Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Tujuan : Penelitian ini ditujukan untuk mengevaluasi sensitivitas dan spesifisitas dari beberapa metode penapisan keganasan pada tumor ovarium jenis epitelial dengan membandingkan Skor Gatot dan Risk Malignancy Index, serta mengajukan modifikasi Skor Gatot. Metode : Empat ratus satu pasien dengan kecurigaan keganasan ovarium tipe epithelial dimasukkan sebagai subjek penelitian, dilakukan prosedur anamnesis, pemeriksaan fisik, laboratoris dan ultrasonografi. Dari data tersebut, diambil variabel-variabel yang sesuai dengan Skor Gatot dan Risk Malignancy Index. Dilakukan analisa statistik berupa perhitungan sensitivitas dan spesifisitas serta ROC dan titik potong optimal. Hasil : Dari 401 subjek penelitian, didapatkan bahwa Skor Gatot memiliki sensitivitas 73.7% dan spesifitas 45.6% (p = 0.000; LR 28.830) sedangkan RMI memiliki nilai sensitivitas 72.4%, spesifisitas 35.94% (p = 0.02, LR 9.588) untuk RMI 1 dan nilai sensitivitas 76%, spesifisitas 30.9% (p = 0.05; LR 7.984) untuk RMI 2. Dilakukan modifikasi pada Skor Gatot dengan pembobotan ulang pada tiap variabel, didapatkan hasil Modifikasi Skor Gatot 1 memiliki titik potong pada nilai 28.5 dengan sensitivitas sebesar 60.4% dan spesifisitas sebesar 61.4% (p= 0.000, LR 44.228) dan Modifikasi Skor Gatot 2 memiliki nilai potong pada titik 5.75 dengan kisaran nilai sensitivitas 49.3 – 69.6% dan sensitivitas 51.6-65.2% ( p = 0.000; LR 36.806). Kesimpulan : Skor Gatot dan RMI memberikan hasil yang kurang memuaskan dalam melakukan prediksi keganasan ovarium. Dengan melakukan pembobotan ulang pada tiap variabel pada Skor Gatot, sensitivitas dan, terutama, spesifisitas dapat ditingkatkan dalam mendeteksi adanya keganasan ovarium tipe epitelial. Hal ini ditujukan agar dapat meningkatkan prediksi keganasan pada pasien dalam usia reproduksi.

---

Objective : The study was designed to evaluate the sensitivity and specificity of several methods in detecting ovarian epithelial malignancy by comparing Gatot Score and Risk Malignancy Index, and also proposing the modification of Gatot Score. Method : Four hundred and one subjects with suspected epithelial ovarian malignancy entered the study and performed anamnesis, physical examinations, laboratories studies and ultrasonography. From the data, we took the variables according to Gatot Score and Risk Malignancy Index. We performed statistic analysis in term of sensitivity, specificity, ROC and optimal cut-off-point. Results : From 401 observation subjects, revealed that Gatot Score possess the sensitivity of 73.7% and specificity of 45.6% (p = 0.000; LR 28.830), while RMI possess the sensitivity of 72.4% and specificity of 35.94% (p = 0.02, LR 9.588) for RMI 1, and the sensitivity of 76% and specificity of 30.9% (p = 0.05; LR 7.984) for RMI 2. Modification to Gatot Score was performed by re-weighting to its all variables, which resulted in Gatot Score Modification 1 with cut-off point of 28.5, sensitivity of 60.4% and specificity of 35.94% (p= 0.000, LR 44.228) and Gatot Score Modification 2 with cut-off point of 5.75, sensitivity range between 49.3 – 69.6% and specificity range between 51.6-65.2% ( p = 0.000; LR 36.806). Summary : Both Gatot Score and RMI resulted in unsatisfactory output in predicting the malignancy of ovary. By reassigning the weighting of all variables in Gatot Score, especially the specificity was improved in detecting the malignancy of epithelial type ovary. This measure was directed for patients in reproductive ages, thus increasing the possibility of true malignancy.

