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Abstrak :
Spinal merupakan tempat metastasis tumor terbanyak, menyebabkan defisit neurologis akibat kompresi saraf spinal, berpotensi distres sehingga mengakibatkan rendahnya kualitas hidup. Kerentanan terhadap distres dipengaruhi strategi koping. Penelitian potong lintang untuk mengetahui strategi koping dan faktor terkait distres pada pasien tumor metastasis spinal di RSCM. Sebanyak 104 subjek diambil dari rawat jalan maupun rawat inap. Analisis bivariat dan multivariat menilai hubungan antara gambaran masalah, strategi koping, faktor sosiodemografi, serta karakteristik tumor spinal dengan distres. Proporsi distres subjek penelitian ini adalah 57,7% masalah terbanyak spesifik tumor spinal (87,5%), namun hubungannya tidak bermakna terhadap distres. Hubungan bermakna ditemukan pada masalah keluarga dan masalah emosional. Strategi religious-focused coping paling sering digunakan. Subjek yang mengalami distres memiliki median total skor problem-focused coping (PFC) lebih rendah, emotional-focused coping (EFC) dan avoidance coping lebih tinggi dibandingkan dengan yang tidak mengalami distres. Hubungan bermakna juga ditemukan pada faktor usia dan karakteristik tumor spinal berupa gangguan motorik, sensorik, otonom, dan status pengobatan. Gangguan sensorik berisiko lebih tinggi terjadi distres dibandingkan defisit neurologis lain. Analisis multivariat menunjukkan strategi EFC dan avoidance coping sebagai faktor risiko. Perlunya dilakukan skrining dan pendampingan psikiatri pada pasien tumor metastasis spinal, serta peningkatan kerja sama psikiatri dengan layanan tumor terpadu. ......Spinal is the most site of tumor metastases, causing neurological deficits due to spinal nerve compression, potentially causing distress resulting in low quality of life. Vulnerability to distress is influenced by coping strategies. A cross-sectional study to determine coping strategies and factors related to stress in patients with spinal metastatic tumors in RSCM. A total of 104 subjects were taken from outpatient and inpatient. Bivariate and multivariate analyzes assessed the relationship between problem description, coping strategies, sociodemographic factors, and characteristics of spinal tumors with distress. The proportion of the subject's distress in this study was 57.7%, the most problems were spinal tumor-specific (87.5%), but the relationship was not significant to distress. Significant relationships were found in family problems and emotional problems. Religious-focused coping strategies are most often used. Subjects who experienced distress had a lower median total score of problem-focused coping (PFC), emotional-focused coping (EFC) and higher avoidance coping than those who did not experience distress. A significant relationship was also found in the age factor and spinal tumor characteristics in the form of motor, sensory, autonomic disorders, and treatment status. Sensory disturbances are at a higher risk of developing distress than other neurologic deficits. Multivariate analysis showed EFC strategy and avoidance coping as risk factors. The need for screening and psychiatric assistance in spinal metastatic tumor patients, as well as increasing the cooperation of psychiatry with integrated tumor services

