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Abstrak :
Pendahuluan: Tesis ini bertujuan untuk mengetahui efek myelosupresi pada pasien kanker ovarium dengan kemoterapi ajuvan carboplatin dan paclitaxel di RSUPN dr. Cipto Mangunkusumo melalui analisis kadar hemoglobin, leukosit, dan trombosit. Kemoterapi ajuvan kombinasi carboplatin dan paclitaxel merupakan rejimen kemoterapi yang paling efektif pada kanker ovarium. Namun pemberian kemoterapi tersebut memiliki efek samping myelosupresi seperti anemia, neutropenia, dan trombositopenia yang berdampak besar terhadap kualitas hidup pasien. Metode: Penelitian ini adalah penelitian hystorical cohort yang dilaksanakan di RSUPN Dr. Cipto Mangunkusumo dengan mengambil sampel penelitian pasien kanker ovarium yang mendapatkan kemoterapi ajuvan dengan carboplatin dan paclitaxel sebanyak enam seri mulai dari Januari 2010 sampai dengan Desember 2014. Hasil: Dari 41 subjek penelitian yang memenuhi kriteria inklusi didapatkan usia pasien berkisar antara 25 sampai dengan 64 tahun (median: 49 tahun), terbanyak adalah multipara (43,9%), premenopause (61,0%), dengan stadium terbanyak adalah stadium IIIC (58,5%), histopatologi terbanyak adalah kistadenokarsinoma serosum (39,0%), dan sebagian besar berdiferensiasi sedang (48,8%). Kesimpulan: Sebagai kesimpulan didapatkan penurunan kadar hemoglobin, leukosit, dan trombosit yang bermakna pasca kemoterapi setiap seri (p < 0,001). ;Background: The objective of this study was to obtain the myelosupression effect on ovarian cancer patient with carboplatin and paclitaxel adjuvant chemotherapy based on haemoglobin, leucocyte, and thrombocyte level. Carboplatin and paclitaxel combination as an adjuvant chemotherapy is the most effective regiment for ovarian cancer. Otherwise this regiment has myelosuppression effect (hematologic toxicity) as anemia, neutropenia, and thrombocytopenia which have impact on quality of life of the patients. Methods: This is an hystorycal cohort study on ovarian caner patients who underwent six series of adjuvant chemotherapy from January 2010 until December 2014 at RSUPN Dr. Cipto Mangunkusumo. Results: From 41 patients range at 25 until 64 years old (median: 49 years), most of them are multiparity (43,9%), premenopausal women (61,0%), with the largest stadium was IIIC (58,5%), the largest pathologic type was serous cystadenocarcinoma (39,0%) and most of them are intermediate differentiation (48,8%). Conclusions: As a conclusion there was a significantly decreased of haemoglobin, leucocyte, and thrombocyte levels after adjuvant chemotherapy on every single cycle (p<0,001). ;Background: The objective of this study was to obtain the myelosupression effect on ovarian cancer patient with carboplatin and paclitaxel adjuvant chemotherapy based on haemoglobin, leucocyte, and thrombocyte level. Carboplatin and paclitaxel combination as an adjuvant chemotherapy is the most effective regiment for ovarian cancer. Otherwise this regiment has myelosuppression effect (hematologic toxicity) as anemia, neutropenia, and thrombocytopenia which have impact on quality of life of the patients. Methods: This is an hystorycal cohort study on ovarian caner patients who underwent six series of adjuvant chemotherapy from January 2010 until December 2014 at RSUPN Dr. Cipto Mangunkusumo. Results: From 41 patients range at 25 until 64 years old (median: 49 years), most of them are multiparity (43,9%), premenopausal women (61,0%), with the largest stadium was IIIC (58,5%), the largest pathologic type was serous cystadenocarcinoma (39,0%) and most of them are intermediate differentiation (48,8%). Conclusions: As a conclusion there was a significantly decreased of haemoglobin, leucocyte, and thrombocyte levels after adjuvant chemotherapy on every single cycle (p<0,001).

