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death of ACCRI patients hopetully could be obtained. Design of the study used was retrospective cohort study. Data collected were retrieved from medical records of ACCRI patients from 1 January 1998 to 31 December 2003 at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, with a total sample of 70 cases. The results of the study showed that mean survival of all ACCRI patients was 8.2 months, mean survival at sixth month was 39%, and mean survival at one year was 3.2%. Median survival was 5.3 months. Prognostic factors affecting the survival of ACCRI patients included histopathological type (adenosquamous cell and cell differentiation), cortical thickness of the kidney less than 1 cm, and nephrostomy. (Med J Indones 2005; 14: 173-8)"

"Kanker serviks menempati urutan pertama kanker terbanyak pada wanita di RSCM. Penelitian ini dilatarbelakangi oleh rendahnya ketahanan hidup pasien kanker serviks di Indonesia. Banyak pasien kanker serviks tidak melanjutkan pemeriksaan setetelah didiagnosa kanker serviks karena keterbatasan biaya. Penelitian ini bertujuan untuk mengetahui perbedaaan ketahanan hidup lima tahun antara pasien kanker serviks jaminan pembiayaan asuransi kesehatan dengan pasien pembiayaan pribadi/non asuransi di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta tahun 2007-2010. Penelitian menggunakan desain studi analitik observasional dengan desain kohort retrospektif. Hasil penelitian menunjukkan terdapat perbedaan ketahanan hidup 5 tahun antara pasien kanker serviks jaminan pembiayaan asuransi dengan pasien jaminan pribadi/non asuransi (p = 0,001). Pasien kanker serviks jaminan pembiayaan pribadi/non asuransi memiliki risiko kematian 5,18 kali (CI: 1,97-13,59) dibandingkan pasien jaminan asuransi, setelah dikontrol diferensiasi sel, pendidikan, stadium kanker, dan kadar hemoglobin.

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Cancer servix is the most frequent cancer occured for female in RSCM. The low rate of 5-year survival rate cervical cancer patients caused by several factors. A lot of diagnosed patients do not return to hospital for getting proper treatment motivates by financial reasons.

This research aim to see correlation of health insurance with 5-year survival rate of cervical cancer patients at Dr. Cipto Mangunkusumo National Hospital, Jakarta year 2007-2010.

Result shows there is correlation between health insurance status and 5 year survival rate of cervical cancer patients (p value = 0,001). Patients who are not covered by insurance are 5,18 times (CI1,97-13,59) likely at death risk compare to insurance covered patients. Rate adjusted with sel differentiation, education, stadium of cancer, and hemoglobin rate as confounding variables."

"The result of breast cancer therapy is usually evaluated using the five-year survival rate. Besides therapeutical aspects, several factors also determine the five-year survival rate, e.g. the stage of cancer and tumor size. The goal of this study is to determine the probability of 5-year survival among breast cancer patients at Dharmais Cancer Hospital Jakarta, and the relationship between cancer stage, tumor size, and 5-year survival rate.The design was a longitudinal study. Data were collected from the medical records of breast cancer patients admitted to Dharmais Cancer Hospital between 1993 and 1996. The sample was 137 women. Data was collected from the medical record as well as by telephoning or sending post mail to establish how long each breast cancer patient survived.The results show that the 5-year survival rate for breast cancer patients at Dharmais Cancer Hospital was 48%, with a median survival rate of 54 months. The 5-year survival rate of patients of early operable stages was 72%, while that of those from late stages was 12%. By us ing patients from early operable stages for baseline comparison, the risk-ratio of death in the late stage was 6.612 (95% CI: 4.014; 10.78). Moreover, the 5-year survival rate of patients with tumors that were less than 5 cm in size was 81 %, whilst the 5-year survival rate of patients with tumors larger than 5 cm was 24%. If compared to patients with a tumor size < 5 cm, the risk-ratio of death among patients with tumors over 5 cm in size was 6,612 (95% CI: 5.50; 12.48)."