Abstrak :
Latar belakang Penyakit trofoblas gestasional (PTG) merupakan keganasan di bidang ginekologi yang sangat sensitif terhadap kemoterapi. Untuk PTG metastasis risiko tinggi, rejimen kemoterapi standar saat ini dari WHO meliputi kombinasi etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO). Kemoterapi EMA-CO telah terbukti memberikan respon terapi yang baik di beberapa negara di dunia, namun kemoterapi EMACO memerlukan biaya yang besar dan fasilitas yang memadai dalam menangani komplikasi efek samping yang mungkin terjadi. Di beberapa senter, termasuk RSUPNCM, dikembangkan kombinasi kemoterapi lain yakni methotrexate dan etoposide (ME) dan methotrexate, actinomycin, cyclophosphamide atau chlorambucil (MAC). Tujuan Mengevaluasi penggunaan kemoterapi ME dan MAC pada tatalaksana PTG metastasis risiko tinggi selama 10 tahun pada periode 2000-2010 di RSUPNCM. Metode Pasien PTG metastasis risko tinggi menurut kriteria Hammond di Rumah Sakit Cipto Mangunkusumo periode Januari 2000 hingga Desember 2010 masuk sebagai subjek penelitian. Kelompok terbagi menjadi kelompok dengan terapi ME dan terapi MAC. Pencatatan angka remisi, resisten, efek samping berupa leukopeni, trombositopeni, dan keluhan gastrointestinal berupa mual dan muntah menjadi keluaran penelitian. Analisis statistik menggunakan uji Fisher. Hasil Terdapat 70 pasien PTG dari tahun 2000-2010 yang masuk ke dalam kriteria inklusi tercatat pada rekam medis RSUPNCM, namun hanya 53 pasien yang menjalani kemoterapi, di mana 43 pasien mendapatkan kemoterapi ME dan 10 pasien mendapatkan kemoterapi MAC. Tidak ada perbedaan bermakna antara angka remisi penggunaan ME dan MAC ( 81.4% vs 90%, p = 1.0). Tidak ada perbedaan bermakna pula dalam kejadian leucopenia (7& vs 10%, p = 1.0), dan kejadian gastrointestinal seperti mual dan muntah (7% vs 10%, p = 1.0). Namun, terdapat perbedaan bermakna antara kejadian trombositopenia, di mana kejadian lebih tinggi pada penggunaan MAC (7% vs 20%, p =0.32). Kesimpulan: Tidak terdapat perbedaan bermakna angka remisi dan efek samping leukopeni dan keluhan mual, muntah pada penggunaan kemoterapi ME dibandingkan MAC pada tatalaksana PTG metastasis risiko tinggi, di mana kejadian trombositopeni lebih tinggi pada penggunaan MAC dibandingkan ME. Kadar beta hCG serum sebelum kemoterapi tidak memberikan perbedaan dalam respon terhadap kemoterapi. Namun, hasil penelitian ini harus dianalisa dengan hati-hati, mengingat jumlah sampel yang sedikit. ......Background Gestational trophoblastic neoplasia (GTN) is a highly chemotherapy sensitive malignancy in gynecology. A combined chemotherapy currently recommended by WHO is the combination of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO). This combined chemotherapy has been shown to give a good outcome in several cancer centres across the world. However, EMACO is costly and required adequate facilities to anticipate the side effects of the chemotherapy. Several oncology centres, including Cipto Mangunkusumo hospital have been trying other chemotherapy combinations, which are methotrexate and etoposide (ME) and methotrexate, actinomycin, cyclophosphamide atau chlorambucil (MAC). Aim To evaluate the outcome of ME and MAC in 10 years treatment of high risk GTN in Cipto Mangunkusumo hospital in a periode of 2000-2010. Methods Metastatic high risk GTN patients according to Hammond criteria in Cipto Mangunkusumo hospital from January 2000 to December 2010 are included in research subjects. The patients were divided into two groups, the patients who received ME and those who received MAC. The remission rate, side effects of leucopenia, thrombocytopenia, and gastrointestinal disorders, such as nausea and vomiting were recorded as the outcome of the treatment. The analytical statistic was using Fisher. Result From the periode of 2000-2010, there were 70 GTN patients in Cipto Mangunkusumo hospital who were included in the inclusion criterias, recorded in the medical records. There was only 53 patients who received chemotherapy, 43 patients received ME, and 10 patients received MAC. There was no difference on the remission rate between ME and MAC ( 81.4% vs 90%, p = 1.0). There was no difference in the incident of leucopenia (7& vs 10%, p = 1.0), and gastrointestinal complaints, such as nausea and vomiting (7% vs 10%, p = 1.0). However, patients treated with ME had lower incidence of thrombocytopenia in comparison to those treated with ME (7% vs 20%, p =0.32). Conclusion: No difference in remission rate and side effects of leucopenia, nausea, and vomiting between ME and MAC group. However, the incidence of thrombocytopenia is higher in MAC group. Serum beta hCG level prior to therapy has not affecting the response towards chemotherapy.

Abstrak :
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. ......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.

