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"Latar Belakang: Kanker ovarium merupakan kanker yang menduduki peringkat kedelapan untuk angka kejadian dan peringkat ketujuh untuk mortalitas pada perempuan di seluruh dunia. Mayoritas pasien akan mengalami rekurensi, terutama pada tiga tahun pertama setelah terapi. Terdapat beragam faktor prognostik klinikopatologis yang mempengaruhi luaran dan rekurensi kanker ovarium, namun hasil penelitian yang telah ada menunjukkan hasil yang tidak konsisten mengenai pengaruh faktor-faktor tersebut.Tujuan: Tujuan penelitian ini adalah mempelajari kejadian rekurensi 3 tahun pasien kanker ovarium epitelial di RSCM dan faktor klinikopatologis yang mempengaruhinya.Metode: Penelitian ini merupakan penelitian kohort retrospektif pada 102 pasien yang menjalani terapi untuk kanker ovarium epitelial di RSCM. Dilakukan pemantauan hingga 3 tahun pasca terapi atau hingga terjadi rekurensi yang didapatkan secara klinis atau radiologis. Dilakukan analisis kesintasan terhadap faktor klinikopatologis yaitu usia, stadium, keberhasilan sitoreduksi, sitologi asites, histopatologi, derajat diferensiasi dan keterlibatan KGB. Faktor yang didapatkan memiliki hubungan bermakna dengan kejadian rekurensi kemudian dianalisis dengan metode regresi Cox.Hasil: Pada penelitian ini didapatkan bahwa rekurensi kanker ovarium epitelial di RSCM pada 1 tahun adalah 17,7%, pada 2 tahun adalah 30,6%, dan pada 3 tahun adalah 36,3%. Median waktu hingga rekurensi adalah 94 minggu. Analisis kesintasan menunjukkan bahwa usia, histopatologi dan derajat diferensiasi tidak memiliki hubungan yang bermakna dengan kejadian rekurensi 3 tahun. Di sisi lain, didapatkan bahwa stadium berdasarkan FIGO, keberhasilan operasi sitoreduksi, sitologi asites dan keterlibatan KGB memiliki hubungan yang bermakna dengan kejadian rekurensi 3 tahun. Setelah dilakukan analisis multivariat, keterlibatan KGB ditemukan sebagai faktor prognostik terhadap kejadian rekurensi 3 tahun pada kanker ovarium epitelial dengan hazard ratio 3,066 (IK 95% 1,186-7,923).Kesimpulan: Angka kejadian rekurensi 3 tahun untuk kanker ovarium epitelial adalah 36,3%. Faktor klinikopatologis yang mempengaruhi rekurensi adalah stadium, keberhasilan operasi sitoreduksi, sitologi asites, dan keterlibatan KGB.

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Background: Ovarian cancer is a cancer that ranks eighth for the incidence and ranks seventh for mortality in women around the world. The majority of patients will experience recurrence, especially in the first three years after therapy. There are a variety of clinopathologic prognostic factors that influence the outcome and recurrence of ovarian cancer, but the results of existing studies show inconsistent results regarding the influence of these factors.

Objective: The purpose of this study was to study the 3-year recurrence rate of epithelial ovarian cancer patients in Cipto Mangunkusumo Hospital and the influencing clinicopathologic factors.

Methods: This study was a retrospective cohort study of 102 patients undergoing treatment for epithelial ovarian cancer in the RSCM. Monitoring is carried out up to 3 years after therapy or until recurrences are obtained clinically or radiologically. Survival analysis of the clinicopathologic factors including age, stage, success of cytoreduction, ascites cytology, histopathology, degree of differentiation and involvement of lymph node was performed. The factors which were found to have a significant relationship with the recurrence event were then analyzed using the Cox regression method.