Abstrak :
Kemoterapi adalah salah satu pilihan pengobatan untuk pasien kanker ginekologi. Kemoterapi menunjukkan efek samping secara fisik, psikososial dan seksual. Pendidikan kesehatan adalah salah satu metode yang digunakan untuk membantu mengurangi efek samping pada pasien yang menjalani kemoterapi. Penelitian ini bertujuan untuk mengidentifikasi pengaruh pendidikan kesehatan DORLAN terhadap masalah fisik, psikososial, dan seksual pada pasien kanker ginekologi yang menjalani kemoterapi. Penelitian kuasi eksperimental dengan teknik pengambilan sampel dengan consecutive sampling. Sampel berjumlah 94 wanita dengan kanker ginekologi yang menjalani kemoterapi dimasukkan dan terdiri dari 47 peserta dalam kelompok intervensi dan 47 peserta dalam kelompok kontrol. Pengumpulan data dilakukan dengan menggunakan kuesioner data demografis, kuesioner FACT-G, Sexual Satisfaction Scale for Women (SSS-W), dan kuesioner Multidimensional Scale of Perceived Social Support (MSPSS). Hasil penelitian menunjukkan bahwa ada perbedaan dalam masalah fisik (p-value 0,000), masalah psikososial (p-value 0,001), masalah seksual (p-value 0,041) sebelum dan sesudah pemberian pendidikan kesehatan DORLAN pada kelompok intervensi. Hasil juga menunjukkan ada perbedaan masalah fisik, psikososial, dan seksual pasien kanker ginekologi selama kemoterapi antara kelompok intervensi dan kelompok kontrol (p-value: 0,049, 0,001 dan 0,003). Pemberian pendidikan kesehatan DORLAN dapat diberikan sebagai usaha preventif terhadap masalah fisik, psikososial, dan seksual pasien kanker ginekologi selama kemoterapi. ...... Chemotherapy is one of the treatment option for gynecological cancer patients. Chemotherapy demonstrates side effects physically, psychosocially and sexually. Health education is one of the methods used to help reduce such side effects in patients undergoing chemotherapy. This study aims to identify the effect of the DORLAN health education on the physical, psychosocial, and sexual problems in gynecological cancer patients undergoing chemotherapy. A quasi-experimental study with consecutive sampling techniques. A sample of 94 women with gynecological cancer who were undergoing chemotherapy were included and consisted of 47 participants in an intervention group and 47 participants in a control group. Data collection was performed using demographic data questionnaires, a FACT-G questionnaire, a Sexual Satisfaction Scale for Women (SSS-W) questionnaire, and a Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. The results showed that there were differences in physical problem (p-value 0.000), psychosocial problem (p-value 0.001), sexual problem (p-value 0.041) before and after delivery of the DORLAN health education to the intervention group. Similarly, there were differences in physical, psychosocial, and sexual problems among gynecological cancer patients during chemotherapy between the intervention group and the control group (p-value: 0.012, 0.029 and 0.001). The DORLAN health education can be given as a preventive measure against physical, psychosocial, and sexual problems of gynecological cancer patients during chemotherapy.

Abstrak :
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. ......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.

Abstrak :
Get the evidence-based, practical guidance you need to provide state-of-the-art care to women with gynecologic cancers. From diagnosis through medical and surgical management, Berek and Hacker's Gynecologic Oncology, 6th Edition delivers invaluable knowledge and expertise on every aspect of gynecologic malignancies. Ideal for gynecologic oncologists and fellows, general gynecologists, and medical and radiation oncologists, this new edition clearly translates basic science to clinical practice, making it your go-to source for everyday reference. Features: concise, comprehensive coverage ensures.

Abstrak :
Radiology illustrated : gynecologic imaging is an up-to-date, image-oriented reference in the style of a teaching file that has been designed specifically to be of value in clinical practice. Individual chapters focus on the various imaging techniques, normal variants and congenital anomalies, and the full range of pathology. Each chapter starts with a concise overview, and abundant examples of the imaging findings are then presented. In this second edition, the range and quality of the illustrations have been enhanced, and image quality is excellent throughout. Many schematic drawings have been added to help readers memorize characteristic imaging findings through pattern recognition. The organization of chapters by disease entity will enable readers quickly to find the information they seek. Besides serving as an outstanding aid to differential diagnosis, this book will provide a user-friendly review tool for certification or recertification in radiology.