Abstrak :
Latar Belakang: Disebutkan pada beberapa literatur bahwa faktor prognostik menentukan laju kejadian rekurensi pada pasien pasca operasi kanker serviks. Faktor- faktor prognostik tersebut diantaranya adalah invasi ruang pembuluh limfa, tipe sel kanker, ukuran tumor primer, kedalaman invasi stroma, bebas/tidak bebasnya tepi vagina hasil reseksi, keterlibatan parametrium, dan status limfonodi. Sampai saat ini belum ada data yang dapat menggambarkan faktor-faktor prognostik pada kanker serviks serta kaitannya dengan kejadian rekurensi di Indonesia.  Metode: Penelitian ini memiliki desain deskriptif dan analitik yang menampilkan sebaran faktor-faktor prognostik pada pasien kanker serviks pasca operasi beserta tingkat rekurensinya. Peneliti menggunakan data rekam medik sebagai sumber data.  Hasil: Hasil dari studi deskriptif adalah sebagai berikut: invasi ruang pembuluh limfa (81,4%), tipe sel kanker tipe skuamosa (62,2%), ukuran tumor primer <4cm (66%), invasi stroma >10mm (59,2%), invasi limfonodi positif (57,3%), hasil reseksi vagina tidak bebas sel kanker (79.7%), dan pasien rekurens (9%). Adapun hasil studi analitik yang mempertemukan antara faktor-faktor prognostik kanker serviks menghasilkan bahwa ukuran tumor primer berhubungan secara signifikan terhadap kejadian rekurensi (nilai p 0.05).  Kesimpulan: Berdasarkan analisis deskriptif, didapatkan bahwa terdapat dominasi pada beberapa sub-komponen pada faktor prognostik seperti yang telah tertera pada bagian Hasil. Pada studi analitik, didapatkan bahwa terdapat hubungan yang bermakna secara statistik antara ukuran tumor primer dengan kejadian rekurensi (nilai p 0.05). ......Background: Multiple prognostic factors affect the recurrence rate in post-operative cervical cancer patients. These factors are lymphovascular space invasion (LVSI), types of cancer cells, primary tumor size, the depth of the stromal invasion, cleanliness of vaginal resection, parametrial involvement, and lymph nodular status. Despite the importance of prognostic factors, there are no data available in the Indonesian population yet. Hence, the writer proposed a study depicting the prognostic factors of cervical cancer.  Method: This research is aimed to acquire a descriptive picture of the prognostic factors in cervical cancer patients, particularly from the Indonesian population data. Moreover, a sub-analytical study of comparative-analytical hypothetical test was added to examine the statistical relation between the prognostic factors and recurrence in post-operative cervical cancer patients. The data is taken from the medical record from Cipto Mangunkusumo Hospital, Jakarta.  Results: The descriptive result of the prognostic factors shows LVSI (81.4%), Squamous Cell Carcinoma type of cervical cancer (62.2%), primary tumor size <4cm (66%), stromal invasion with depth >10mm (59.2%), positive lymph node invasion (57.3%), non-clear vaginal resection (79.7%), and recurrent patients (9%). The analytical study shows a statistical significance between the size of the primary tumor and the recurrence in post-operative cervical cancer patients (p-value 0.05).  Conclusion: From the descriptive study, there are several dominances seen in the prognostic factors of the cervical cancer patient. Also, the analytical study shows a significant statistical relationship between primary tumor size and recurrence.