Abstrak :
Germ cell tumor (GCT) adalah sebuah penyakit yang relatif jarang. Hanya 1% dari seluruh keganasan pada pria, yang sebagian besar terjadi pada pria berusia 15 sampai 35 tahun. Terdapat penurunan yang luar biasa pada jumlah kematian karena kanker testis dalam 3 tahun terakhir, karena kemajuan dalam kemoterapi. Penelitian ini mengevaluasi hasil dari pemberian kemoterapi bleomycin, etoposide, dan cisplatin (BEP) untuk pasien GCT di Rumah Sakit Pusat Kanker Nasional Dharmais. Penelitian ini meninjau karakteristik dan kesintasan semua pasien yang mendapatkan BEP di Rumah Sakit Pusat Kanker Nasional Dharmais pada tahun 2011 sampai 2017. Tingkat kesintasan dianalisa dengan metode Kaplan-Meier. Dalam seri ini tingkat kesintasan 1, 3, dan 5 tahun masing-masing adalah 93,75% (30), 90,63% (29), dan 81,25% (26), sedangkan tingkat kesintasan bebas rekurensi adalah 81,25% (26), 75% (24), and 62,55% (20). Rekurensi terjadi pada 6 (18,7%) pasien setelah respon komplet kemoterapi. Tingkat kesintasan lima tahun pasien dengan stadium penyakit II dan III adalah 84,6% dan 78,8%, dan tingkat kesintasan lima tahun pasien dengan prognosis baik, sedang, dan buruk berdasarkan klasifikasi IGCCCG adalah 88,9%, 85,7%, dan 66,7%. Pasien dengan GCT metastasis menunjukkan respons yang baik terhadap BEP sebagai kemoterapi lini pertama, dan pasien yang diterapi dengan BEP dapat mencapai hasil prognostik yang baik. Tingkat kesintasan lebih baik ketika pasien datang pada stadium lebih awal dan memiliki prognosis yang lebih baik sesuai dengan klasifikasi IGCCCG. ......Germ cell tumor (GCT) is a relatively rare disease, accounting for only 1% of all malignancies in men, affecting mostly men between 15 to 35 years of age. There has been a remarkable decline in testicular cancer mortality over the past 3 years, due to advances in chemotherapy. This study evaluate the outcome of bleomycin, etoposide, and cisplatin (BEP) chemotherapy for GCT patients in Dharmais National Cancer Hospital. This study reviewed characteristics and survival of all patients receiving BEP in Dharmais National Cancer Hospital between year 2011 to 2017. Survival rates were analyzed by Kaplan-Meier method. In these series, 1, 3, and 5 year survival rates were 93,75% (30), 90,63% (29), and 81,25% (26), respectively, while recurrence-free survival rates were 81,25% (26), 75% (24), and 62,55% (20). Recurrences occur in 6 (18,7%) patients after complete response of chemotherapy. Five-year survival rate patients with stage II and III of disease were 84,6% and 78,8%, and five year survival of patients with good, intermediate, and poor prognosis based on IGCCCG classification is 88,9%, 85,7%, and 66,7%. Patients with metastatic GCTs showing favorable response to BEP as first-line chemotherapy, and patients treated with BEP could achieve good prognostic outcome. Survival rate is better when the patient came with earlier stage and has a better prognosis according to IGCCCG classification.

Abstrak :
Pendahuluan: Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Metode: Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 – 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Hasil: Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 – 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 – 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 – 7,6). Kesimpulan: Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD. ......Introduction: Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates quite morbidity and in the end affect the patient’s quality of life and survival. Methods: This study uses cross sectional design with total sampling at Cipto Mangunkusumo Hospital. MBD diagnosed patient during 2008 – 2018 were evaluated for characteristics, survival rate. Survived patient will evaluated for functional score with SF-36 and MSTS. Results: From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 – 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 – 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 – 7,6). Conclusion: Surgery has a significant association with MBD patient survival.

Abstrak :
ABSTRAK
Pendahuluan : Docetaxel telah menunjukkan efek dalam pengobatan CRPC biladigunakan sebagai monoterapi atau dalam kombinasi dengan kemoterapi lainnya.Banyak penelitian telah menunjukkan korelasi penurunan Prostate Specific Antigen PSA dengan kesintasan pasien CRPC yang mendapatkan terapi Docetaxel.Penelitian-penelitian sebelumnya juga menyatakan adanya korelasi antara volumeprostat, Gleason Score, dan insiden metastasis dengan nilai PSA. Penelitian inibertujuan untuk menganalisis hubungan antara volume prostat, Gleason Score, danada tidaknya metastasis terhadap penurunan PSA sebagai prediktor respon padapasien CRPC yang mendapatkan Docetaxel.Metode : Penelitian analitik retrospektif dengan mengunakan data rekam medisRumah Sakit Umum H. Adam Malik Medan yang dilaksanakan pada periode 1Januari 2016-31 Juli 2016. Populasi dan sampel dalam penelitian ini adalah seluruhpasien dengan penderita CRPC yang telah menjalani kemoterapi Docetaxelsebanyak 10 siklus. Pasien yang memenuhi kriteria inklusi, dipaparkan denganvariabel independen Taksiran Besar Prostat, Skor Gleason, Status Metastase danvariabel dependen perubahan PSA .Hasil : Sebanyak 8 pasien yang memenuhi kriteria inklusi yang berusia rata-rata 65tahun dengan taksiran berat prostat 38,6 gram dengan skor gleason ge; 7 sebanyak 6orang 75 sedangkan