Results: In this study it was found that the recurrence of epithelial ovarian cancer in the RSCM at 1 year was 17.7%, at 2 years was 30.6%, and at 3 years was 36.3%. The median time to recurrence is 94 weeks. Survival analysis showed that age, histopathology and degree of differentiation did not have a significant relationship with the incidence of recurrence at 3 years. Conversely, it was found that stage based on FIGO, successful cytoreductive surgery, ascites cytology and lymph node involvement had a significant relationship with the incidence of recurrence at 3 years. After multivariate analysis, lymph node involvement was found as a prognostic factor for the incidence of 3-year recurrence in epithelial ovarian cancer with a hazard ratio of 3.066 (95% CI 1.186-7.923).

Conclusion: The 3-year recurrence rate for epithelial ovarian cancer is 36.3%. Clinicopathologic factors that influence recurrence are stage, success of cytoreductive surgery, ascites cytology, and lymph node involvement.

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"ABSTRAKNama : Ken Indra TProgram Studi : : Pendidikan Dokter Spesialis Obstetri dan GinekologiJudul : Prevalensi Occult metastasis pada omentum Pasien Kanker Ovarium Epitelial Stadium Awal Yang Menjalani Surgical staging di RSCM Tahun 2009 ndash; 2015TUJUAN: Mengetahui besarnya prevalensi occult metastasis kanker ovarium epitelial stadium klinis dini pada omentum yang dilakukan pembedahan di RSCM periode Januari 2009 ndash; Desember 2015.LATAR BELAKANG: Secara anatomis, omentum adalah lokasi utama penyebaran dari kanker ovarium epithelial. Hal ini ditunjukkan dari berbagai penelitian yang menyebutkan bahwa terdapat prevalensi metastasis yang tinggi ke omentum. Hal ini menyebabkan FIGO membuat rekomendasi untuk melakukan pembedahan sitoreduksi dan surgical staging yang teliti dan hati-hati pada kasus-kasus dengan kecurigaan kanker ovarium. Penelitian mengenai omentektomi dalam pembedahan kanker ovarium epithelial masih belum ada di Indonesia sehingga kami melakukan penelitian inilDESAIN DAN METODE: Penelitian ini menggunakan desain potong silang dengan mengambil rekam medis pasien kanker ovarium yang dilakukan pembedahan di RSCM pada bulan Januari 2009 ndash; Desember 2015.HASIL: Pada sebanyak 1 subjek dari 51 subjek penelitian 2 ditemukan occult metastasis pada omentum. Prevalensi metastasis pada kanker ovarium epithelial stadium dini pada tahun 2009 ndash; 2015 adalah sebesar 33,3 17 dari 51 subjek , dimana keterlibatan omentum ditemukan pada 2 subjek 1 dari 51 .KESIMPULAN: Prevalensi occult metastasis kanker ovarium epithelial stadium klinis dini yang dilakukan pembedahan di RSCM tahun 2009 ndash; 2015 adalah sebesar 2 1 dari 51 subjek Kata Kunci: Metastasis, Omentum, Karsinoma Ovarium, Epitelial, Prevalensi

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ABSTRACTName Ken IndraStudy Program Obstetrics and GynecologyTitle Prevalence of occult omental metastases of early stage epithelial ovarian cancer patients whom had surgical staging in RSCM from 2009 ndash 2015. AIM To know the prevalence of occult metastases of epithelial ovarian cancer clinically early stage in RSCM.BACKGROUND Topographically, omentum is the main spread location of epithelial ovarian cancer. This is shown by various study showing that there is high incidences of metastases of ovarian cancer to the omentum. This made FIGO to produce a guideline to remove omentum in surgical staging of ovarian cancer. Omentectomy study in epithelial ovarian cancer surgery has not been performed in Indonesia, thus we made this study.DESIGN AND METHODOLOGY Cross sectional study. We collect data retrospectively from medical records of cases of epithelial ovarian cancer who were operated in RSCM from January 2009 ndash December 2015.RESULTS 1 out of 51 subjects 2 was found to have occult metastases in the omentum. The prevalence of metastases of epithelial ovarian cancer clinically early stage from 2009 ndash 2015 is 33.3 17 out of 51 subjects whereas the involvement of omentum was found in 2 1 out of 51 subjects .CONCLUSION The prevalence of occult omental metastases of ephitelial ovarian cancer clinically early stage in RSCM from 2009 ndash 2015 is 2 1 out of 51 subjects .Keywords Metastases, Omentum, Ovarian Cancer, Prevalence."