Abstrak :
Latar belakang: Krioterapi adalah salah modalitas terapi yang sering dilakukan pada lesi IVA positif di Indonesia. Selain memiliki angka kesembuhan yang cukup tinggi, krioterapi tergolong murah dan mudah dilakukan dengan sumber daya yang terbatas. Namun, efek samping pasca krioterapi seperti keputihan, perdarahan bercak, dan nyeri adalah hal yang tidak bisa dihindari. Beberapa penelitian mengaitkan adanya hubungan derajat dan luas lesi prakanker dengan angka kesembuhan pasca krioterapi. Jenis krioterapi (single-freeze atau double-freeze) juga dihubungkan dengan luas area nekrosis pasca krioterapi. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan luas lesi IVA positif dan jenis krioterapi terhadap efek samping pasca krioterapi Metode: Penelitian ini merupakan studi kohort prosepektif. Populasi terjangkau adalah pasien dengan IVA positif yang menjalani krioterapi oleh Female Cancer Program dari Juli sampai dengan Oktober 2019 di Jakarta. Evaluasi dilakukan dengan pengisian lembar keluhan efek samping krioterapi selama satu bulan. Analisis data dalam bentuk deskriptif dan analitik. Hasil: Didapatkan 43 subjek IVA positif, 27 (62,8%) subjek lesi luas, dan 16 (37,2%) subjek lesi sempit, jenis krioterapi dibagi menjadi 33 (76,7%) subjek double-freeze, 10 (23,3%) subjek single-freeze, setelah sebulan didapatkan keluhan keputihan sebanyak 88,4%; perdarahan bercak 51,2%, nyeri 58,1%; tidak didapatkan hubungan bermakna antara luas lesi IVA positif dengan keputihan (nilai-p 0,63), perdarahan bercak (nilai-p 0,61), dan nyeri (nilai-p 0,54), krioterapi double-freeze berhubungan bermakna dengan efek samping perdarahan bercak (RR 0,5; nilai-p 0,0032; CI 0,3-0,9). Kesimpulan: krioterapi double-freeze berhubungan bermakna dengan efek samping perdarahan bercak pasca krioterap. ......Background: Cryotherapy is a procedure often performed in positive VIA lesions in Indonesia. Not only having a high cure rate, but cryotherapy is also relatively cheap and easy to perform with limited resources. However, side effects such as vaginal discharge, spotting, and pain are unavoidable. Several studies have linked the degree and width of precancerous lesions with cure rate after cryotherapy. Type of cryotherapy (single-freeze or double-freeze) is also related with amount of necrosis area produced after cryotherapy. Objective: To determine the association of positive VIA area and the type of cryotherapy with post-cryotherapy side effects. Method: This is a prospective cohort study. The population are women with positive VIA result who underwent cryotherapy by the Female Cancer Program from July to October 2019 in Jakarta. Evaluation was performed by filling out the patients complaint sheet for one month. Data was analysed descriptively and analytically. Results: There were 43 women with positive VIA results, grouped into 27 (62.8%) large lesion, and 16 (37.2%) small lesion, types of cryotherapy was grouped into 33 (76.7%) double-freeze, 10 (23,3%) single-freeze, after one month follow-up there were complaints of vaginal discharge 88.4%; spotting 51.2%, pain 58.1%; found unsignificantly association between width of positive VIA area with vaginal discharge (p-value 0.63), spotting (p-value 0.61), and pain (p-value 0.54), double-freeze cryotherapy was significantly associated with side effect of spotting (RR 0.5; p-value 0.0032; CI 0.3-0.9). Conclusion: double-freeze cryotherapy is significantly related with side effect of spotting.