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ABSTRACT
Introduction Docetaxel has shown efficacy in CRPC treatment as monotherapy or combination therapy. Previous research showed a correlation between prostat volume, Gleason score, and metastases with PSA value. This study aimed toanalyze the correlation between prostat volume, gleason score, and metastases withPSA value decrement as a response predictor in CRPC patients who receiveDocetaxel.Methods This is a retrospective analytic research, using data in medical recordsin RSU H. Adam Malik Medan, conducted on January 1 July 31 2016. Populationand samples in this research are patients with CRPC who already received 10 cyclesof Docetaxel chemotherapy. Patients that fulfilled the inclusion criteria areanalyzed with dependent and independent variables estimated prostate volume,Gleason Score, and metastatic status . Results Total of 8 patients who fulfilled inclusion criteria were averagely 65 yearsold, estimated prostate weight of 38.6 gram, and 6 people had Gleason score ge 7 75 and 2 people had Gleason score

Abstrak :
Germ cell tumor (GCT) adalah sebuah penyakit yang relatif jarang. Hanya 1% dari seluruh keganasan pada pria, yang sebagian besar terjadi pada pria berusia 15 sampai 35 tahun. Terdapat penurunan yang luar biasa pada jumlah kematian karena kanker testis dalam 3 tahun terakhir, karena kemajuan dalam kemoterapi. Penelitian ini mengevaluasi hasil dari pemberian kemoterapi bleomycin, etoposide, dan cisplatin (BEP) untuk pasien GCT di Rumah Sakit Pusat Kanker Nasional Dharmais. Penelitian ini meninjau karakteristik dan kesintasan semua pasien yang mendapatkan BEP di Rumah Sakit Pusat Kanker Nasional Dharmais pada tahun 2011 sampai 2017. Tingkat kesintasan dianalisa dengan metode Kaplan-Meier. Dalam seri ini tingkat kesintasan 1, 3, dan 5 tahun masing-masing adalah 93,75% (30), 90,63% (29), dan 81,25% (26), sedangkan tingkat kesintasan bebas rekurensi adalah 81,25% (26), 75% (24), and 62,55% (20). Rekurensi terjadi pada 6 (18,7%) pasien setelah respon komplet kemoterapi. Tingkat kesintasan lima tahun pasien dengan stadium penyakit II dan III adalah 84,6% dan 78,8%, dan tingkat kesintasan lima tahun pasien dengan prognosis baik, sedang, dan buruk berdasarkan klasifikasi IGCCCG adalah 88,9%, 85,7%, dan 66,7%. Pasien dengan GCT metastasis menunjukkan respons yang baik terhadap BEP sebagai kemoterapi lini pertama, dan pasien yang diterapi dengan BEP dapat mencapai hasil prognostik yang baik. Tingkat kesintasan lebih baik ketika pasien datang pada stadium lebih awal dan memiliki prognosis yang lebih baik sesuai dengan klasifikasi IGCCCG. ......Germ cell tumor (GCT) is a relatively rare disease, accounting for only 1% of all malignancies in men, affecting mostly men between 15 to 35 years of age. There has been a remarkable decline in testicular cancer mortality over the past 3 years, due to advances in chemotherapy. This study evaluate the outcome of bleomycin, etoposide, and cisplatin (BEP) chemotherapy for GCT patients in Dharmais National Cancer Hospital. This study reviewed characteristics and survival of all patients receiving BEP in Dharmais National Cancer Hospital between year 2011 to 2017. Survival rates were analyzed by Kaplan-Meier method. In these series, 1, 3, and 5 year survival rates were 93,75% (30), 90,63% (29), and 81,25% (26), respectively, while recurrence-free survival rates were 81,25% (26), 75% (24), and 62,55% (20). Recurrences occur in 6 (18,7%) patients after complete response of chemotherapy. Five-year survival rate patients with stage II and III of disease were 84,6% and 78,8%, and five year survival of patients with good, intermediate, and poor prognosis based on IGCCCG classification is 88,9%, 85,7%, and 66,7%. Patients with metastatic GCTs showing favorable response to BEP as first-line chemotherapy, and patients treated with BEP could achieve good prognostic outcome. Survival rate is better when the patient came with earlier stage and has a better prognosis according to IGCCCG classification.