"ABSTRAKLatar Belakang: Berbagai registrasi kanker menunjukkan proporsi pasien kanker payudara usia muda yang lebih tinggi di negara Asia. Tingginya proporsi kanker payudara usia muda perlu mendapat perhatian khusus karena populasi pasien ini membutuhkan pendekatan klinis yang berbeda terkait perangai biologis yang lebih ganas, prognosis yang lebih buruk, serta terkait dampak psikososial yang lebih besar untuk wanita usia muda. Penelitian ini bertujuan mencari karakteristik payudara usia muda di Indonesia serta hubungannya dengan kesintasan.Metode Penelitian: Penelitian ini merupakan studi analisis kesintasan dengan sampel penelitian pasien usia muda dengan diagnosis kanker payudara yang telah dibuktikan secara histopatologis sejak Januari 2008-Agustus 2015 dan menjalani terapi operasi dan/atau kemoterapi dan/atau radiasi di RSCM. Data didapatkan dari penelusuran rekam medis serta wawancara pasien.Hasil Penelitian: Didapatkan bahwa 35 pasien kanker payudara di RSCM berusia

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ABSTRACTBackground: Various cancer registrations and reports had confirmed the higher proportion of young women with breast cancer in Asian countries. This mandates special attention for clinician since this group of patients need different management approach, especially regarding the more aggressive biological behaviour, worse prognosis and the escalating psychosocial burden that young women endures. We conducted a study to describe the clinicopathological characteristics of young age breast cancer in Indonesia and its relation with overall survival. Methods: This is a survival analysis study using samples all young age women with histologically-proven cancer diagnosis that underwent treatment surgery and/or chemotherapy and/or radiation therapy since January 2008-August 2015. Data were collected from both medical records and interview. Results: Young age women comprises 35 of total breast cancer patients, with the majority of cases were in the locally advanced stage, histologic type NST, grade 2, no lymphovascular invasion, positive hormone receptors, negative HER2 status, high Ki-67 and Luminal B subtype. The 5-year overall survival rates were 64 ; variables that showed statistically significant corelation was tumor size, nodal status, metastatic status and clinical stage. Histologic type NST, grade 2, positive lymphovascular invasion, high Ki-67 and positive HER2 were related to survival, but this corelation was not statistically significant. Conclusion: The 5-year overall survival rates of young age breast cancer at RSCM was 64 , much lower that reported figures from literatures and other countries rsquo; reports. Clinical stage was the only variable with statistically significant corelation. Luminal B subtype was observed the most, but the worst survival was found in the HER2 subtype group. "