Abstrak :
ABSTRAK Latar Belakang: Sekitar 9-33% pasien penyakit trofoblas maligna (PTM) yang diobati dengan kemoterapi agen tunggal akan membutuhkan terapi multi agen karena adanya resistensi terhadap obat lini pertama, termasuk metotreksat (MTX), atau efek samping toksisitas. Hingga saat ini, resistensi terapi lini pertama masih menjadi masalah akibat tingkat identifikasi yang masih rendah. Sebelumnya, belum pernah dilakukan penelitian mengenai kadar Beta-HCG sebagai prediktor resistensi pada pasien PTM risiko rendah. Tujuan: Mengetahui nilai prediktif kadar Beta-HCG untuk risiko resistensi metotreksat pada PTM risiko rendah. Metode: Penelitian ini adalah studi analitik potong lintang menggunakan data rekam medis dari 58 subjek. Subjek adalah semua pasien yang terdiagnosis dengan PTM risiko rendah dan diberikan terapi MTX pada bulan Januari 2011 hingga Desember 2016 di RSUPN Dr. Cipto Mangunkusumo. Pengambilan subjek dilakukan secara konsekutif. Subjek dengan data yang tidak lengkap atau adanya riwayat PTM sebelumnya dieksklusi dari penelitian ini. Hasil: Prevalensi resistensi MTX yaitu 32,8%. Tidak ditemukan asosiasi bermakna antara karakteristik demografik (usia, paritas, pekerjaan, dan pendidikan) ataupun karakteristik klinis (riwayat kehamilan, interval antara kehamilan terakhir dan awal kemoterapi, ukuran tumor, riwayat gagal kemoterapi, lokasi dan jumlah metastasis) dengan resistensi MTX. Ditemukan perbedaan bermakna pada kadar Beta-HCG antara kelompok resistensi dan tidak resistensi pada siklus 4 (p<0,001), 6 (p<0,001), dan 8 (p<0,001). Perbedaan bermakna juga ditemukan pada perubahan kadar Beta-HCG dari awal hingga minggu kedua (p<0,001, AUC 0,8). Cut-off penurunan Beta-HCG sebesar 23% memiliki sensitivitas sebesar 78,9% dan spesifisitas sebesar 74,4% untuk memprediksi resistensi MTX.

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ABSTRACT Background: Approximately 9-33% patients with gestational trophoblastic neoplasia (GTN) treated with single agent chemotherapy would need multi agent chemotherapy, whtether due to resistance to first-line therapy, including methotrexate (MTX), or toxic side effect. Currently, resistance to first-line therapy is still a problem due to low identification rate. To this date, there are no studies regarding Beta-HCG level as a MTX resistance predictor for low risk GTN. Purpose: Identify the predictive value of Beta-HCG level for the risk of MTX resistance in low risk GTN. Methods: This was an analytical cross-sectional study using medical records of 58 subjects. Subjects were all patients diagnosed with low risk GTN and given MTX therapy during the period of January 2011 to December 2016 at Cipto Mangunkusumo Hospital. Consecutive sampling was done. Subjects with incomplete data or history of previous GTN were excluded from this study. Results: The prevalence of MTX resistance was 32,8%. No significant association was found between demographic characteristics (age, parity, job, and education) or clinical characteristics (gestational history, interval between last pregnancy and the start of chemotherapy, tumor size, history of chemotherapy failure, location and number of metastasis) and MTX resistance. A significant difference in the level of Beta-HCG between resistance and non-resistance groups were found on cycle 4 (p<0,001), 6 (p<0,001), and 8 (p<0,001). A significant difference was also found in the change of Beta-HCG from the start to the second week of therapy (p<0,001, AUC 0,8). Beta-HCG decrease cut-off of 23% had the sensitivity of 78,9% and specificity of 74,4% to predict MTX resistance. Conclusions: The prevalence of MTX resistance was 32,8% in this study. The decrease in Beta-hCG level from the start to the second week of therapy could be used as a MTX resistance predictor in low risk GTN patients.

Abstrak :
[ABSTRAK
Penelitian ini bertujuan untuk mengetahui gambaran umum kanker ovarium di Rumah Sakit Ciptomangunkusumo (RSCM) 5 tahun terakhir beserta faktor-faktor yang berhubungan dengan kanker ovarium. Penelitan ini mengambil data pasien kanker ovarium selain tipe borderline yang terdapat di Cancer Registry divisi Ginekologi Onkologi dan masih memiliki rekam medis di RSCM pada periode Januari 2010 – Desember 2014, dilakukan follow up untuk mengetahui kesintasan hidup selama 4 tahun. Kami mendapatkan 98 subyek penelitian. Pada penelitian ini didapatkan insidensi kanker ovarium terbanyak pada usia 45-54 tahun (33,6%), insidensi kanker ovarium menurun dengan bertambahnya jumlah anak, sebagian besar kanker ovarium merupakan tipe epitelial (76,5%) dan sebagian besar pasien didiagnosa pada stadium lanjut (55.1%). Kesintasan hidup 4 pasien kanker ovarium tipe epitelial 77%; tipe germinal 83.3%; tipe stroma 100%. Kesintasan hidup 4 tahun dengan terapi pembedahan 84.1%; pembedahan disertai kemoterapi adjuvan 83.3%; kemoterapi neoadjuvan sebelum pembedahan 68.4%. Terdapat 63% respon komplit pada kelompok kemoterapi adjuvan; dan 41.2% pada kelompok kemoterapi neoadjuvan.