Abstrak :
Latar belakang: Sebagian besar pasien kanker usia lanjut terdiagnosis pada stadium lanjut dengan peningkatan risiko mortalitas. Identifikasi faktor prediktor yang memengaruhi terjadinya mortalitas satu tahun diharapkan dapat membantu stratifikasi risiko dan menjadi pertimbangan perencanaan pelayanan kesehatan, edukasi, serta persiapan advanced care planning. Tujuan: Mengetahui faktor prediktor mortalitas satu tahun pada lansia dengan kanker padat metastasis dan mengembangkan model prediksi mortalitas satu tahun. Metode: Studi kohort retrospektif dengan menelusuri rekam medis pasien berusia ≥60 tahun dengan kanker padat metastasis berdasarkan pemeriksaan histopatologi atau radiologi yang berobat di poli onkologi RS Kanker Dharmais pada Januari 2020 hingga Desember 2021. Dilakukan analisis bivariat chi-square antara usia, jenis kelamin, ADL, ECOG-PS, jenis kanker, metastasis organ, jumlah metastasis, status nutrisi, komorbid, jumlah komorbid, polifarmasi, gangguan kognitif, gangguan mood, dan best supportive care dengan mortalitas satu tahun sesudah diagnosis kanker metastasis. Analisis multivariat dan model prediksi dilakukan dengan regresi logistik. Hasil: Terdapat 210 subjek dengan hasil analisis bivariat menunjukkan hubungan antara ECOG-PS, status nutrisi, dan pemberian best supportive care dengan mortalitas satu tahun (p<0,05). Hasil regresi logistik menunjukkan faktor prediktor independen mortalitas yaitu metastasis organ (OR 2,468 [IK 95%1,163-5,317]), status nutrisi (OR 1,943 [IK 95%1,048-3,604]), ECOG-PS (OR 2,302 [IK 95%1,241-4,271]), dan best supportive care (OR 3,157 [IK 95%1,288-7,738]). Model prediksi mortalitas satu tahun memiliki nilai AUC 0,705 (IK 95%95%: 0,629 – 0,781). Kesimpulan:Faktor prediktor independen terhadap mortalitas 1 tahun sesudah diagnosis metastasis yaitu metastasis organ, ECOG-PS, status nutrisi, dan best supportive care. ......Background: Identification of patients on their final year is important to help physicians to make personalized treatment plan according to life expectancy and to guide patients and families to prepare an advanced care planning. Methods: We retrospectively included patients aged ≥60 years who had metastatic solid cancer and in whom geriatric assessment was performed in Dharmais National Cancer Center outpatient clinic. A total of 210 subjects were enrolled between January 2020 to December 2021. The primary analyses were performed from April to May 2023. Chi square analysis was performed between age, sex, ADL, ECOG-PS, type of cancer, visceral metastasis, number of metastatic sites, nutritional status, comorbidity, multimorbidity, polypharmacy, cognitive impairment, mood disorder, and best supportive care with one-year mortality. Variables with p value <0.25 were analysed further with logistic regression to develop a prediction model. The model’s discriminative ability was assessed with model’s area under the curve. Calibration was performed using bootstrap method. Result: We collected 210 subjects, with median age, 66,5 years. Lung cancer was the most common malignancy (44.3%). Logistic regression results showed visceral metastasis (OR 2.468; 95% CI 1.163-5.317), nutritional status (OR 1.943; 95% CI 1.048-3.604), ECOG-PS (OR 2.302; 95% CI 1.241-4.271), and best supportive care (OR 3.157; 95% CI 1.288-7.738) were independent predictors of one year mortality. The one-year mortality prediction model has an AUC value of 0.705 (95% CI: 0.629-0.781). Conclusion: Model developed from this study can assist clinicians to identify patients in their last year of life who need palliative care and to prepare an advance care planning.