"ABSTRAKFaktor-faktor yang Mempengaruhi Kesintasan Hidup Pasien KankerServiks di RSUD Raden Mattaher Jambi Tahun 2011-2016Pembimbing : Dr.dr. Tri Yunis Miko Wahyono, MScKanker serviks menduduki peringkat keempat kanker yang paling sering terjadi padasemua wanita dan peringkat kedua kanker yang paling sering ditemukan pada wanitausia 15-44 tahun di dunia, menyebabkan 265.672 kematian pada tahun 2012.Di duniasetiap 2 menit seorang perempuan meninggal akibat kanker serviks, sedangkan diIndonesia setiap 1 jam. Provinsi Jambi menurut Pusdatin 2015, estimasi jumlah kasuskanker serviks tahun 2013 adalah 1.792 dan semakin meningkat dari tahun-tahunsebelumnya. RSUD Raden Mattaher Jambi sebagai rumah sakit rujukan mengalamipeningkatan jumlah pasien kanker serviks dengan total pasien baru 318 sejak 2011-2016. Tujuan dari penelitian ini adalah untuk mengetahui angka kesintasan hidup secarakeseluruhan dan faktor-faktor yang mempengaruhi pada pasien di RSUD RadenMattaher Jambi tahun 2011-2016. Jumlah sampel yang didapat adalah 180 penderitayang pernah dirawat di RSUD ini dari Januari 2011-Desember 2016. Desain yangdigunakan dalam penelitian ini adalah kohort retrospektif dengan metode Kaplan meier.Kesintasan hidup pasien kanker serviks secara keseluruhan yaitu 23,2 dengan mediansurvival 24 bulan. Faktor ndash; faktor yang mempengaruhi yaitu umur, perkawinan, kadarhaemoglobin saat pertama kali didiagnosa, komorbid, stadium dan terapi. dengan faktoryang paling dominan yaitu komorbid HR=4,711 .Kata kunci:Kesintasan hidup, kanker serviks, event, sensor.

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ABSTRACT Affecting Survival Rate Factors Of Cervical Cancer Patients AtA Raden Mattaher Hospital Jambi In 2011 2016Counsellor Dr.dr. Tri Yunis Miko Wahyono, MScCervical cancer ranked fourth most common cancer in all woman and ranked secondmost common cancer found in women aged 15 44 years in the world causing 265.672deaths in 2012. Every 2 minutes a woman dies from cervical cancer in the world, whilein Indonesia every 1 hour. In Jambi province according to Pusdatin 2015 estimatednumber of caces of cervical cancer in 2013 is 1792 and increasing from the year before.Raden Mattaher hospital in Jambi as a referral hospital has increasing number ofcervical cancer patients with a total of 318 new patients since 2011 2016. The purposeof this study was to determine the overall survival rate and factors that affect thepatients in Raden Mattaher Hospital Jambi in 2011 2016. The number of patientsobtained is 180 patients who had been treated in this hospital from Januari 2011 toDecember 2016. The design used in this study was a retrospective cohort with theKaplan meier method. Overall survival of cervical cancer patients was 23.2 percent witha median survival of 24 months. The factors that influence are age, marriage,hemoglobin when first diagnosed, comorbid, stage and therapy. With the most dominantfactor is comorbid. HR 4.711 .Key words Survival rate, cervical cancer, event, cencor"

"Tujuan: Mengetahui pengaruh mutasi patogenik BRCA1/2 tumor terhadap kesintasan pasien advanced stage-high grade serous epithelial ovarian cancer di RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, dan RS MRCCC Siloam Jakarta.Metode: Sejumlah 68 sampel dari 144 pasien diagnosis high-grade serous epithelial ovarian cancer (HGSOC) stadium FIGO IIB-IV, periode 1 Januari 2015 sampai 31 Maret 2021, di RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, dan RS MRCCC Siloam Jakarta, menjalani pemeriksaan NGS mutasi patogenik BRCA1/2 tumor, dilibatkan dalam penelitian kohort historikal ini. Kami membandingkan karakteristik klinikopatologis pasien, dan hasil luaran kesintasan, setelah pasien menjalani tatalaksana primer, berdasarkan status mutasi patogenik BRCA1/2 tumor. Faktor terkait tatalaksana, yang diperkirakan berpengaruh terhadap hasil luaran kesintasan pasien, juga turut dianalisis dalam penelitian ini.Hasil: Angka kejadian mutasi patogenik BRCA1/2 tumor diketahui sebesar 27,94% (19/68). Antara kelompok mutasi patogenik BRCA1/2 tumor, dengan kelompok tanpa mutasi patogenik, tidak terdapat perbedaan statistik signifikan berdasarkan usia, paritas, indeks massa tubuh (kg/m2), riwayat kanker payudara, stadium FIGO 2014, kadar CA125 serum pre operatif (U/mL), volume cairan ascites intra operatif (mL), lesi residual pasca laparotomi debulking, pemberian neoadjuvant chemotherapy (NACT), pemberian kemoterapi adjuvant. Riwayat kanker keluarga terkait HBOC, merupakan variabel paling berpengaruh terhadap mutasi patogenik BRCA1/2 tumor. Kelompok dengan riwayat kanker keluarga terkait HBOC, berisiko 5,212 kali lebih besar mengalami mutasi patogenik BRCA1/2 tumor, dibandingkan dengan kelompok tanpa riwayat kanker tersebut (RR adjusted 5,212; 95%CI 1,495-18,167; nilai p=0,010).Pada kelompok mutasi patogenik BRCA1/2 tumor, kemungkinan meninggal 86% lebih rendah (RR adjusted 0,149; 95%CI 0,046-0,475; nilai p=0,001), dan median survival yang lebih baik (median 46 bulan; 95%CI 34,009-57,991; nilai p=0,001), apabila dibandingkan dengan kelompok tanpa mutasi patogenik (median 23 bulan; 95%CI 15,657-30,343; nilai p=0,001). Analisis multivariat menunjukkan mutasi patogenik BRCA1/2 tumor merupakan faktor prognostik independen yang baik terhadap hasil luaran kesintasan (RR adjusted 0,149; 95%CI 0,046-0,475; nilai p=0,001).Kesimpulan: Pasien advanced stage-high grade serous epithelial ovarian cancer, dengan mutasi patogenik BRCA1/2 tumor, memiliki kesintasan lebih baik, dibandingkan pasien tanpa mutasi patogenik BRCA1/2 tumor.