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ABSTRACT
The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.;The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.;The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy., The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.]

Abstrak :
Latar Belakang: Kanker serviks masih menjadi kanker tersering kedua di Indonesia dengan insiden 2638 kasus pada tahun 2008. Sejak tahun 1999, National Cancer Institute merekomendasikan penatalaksanaan kanker serviks dengan menggunakan kemoradiasi. Namun selama ini tatalaksana kanker serviks lebih banyak mengacu untuk klasifikasi histopatologi karsinoma sel skuamosa, sementara angka kanker serviks dengan tipe sel adenokarsinoma meningkat dan menurut beberapa penelitian memiliki prognosis yang lebih buruk. Tujuan: Penelitian ini memiliki tujuan mengetahui perbandingan keberhasilan terapi dengan kemoradiasi dibandingkan dengan radiasi saja serta untuk mengetahui adanya perbedaan respon terapi pada kanker serviks dengan klasifikasi histopatologi karsinoma sel skuamosa dan adenokarsinoma. Metode: yang digunakan adalah secara cross sectional dimana sampel diambil dari pasien kanker serviks IIB ndash; IIIB pada tahun 2011 ndash; 2013 di RSCM yang menjalani terapi radiasi atau kemoradiasi. Hasil: Dari 163 sampel yang dipelajari, sebanyak 107 pasien adalah pasien dengan karsinoma sel skuamosa dan 56 pasien dengan adenokarsinoma. Menurut klasifikasi histopatologi, karsinoma sel skuamosa didapatkan memiliki angka respon lengkap yang tidak berbeda secara signifikan, yaitu 82,2 dibandingkan dengan adenokarsinoma 78,6 p = 0,721 Sebanyak 67,5 pasien mendapatkan terapi radiasi dan 32,5 mendapatkan terapi kemoradiasi dengan agen kemoterapi berbasis platinum, terapi dengan kemoradiasi didapatkan memiliki respon terapi yang lebih baik yaitu dengan angka respon lengkap sebanyak 98,1 dibandingkan dengan radiasi 72,7 p = 0,001 . Pada kelompok pasien yang dilakukan radiasi, pasien dengan karsinoma sel skuamosa tidak memiliki respon yang berbeda dengan kemoradiasi, yaitu respon komplit 76,9 dibandingkan dengan 62,5 p= 0,191 . Begitu juga dengan kelompok kemoradiasi, tidak ada perbedaan respon terapi antara pasien karsinoma sel skuamosa 96,6 dengan adenokarsinoma 100. Kesimpulan: Dari penelitian ini didapatkan tidak ada perbedaan respon terapi pada tipe sel karsinoma sel skuamosa dan adenokarsinoma. Pada masing-masing kelompok radiasi dan kemoradiasi, karsinoma sel skuamosa dan adenokarsinoma tidak terdapat perbedaan. Pasien yang diterapi dengan kemoradiasi memiliki respon terapi yang lebih baik dibandingkan radiasi saja. ...... Background: Cervical cancer is the second most frequent cancer in Indonesia with incident of 2638 cases in 2008. Since 1999, National Cancer Institute in the United States recommend to give concurrent chemoradiation for advanced stage cervical cancer. Until now the therapy recommention mostly addressed for squamous cell carcinoma, meanwhile the incidence of adenocarcinoma arise with also worse prognosis. Objective: To know the correlation between histopathological type squamous cell carcinoma and adenocarcinoma with the teurapeutic response and to compare the response of treatment using radiation only and chemoradiation. Method: This study was using cross sectional method, sampel was taken by secondary data using medical report of patient with cervical cancer staged IIB IIIB year 2011 ndash 2013 at RSCM who underwent radiation and chemoradiation. Result: From 163 subjects, 107 was patient with squamous cell carcinoma and 56 patients with adenocarcinoma. According to histopathological type, squamous cell carcinoma and adenocarcinoma had insignificant difference in theurapetical response, which is 82,2, compared to 78,6 p 0,721. There