Abstrak :
ABSTRACT
Lung cancer is a devastating disease with a high incidence, mortality and morbidity rate, especially in developing countries. Conventional treatment with cytotoxic chemotherapy has some limitations attributed to chemoresistance and toxicity. Recent advances have shown that first generation Tyrosine Kinase Inhibitor (TKI), Gefitinib and Erlotinib, and the newest available second generation Tyrosine Kinase Inhibitor (TKI), Afatinib, have the potential to be an option in the management of patients with epidermal growth factor receptor/ EGFR mutation positive advanced/ metastatic non-small cell lung cancer. Afatinib works by binding to EGFR irreversibly, thus inactivating the tyrosine kinase receptor. Some studies demostrated that Afatinib first-line may result in longer progression free survival (PFS) and better disease control, and as an alternative for patients who intolerance to Gefitinib or Erlotinib. In Indonesia, the era of National Health Insurance has been implemented and National Health Insurance has covered treatment for cancer, including first generation TKIs, Gefitinib dan erlotinib, for patients with EGFR mutation positive advanced/ metastatic non-small cell lung cancer at Cipto Mangunkusumo National Hospital. Afatinib, as one of the newest available second generation TKI, may be given free of charge too as an alternative if the National Health Insurance will be covered in the future. Further research is needed to know the efficacy and adverse effects that may occur in patients from developing countries.

Abstrak :
Tujuan: untuk menganalisis penanda biologi CXCR4, IL11-RA, TFF1 dan MLF1P, klinikopatologi dan profil ekspresi genetik mRNA sebagai penanda peningkatan kejadian metastasis tulang pada pasien kanker payudara stadium lanjut. Metode: studi ini merupakan penelitian potong lintang. Analisis dilakukan pada total 92 pasien kanker payudara, terdiri atas 46 pasien metastasis tulang dan 46 pasien dengan metastasis nontulang. Analisis imunohistokimia dan microarray, dilakukan pada 81 sampel formalin fixed paraffin embedded (FFPE) dari 81 pasien yang didapat. Data dikumpulkan melalui rekam medis, pemeriksaan imunohistokimia (IHK), dan microarray dengan nanoString nCounterTM. Hasil: artikel ini merupakan bagian satu dari dua tahap pelaporan hasil penelitian. Pada tahap satu diperoleh hasil analisis IHK, IL11-RA dengan cut-off ≥103,5 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 3,803 (95 % interval kepercayaan [IK], 1,375-10,581), p=0,010, dan MLF1P dengan cut-off ≥83,0 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 2,784 (95% IK, 1,009-7,681), p=0,048. Status ER+ menunjukkan peningkatan kejadian metastasis tulang, dengan OR 7,640 (95 % IK, 2,599-22,459), p<0,000. AUC gabungan IL-11RA, MLF1P dan ER+, mempunyai ketepatan hampir 80% (meningkat dibandingkan AUC masing-masing secara terpisah), untuk membedakan dan menjelaskan kejadian metastasis tulang, pada kanker payudara stadium lanjut. Kesimpulan: IL11-RA, MLF1P dan ER+, merupakan determinan peningkatan kejadian metastasis tulang pasien kanker payudara stadium lanjut.

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Aim: to analyze expression of biomarkers CXCR4, IL11-RA, TFF1 and MLF1P, and clinico pathology in advanced breast cancer patients with bone metastatic. Methods: this is a cross-sectional study. Analysis was done against a total of 92 breast cancer patients, including 46 bone metastatic patients and 46 non-bone metastatic patients. Immunohistochemistry and microarray analysis was performed in 81 formalin fixed paraffin embedded (FFPE) samples from 81 patients were used. Data were collected through medical records, immunohistochemistry (IHC), and microarray with nanoString nCounterTM. Results: this article is part one of a two stage reporting research results. In part one we got the results of the IHC analysis, IL11-RA with cut-off ≥103.5 showed OR 3.803 (95 % confidence interval [CI], 1.375-10.581), p=0.010, MLF1P with cut-off ≥83.0 OR 2.784 (95% CI, 1.009-7.681), p=0.048, and ER+ OR 7.640 (95 % CI, 2.599-22.459), p<0.000, were associated with bone metastastic incidences in advanced breast cancer, and were statistically significantly different. A combination of IL-11RA, MLF1P and ER+, showed an accuracy of approaching 80% to discriminate between bone metastatic and non bone metastatic in advanced breast cancer patients. Conclusion: IL11-RA, MLF1P, and ER+ were the determinants that were associated with increasing bone metastasis incidence.