"ABSTRAKNama :Nugraha Utama PelupessyProgram Studi :S3 Ilmu KedokteranJudul :Marker Cancer Stem Cells CD133, CD44, dan ALDH1A1 Sebagai Faktor Prognostik pada Kanker Ovarium Tipe Epitelial Kanker ovarium merupakan penyakit yang bersifat heterogen dan kebanyakan pasien datang dengan stadium lanjut. Kanker ovarium epitelial tipe II mempunyai sifat pertumbuhan tumor yang cepat dan secara genetik labil dibandingkan tipe I. Keberadaan cancer stem cells CSC dianggap sebagai salah satu faktor prognostik terjadinya kemoresisten dan kesintasan hidup yang rendah.Penelitian ini bertujuan untuk membuktikan CSC sebagai faktor prognostik dengan menggunakan marker CD133, CD44, dan ALDH1A1 pada kanker ovarium tipe epitelial.Marker CD133, CD44, dan ALDH1A1 diperiksa dengan imunohistokimia dan flowcytometry. Hasil ekspresi marker CSC pasien kanker ovarium tipe I dan tipe II dimasukkan kedalam suatu tabel yang dihubungkan dengan respons kemoterapi dan kesintasan hidup. Analisis data dilakukan dengan program computer STATA 14. Analisis kesintasan dilakukan dengan analisis Kaplan-Meier dan uji asumsi cox proportional hazard. Analisis multivariat dipakai untuk model prognosis selama 10 bulan. Sistem skoring dibuat dengan menggunakan receiver operating characteristic ROC curve analyses.Data demografi kelompok terbanyak adalah usia ge; 45 tahun; 40 sampel 72,7 , stadium I, 23 sampel 41,8 , diferensiasi buruk 30 sampel 54,5 , dan tipe II 16 sampel 29,1 . Perbedaan yang bermakna antara tipe histopatologi dengan marker CSC hanya terlihat pada marker CD44. Skor Prediksi Kemoresisten SPKr 10 bulan yang dihubungkan dengan 4 variabel yaitu usia ge; 45 tahun, tipe II, stadium III minus;IV, dan CD44 tinggi dengan ROC 72,47 dan probabilitas post test 82,5 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 negatif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841. Skor Prediksi Kematian SPKm 10 bulan yang dihubungkan dengan 3 variabel yaitu stadium III minus;IV, tipe II, dan CD44 tinggi dengan AUC 80,44 dan probabilitas post test 78,7 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 positif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841.Simpulan: Marker CD44 terbukti berperan pada kanker ovarium tipe II. Skor Prediksi Kemoresisten dan Skor Prediksi Kematian dapat ditentukan selain dengan faktor klinikopatologi, juga dengan memakai marker CSC. Kata kunci: ALDH1A1, CD44, CD133, CSC, kanker ovarium epitelial, kesintasan hidup, respons kemoterapi.

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ABSTRACTName : Nugraha Utama PelupessyStudy Program : Doctoral Program Medical SciencesTitle :Cancer Stem Cell CD133, CD44 andALDH1A1 Markers As Prognostic Factors on Epithelial Ovarian Cancer. Ovarian cancer is a heterogeneous disease and most of the patients came with an advanced stage. Epithelial ovarian cancer type II has the characteristic of rapid tumor growth and genetically more labile than that of type I. The presence of cancer stem cells CSC is considered as one of the prognostic factors of low mortality and survival.The aims of this study was to prove CSC as prognostic factors using CD133, CD44, and ALDH1A1 markers on epithelial ovarian cancer.Clinicopathology and demographic data were collected from medical records. CD133, CD44, and ALDH1A1 markers were examined with flowcytometry and immunohistochemistry. CSC marker expression of the patients with ovarian cancer type I and II was connected with chemotherapy and survival response. Data analysis was done by using STATA 14 software. Survival analysis was done by using Kaplan-Meier analysis and Cox proportional hazard test. Multivariate analysis is used for prognosis model for ten months. Receiver Operating Characteristic ROC curve analyses was used as the system scoring. The highest group demographic data were age ge; 45 years; 40 samples 72.7 , stage I, 23 samples 41.8 , poor differentiation 30 samples 54.5 , and type II 16 samples 29.1 . A significant difference between the histopathologic type and the CSC marker was seen only in CD44 marker. Chemoresistance Prediction Score in 10 months was associated with 4 variables ie age ge; 45 years, type II, stage III minus;IV, and CD44 high with ROC 72.47 and posttest probability 82.5 . The highest chemoresitency scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, negative CD133, high CD44, and high ALDH1A1, was 0.841. Mortality Prediction Score in 10 months was associated with 3 variables is stage III minus;IV, type II, and CD44 high with AUC 80.44 and posttest probability 78.7 . The highest mortality scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, positive CD133, high CD44, and high ALDH1A1, was 0.841. Conclusion: The CD44 marker has a role in type II ovarian epithelial cancer. Chemoresistance Prediction Score and Mortality Prediction Score can be determined from clinicopathological factors and using CSC marker. Keywords: ALDH1A1, CD44, CD133, chemotherapy response, CSC, Epithelial Ovarian Cancer, survival"