were 67,5 patients got radiation only and 32,5 got concurrent chemoradiation therapy using platinum based agent. Among patient who were treated with chemoradiation, 98,1 patients achieved complete respons and for patient with radiation only 72,7 achieved complete respons 72,7 p 0,001. Patients who were treated with radiation only, when compared to its pathological type, the complete respons were not different 76,9 in squamous cell carcinoma, compared to 62,5 in adenocarcinoma p 0,191. And so as patient with chemoradiation, there were no difference in theurapetical respons in squamous cell carcinoma 96,6 compared with 100 in adenocarcinoma. Conclusion: There was no difference in theurapetical respons in patient with squamous cell carcinoma compared to adenocarcinoma. Chemoradiation appeared to have better theurapetic respon compared to radiation only therapy. In each theurapetic modality group the respon therapy for squamous cell carcinoma and adenocarcinoma had no difference in theurapetical response.

Abstrak :
Krioterapi adalah terapi yang rutin dilakukan pada lesi IVA positif di Indonesia. Selain terbukti efektif, krioterapi tergolong murah dan mudah dilakukan. Namun, efek samping pasca krioterapi seperti keputihan, perdarahan bercak, dan nyeri tidak bisa dihindari. Beberapa penelitian mengaitkan adanya hubungan luas lesi prakanker dengan angka kesembuhan. Jenis krioterapi (single-freeze atau double-freeze) juga dihubungkan dengan luas area nekrosis yang terbentuk. Tujuan penelitian ini untuk mengetahui hubungan luas lesi IVA positif dan jenis krioterapi terhadap efek samping krioterapi. Penelitian ini menggunakan studi kohort prosepektif observasional. Populasi terjangkau adalah pasien dengan IVA positif yang menjalani krioterapi oleh Female Cancer Program dari Juli hingga Oktober 2019 di Jakarta. Evaluasi dilakukan dengan pengisian lembar keluhan efek samping krioterapi. Didapatkan 43 subjek IVA positif, 27 (62,8%) subjek lesi luas, dan 16 (37,2%) subjek lesi sempit, jenis krioterapi dibagi menjadi 33 (76,7%) subjek double-freeze, 10 (23,3%) subjek single-freeze, setelah sebulan didapatkan keluhan keputihan sebanyak 88,4%; perdarahan bercak 51,2%, nyeri 58,1%; tidak didapatkan hubungan bermakna antara luas lesi IVA positif dengan keputihan (nilai-p 0,63), perdarahan bercak (nilai-p 0,61), dan nyeri (nilai-p 0,54), krioterapi double-freeze berhubungan bermakna dengan perdarahan bercak (RR 0,5; nilai-p 0,0032; CI 0,3-0,9). ......Cryotherapy is often performed to positive VIA lesions in Indonesia. Not only effective, it is also cheap and easy to perform. However, side effects such as vaginal discharge, spotting, and pain are unavoidable. Several studies have linked the width of lesions with cure rate. Type of cryotherapy (single-freeze or double-freeze) is also related with amount of necrosis area produced. This study was performed to determine the association of positive VIA area and type of cryotherapy with the side effects. This is a observational prospective cohort study. The population are women with positive VIA who underwent cryotherapy by the Female Cancer Program from July to October 2019 in Jakarta. Evaluation was performed by filling out the patients complaint sheet for one month. There were 43 women with positive VIA results, grouped into 27 (62.8%) large lesion, and 16 (37.2%) small lesion, cryotherapy was performed 33 (76.7%) double-freeze, 10 (23,3%) single-freeze, after one month follow-up there were complaints of vaginal discharge 88.4%; spotting 51.2%, pain 58.1%; found no association between width of positive VIA with vaginal discharge (p-value 0.63), spotting (p-value 0.61), and pain (p-value 0.54), double-freeze cryotherapy was significantly associated with side effect of spotting (RR 0.5; p-value 0.0032; CI 0.3-0.9).