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Objective: To evaluate the impact of pathogenic BRCA1/2 tumor mutational status on advanced stage- high grade serous epithelial ovarian cancer survival outcome at RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, and RS MRCCC Siloam Jakarta.

Methods: A total 68 of 144 patients diagnosed with FIGO 2014 stage IIB-IV high grade serous epithelial ovarian cancer (HGSOC) between January 1st, 2015 until March 31st, 2021, at RSUPN Dr. Cipto Mangunkusumo, RSUP Persahabatan, and RS MRCCC Siloam Jakarta, underwent NGS tumor BRCA1/2 gene testing, and were included in this cohort hystorical study. We compared patients clinicopathological characteristics, and survival outcomes after primary treatment, according to pathogenic BRCA1/2 tumor mutational status. Treatment-related factors that might affect patients’ survival outcome were also investigated.

Results: The BRCA1/2 pathogenic tumor mutations prevalence was observed in this study 27.94% (19/68). There were no significant statistical differences in age, parity, body mass index (kg/m2), previous breast cancer history, FIGO 2014 staging, pre-operative serum CA 125 level (U/mL), intra operative ascites volume (mL), post cytoreductive surgery residual lesion, neoadjuvant chemotherapy (NACT), and adjuvant chemotherapy administration, between the pathogenic tumor BRCA1/2 mutation, and no pathogenic tumor BRCA1/2 mutation groups. The hereditary breast ovarian cancer family history (HBOC) variable has the strongest correlation with pathogenic tumor BRCA1/2 mutation. The group with a family history of HBOC-related cancer had a 5.212 times greater risk of developing pathogenic BRCA1/2 tumor mutations, compared with the group without a history of those cancer (RR adjusted 5.212; 95%CI 1.495-18.167; p value=0.010).

The pathogenic BRCA1/2 tumor mutation group displayed better survival outcome. In the pathogenic BRCA1/2 tumor mutation group, the likelihood of dying was 86% lower (RR adjusted 0.149; 95%CI 0.046-0.475; p-value=0.001), and the median survival was better (median 46 months; 95%CI 34.009- 57.991; p value=0.001), than without pathogenic BRCA1/2 tumor mutations group (median 23 months; 95%CI 15.657-30.343; p value=0.001). The multivariate analyses identified pathogenic BRCA1/2 tumor mutation as an independent favorable prognostic factor for survival outcome (RR adjusted 0.149; 95%CI 0.046-0.475; p-value=0.001).

Conclusions: In advanced stage-HGSOC, patients with pathogenic BRCA1/2 tumor mutations have a better prognosis with longer survival outcome than those without pathogenic BRCA1/2 tumor mutations."

"Di Indonesia umumnya pasien kanker serviks datang berobat pada stadium lanjut (62 %) sehingga kanker serviks merupakan 66 % dari penyebab kematian ginekologik.1 Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan keterlambatan pasien kanker serviks memeriksakan diri. Penelitian menggunakan metode kuantitatif dan kualitatif dengan sampel yang diambil dari seluruh pasien baru kanker serviks tahun 2000 dan 2001 yang datang berkunjung kembali ke RSUPN Dr. Cipto Mangunkusumo Jakarta pada bulan Agustus sampai dengan Oktober 2001. Kesimpulan : Variabel yang berhubungan secara signifikan dengan waktu memeriksakan diri ialah pengetahuan, sikap, ketersediaan pelayanan Pap smear dan dukungan suami. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan. (Med J Indones 2003; 12: 162-5)

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In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %). This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel. (Med J Indones 2003; 12: 162-5)"