"Latar Belakang: Kanker ovarium epitelial merupakan jenis keganasan ovarium yang paling sering ditemukan dan bersifat agresif. Upaya melakukan deteksi dini dilakukan dengan pemeriksaan ginekologi, dikombinasi dengan pemeriksaan ultrasonografi, advanced imaging (CT-Scan, MRI) dan pemeriksaan kadar serum CA-125, namun untuk menentukan diagnosis pasti diperlukan pemeriksaan histopatologi. Tujuan: Membandingkan temuan metastasis kelenjar getah bening pada advanced imaging (CT-Scan, MRI) dengan histopatologi pada kasus kanker ovarium epitelial.dan menentukan rentang waktu antara dilakukkan advanced imaging dengan tindakan operasi. Metode: Penelitian ini bersifat kohort retrospektif. Sampel penelitian adalah pasien dengan riwayat kanker ovarium epitelial stadium awal yang sudah dilakukan limfadenektomi di RSCM pada tahun 2017-2022 dengan teknik consecutive sampling. Pengumpulan data melalui data sekunder. Data dianalisis secara univariat dan bivariat dengan uji Mc Nemar atau Kappa. Hasil: Dari karakteristik didapatkan usia rata-rata 48 tahun, paling banyak dengan jenis clear cell carcinoma (36.7%), dan ditemukan paling banyak pada ovarium kanan (43.3%). Hasil advanced imaging tidak memiliki nilai kesepakatan yang berarti dengan hasil histopatologi (Kappa value -0.01, p >0.05). Hasil paling banyak ditemukan metastasis di pelvis kiri. Rentang waktu dilakukannya operasi setelah pemeriksaan advanced imaging, paling banyak dalam waktu kurang dari 3 bulan (50.0%). Kesimpulan: Semakin cepat waktu dilakukan tindakan operasi semakin tinggi survival rate. Tidak ada hubungan yang signifikan antara ditemukannya limfadenopati pada advanced imaging dan histopatologi.

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Background: Epithelial ovarian cancer is the most common and aggressive type of ovarian malignancy. Efforts aimed at early detection are gynecological examination, combined with ultrasound examination, advanced imaging (CT-Scan, MRI) and CA-125 levels, but to determine a definite diagnosis a histopathological examination is needed. Objective: To compare the findings of lymph node metastases on advanced imaging (CT-Scan, MRI) with histopathology in cases of epithelial ovarian cancer. And to determine the time interval between advanced imaging and surgery. Methods: This study used a retrospective cohort. The sample of the study was patients with a history of early-stage epithelial ovarian cancer who had undergone lymphadenectomy at RSCM in 2017-2022 by consecutive sampling technique. Data collection through secondary data. Data were analyzed univariately and bivariately with the Mc Nemar or Kappa test. Results: The features revealed that the average age was 48 years, that clear cell carcinoma was the most prevalent form (36.7%), and that it was most frequently discovered in the right ovary (43.3%). According to the study's findings, there was no significant correlation between the outcomes of advanced imaging and those of histopathology (Kappa value: -0.01, p >0.05). The results showed that most metastases were found in the left pelvis. This study evaluated the length of surgery following enhanced imaging test revealed that 50% of patients underwent surgery in less than three months on average. Conclusion: The difference between preoperative and intraoperative findings will be minimized if surgery is conducted early. There was no significant correlation between lymphadenopathy findings on advanced imaging and histopathology."

"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."

"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh duniasetiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadapmetastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakansalah satu penentu surgical staging. Surgical staging yang optimal merupakansebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yangbaik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitianini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengankanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiksyang dilakukan pembedahan primer di RSCMMetode: Penelitian ini merupakan studi potong lintang menggunakan data rekammedis pasien kanker ovarium epitelial yang menjalani pembedahan primer danapendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhikriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi daneksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43subjek (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 yangmenjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar.Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjekterdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinissatu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuanhistologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukanpembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atasjenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapatdipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadiumlanjut.

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Background: Around 152,000 women were death every year because of ovariancancer. Appendix is an intraperitoneal organ which prone to ovarian epithelialcancer 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 tosee appendix involvement from primary surgery in ovarian epithelial cancer atRSCMAim: To determine prevalence of metastasis to the appendix from primary surgeryin ovarian epithelial cancer at RSCMMethod: This cross sectional study used ovarian epithelial cancer patient medicalrecord which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutiverandom sampling were used.Result: Eighty subjects which were taken from inclusion and exclusion criteria hasaverage age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadiumI patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, andnone 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 chronicappendicitis and 53 subjects (66.3%) doesnt have metastasis to the appendix. Fromeight subjects which has appendix involvement, four were defined have mucinoushistology, two serous, and two endometrioid. Six out of eight were diagnosed atclinical stadium III and two were diagnosed at stadium I. These two stadium Isubjects has mucinous histology.Conclusion: There are 10 percent appendix metastases from primary surgery inovarian epithelial cancer at RSCM which consist of mucinous, serous, andendometrioid histological types. Based on this research, appendectomy can beconsidered done on surgery whether in early or late stadium."

"Latar Belakang : Kanker ovarium merupakan penyebab kematian tertinggi pada kelompok kanker ginekologik dengan angka kekambuhan dua tahun sebesar 50%. Tujuan: mengetahui faktor yang berperan pada kekambuhan kanker ovarium. Metode : Penelitian ini menggunakan desain kohort retrospektif dengan teknik analisis kesintasan untuk melihat peran faktor ekspresi Human Epidermal Receptor (HER-2), residu tumor post operasi, jenis subtipe sel kanker dan tingkat diferensiasi sel kanker terhadap kekambuhan kanker ovarium epitelial. Analisis bivariat menggunakan metode log rank test digunakan untuk menilai hubungan antara 2 variabel. Hasil Penelitian : Sebanyak 65 pasien kanker ovarium epitelial (tahun 1998-2012) yang telah remisi diamati selama 24 bulan. Terlihat bahwa median usia 50 tahun dengan proporsi kekambuhan sebesar 36,9% pasien dan mean waktu kekambuhan pertama 19,15 bulan. Volume residu tumor post operasi berukuran lebih dari 1 cm meningkatkan Rasio Hazard kekambuhan dua tahun pasien kanker ovarium epitelial, nilai p: 0,02 dan HR 3,31 (IK95% 1,46-7,49) sementara jenis subtipe histologi dan tingkat diferensiasi sel kanker tidak berhubungan dengan terjadinya kekambuhan ini. Satu dari 38 pasien memperlihatkan adanya cytoplasmic staining pada pemeriksaan ekspresi HER-2 dengan metode imunohistokimia. Simpulan : Volume residu tumor post operasi yang berukuran lebih dari 1 cm meningkatkan Rasio Hazard kekambuhan dua tahun pasien kanker ovarium epitelial, sementara jenis subtipe histologi dan tingkat diferensiasi sel kanker tidak berperan pada kekambuhan ini. Pada pemeriksaan ekspresi HER-2, menggunakan teknik imunohistokimia dilaporkan 1 sampel memperlihatkan cytoplasmic staining.

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Background : Ovarian cancer was the leading cause of death in gynecologic cancer which had the two years recurrency rate of 50%.

Aim : to know factors that influenced on epithelial ovarian cancer recurrency.

Methods : We used retrospective cohort design with survival analysis technique for this study to examine the role of HER-2 expression, residual tumor post operation, cancer cell histological subtype and cancer cell grading on epithelial ovarian cancer recurrency. Bivariate analyze using log rank test methods were done to examine significance between two variables.

Results : Sixty-five epithelial ovarian cancer patient (1998-2012) who had achieved remission were observed for 24 months. We reported median age of 50 years with recurrency rate of 36.9% and mean time of recurrency was 19,15 months. Volume of post surgery residual tumor more than 1 cm increase Hazard Ratio of two years recurrency of epithelial ovarian cancer, p value 0.02 and HR of 3.31 (95% CI 1.46-7.49) but histology subtype and cancer cell grading did not influence the recurrency. One of 38 patients showed cytoplasmic staining in HER-2 expression examination by imunohistochemistry methods.

Conclusion : Volume of post surgery residual tumor more than 1 cm increase Hazard Ratio of two years recurrency of epithelial ovarian cancer while histology subtype and cancer cell grading did not influence the recurrency. One sample showed cytoplasmic staining on HER-2 examination by imunohistochemistry methods."

"ABSTRAKPendahuluan. Tumor Ganas Jaringan Lunak Soft Tissue Sarcoma merupakan kelompok heterogen tumor ganas mesenkim dengan jumlah kasus yang sangat sedikit dengan gejala klinis sulit dibedakan dengan tumor jinak, menjadikan tumor ini sering ditangani tanpa mengetahui batas tumor yang jelas unplanned excision . Penanganan tumor ganas jaringan lunak secara inadekuat ini mengakibatkan tumor masih tersisa sehingga beresiko terjadi rekurensi dan mortalitas. Penelitian ini bertujuan untuk mengetahui rekurensi dan mortalitas pasien tumor ganas jaringan lunak ekstremitas yang telah dilakukan unplanned excision, serta faktor-faktor yang memengaruhinya.Metode Penelitian. Penelitian ini merupakan penelitian deskriptif analitik dengan rancangan kohort retrospektif yang menggunakan data pasien RS Cipto Mangunkusumo tahun 2005 hingga 2015. Pada penelitian ini, didapati yang memenuhi kriteria sebanyak 87 subjek, yakni pasien unplanned excision tumor ganas jaringan lunak ekstremitas yang dilakukan analisis angka rekurensi dan mortalitas serta faktor-faktor yang berhubungan dengan rekurensi dan mortalitas tersebut.Hasil Penelitian. Terdapat hubungan yang bermakna antara tingkat rekurensi dengan operator yang tidak berkompeten non orthopaedi onkologi p0,05 . Tidak terdapat hubungan yang bermakna secara statistik antara mortalitas dengan operator pembedahan, lokasi tumor, ukuran awal tumor dan tipe rumah sakit P>0,05 .Kesimpulan. Faktor yang memengaruhi rekurensi pada pasien unplanned excision tumor ganas jaringan lunak yakni operator non orthopaedi onkologi.

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ABSTRACTIntroduction. Soft tissue sarcoma is part of mesenchymal malignant tumor heterogeneous group with very little number of cases. Unplanned excision often become the choice of treatment due to difficulties to differentiate it with benign tumor. The inadequate treatment of this soft tissue sarcoma often leave trace of the tumor, leading to recurrence and mortality. We studied the recurrence and mortality of patients with unplanned excision on soft tissue sarcoma of extrimities, including affecting factors.Methods. This is an analytical descriptive study with retrospective cohort design, using patient rsquo s data in Cipto Mangunkusumo hospital during 2005 to 2015. Our study acquired 87 subjects with unplanned excision on soft tissue sarcoma of extrimities. Analysis of recurrence rate, mortality rate, and related factores were examined and analysed.Results. There was significant relationship between recurrence rate with incompetent surgeon non oncology orthopaedics p0,05 . However, this study could not find statistical significance between mortality with non oncology orthopaedic surgeon, location of the tumour, initial size of the tumour, and hospital type P 0,05 .Conclusion. There is relationship between recurrence rate with non oncology orthopaedics operator. "

"ABSTRAKTUJUAN : Mengetahui insiden metastasis kanker ovarium epitelial yang dilakukan pembedahan primer pada kelenjar getah bening pelvik, paraaorta dan pelvik/paraaorta di RSCM periode Januari 2009 Desember 2015. LATAR BELAKANG : Tatalaksana mengenai limfedenektomi pada kanker ovarium masih merupakan kontroversi. Adanya kekurangan data penelitian prosfektif ataupun RCT tentang patologi antomi merupakan penyebab kontroversi tatalaksana limfedentomi. Namun sampai saat ini sejak 1998 FIGO mengatakan bahwa limfedenektomi pelvik dan paraaorta merupakaan bagian terintegrasi yang tidak dapat dipisahkan pada surgical staging kanker ovarium. Namun penelitian mengenai limfedenektomi masih terbatas, sampai saat belum menemukan adanya publikasi penelitian insiden metastasis kanker ovarium epitelial pada kelenjar getah bening di RSCM. METODE Penelitian ini menggunakan desain penelitian potong lintang, data diambil dari rekam medis, dari data kanker register didapatkan 1584 daftar rekam medik, namun didapatkan 401 pasien kanker ovarium, dan 306 yang ekslusi, didapatkan 55 data yang masuk kriteria inklusi. HASIL Dari 55 sampel yang dilakukan pembedahan primer pada kanker ovarium tipe epitel. Penyebaran kelenjar getah bening pada kanker epitel ovarium yang dilakukan pembedahan primer pada KGB paraaorta adalah 20 , pelvik 9.1 dan pelvik/paraaorta 23,6 . KESIMPULAN : 1. Insiden metastasis KGB kanker epitel ovarium pada paraaorta sebanyak 20 , pelvik 9,1 dan pada pelvik/paraaorta 23,6 di RSCM dari tahun 2009-2015.. 2. Semakin tinggi stadium, maka semakin tinggi keterlibatan KGB pelvik dan paraaorta . 3. Pada subtipe serosum lebih banyak menyebabkan keterlibatan pada KGB pelvik dan paraaorta . 4. Semakin buruk derajat differensiasinya, maka semakin tinggi keterlibatan pada KGB paraaorta . 5. Pada stadium I subtipe musinosum derajat difensiasi baik dengan keterlibatan pada KGB yang minimal sehingga dapat lebih selektif dalam mempertimbangkan risk dan benefit dari limfedenektomi

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ABSTRACTAIM To evaluate the incidence of pelvic and paraaortic lymph node metastasis of epithelial ovarian cancer underwent primary surgery in Cipto Mangunkusumo Hospital from Januari 2009 to December 2015. BACKGROUND The definitive objective of lymphadenectomy in ovarian cancer is still controversial due to the lack of prospective research or randomized controlled trial. Since 1998, FIGO has stated that pelvic and paraaorta lymphadenectomy are part of ovarian cancer surgical staging. But, there is still limited research and still not published the incidence of pelvic and paraaortic lymph node metastasis of epithelial ovarian cancer underwent primary surgery in Cipto Mangunkusumo Hospital. METHODS This research is cross sectional from medical records, the INASGO cancer registry. A hundred fifty four medical records were included but we found only 401 ovarian cancer, 306 data were excluded and 55 data were included. RESULTS From 55 epithelial ovarian cancer patients underwent the primary surgery, there are 20 metastasis to paraortic lymph node, 9,1 metastasis to pelvic lymph node, and 23,6 metastasis to both. CONCLUSION 1. Lymph node metastases incident of ovarian epithelial cancer in paraorta amounts 20 , pelvic 9.1 and pelvic or paraortic 23.6 2. Higher the stadium, the lymph node involvements will be higher as well pelvic and paraortic 3. In serous subtype, there is more incidents of lymph node involvements pelvic and paraaortic 4. If the differentiation type is worse, there will be higher rate of pelvic and paraaortic lymph node involvement. 5. In stadium 1 of mucinous subtype with well differentation has minimal lymph node involvement so we can be more selective in considering the risk and benefit of lymphadenectomy. The suggestion is the advanced research needs to be done prospectively by increase the number of samples for finding the metastatic factors to lymph node more accurately. "