Abstrak :
Latar belakang: Kanker serviks merupakan keganasan genitalia perempuan yang paling sering ditemui. Tata laksana sesuai stadium telah distandarisasi. Kendati demikian, rekurensinya mencapai 18 – 44,3%. Kanker serviks rekuren memiliki kesintasan yanglebih buruk, sehingga deteksi faktor prognosis rekurensi dapat menjadi langkah awal upaya pencegah rekurensi. Sampai saat ini belum ada studi mengenai angka rekurensi dan faktor prognosis yang mempengaruhi rekurensi kanker serviks di Indonesia. Tujuan: Mengetahui angka rekurensi kanker serviks stadium IA2 – IIA2 serta faktor-faktor prognosis yang memengaruhinya. Metode: Penelitian ini merupakan penelitian kohort retrospektif. Sejumlah 382 pasien kanker serviks stadium IA2 – IIA2 yang terdiagnosis tahun 2009 – 2018, yang dioperasi histerektomi radikal, limfadenektomi pelvis dengan konfirmasi diagnosis melalui pemeriksaan histopatologi di RSCM telah dikumpulkan. Analisis dilakukan dengan melihat hubungan antara 7 faktor prognosis yaitu, status limfonodi, ukuran tumor primer, kedalaman invasi stroma, invasi ruang limfovaskular, keterlibatan parametrium, tipe histologi sel kanker, dan status batas sayatan vagina dengan rekurensi. Hasil: Rerata usia pasien kanker serviks stadium IA2 – IIA2 di RSCM adalah 52 tahun dengan 90,8% berusia di atas 40 tahun. Rekurensi terjadi pada 12% kasus. Faktor prognosis yang mempengaruhi rekurensi adalah ukuran tumor ≥4 cm; RR 2,242 (95%CI 1,161 – 4,332) dan invasi ruang limfovaskular; RR 2,037 (95%CI 1,039 – 3,994). Status limfonodi, kedalam invasi stroma, keterlibatan parametrium, tipe histologi sel kanker, dan status batas sayatan vagina tidak berhubungan dengan rekurensi (p>0,05) Kesimpulan: Rekurensi terjadi pada 12% kasus kanker serviks stadium IA2 – IIA2 di RSCM. Faktor – faktor prognosis yang mempengaruhi rekurensi tersebut secara signifikan adalah ukuran tumor primer ≥ 4cm dan invasi ruang limfovaskular ......Background: Cervical cancer is the most common female reproductive organ malignancy. Despite the prompt diagnosis and proper management based on the disease’s stage, the recurrent rate remains high, ranging from 18 – 44,3%. Prognostic factors detection may be the first step in reducing recurrent disease. To our knowledge, there are no studies that report the recurrence rate of cervical cancer and the prognostic factors in Indonesia yet. Objective: This study aims to report the recurrent rate of cervical cancer stage IA2 – IIA2 and the prognostic factors. Methods: This is a retrospective cohort study. Histopathology results from 382 cervical cancer stage IA2 – IIA2 patients who underwent radical hysterectomy and pelvic lymphadenectomy were reviewed. Analysis was performed to compare recurrent disease based on 7 prognostic factors: lymph node status, tumor size, depth of stromal invasion, lymphovascular space invasion (LVSI), parametrial involvement, histology type, and vaginal resection margin status. Results: Most cervical cancer patients with stage IA2 – IIA2 was more than 40 years, with mean age was 52 years. The recurrent rate was 12%. Prognostic factors that were significantly associated with recurrence were tumor size ≥4 cm; RR 2,242 (95%CI 1,161 – 4,332) and LVSI; RR RR 2,037 (95%CI 1,039 – 3,994). Conclusions: The recurrence rate of cervical cancer stage IA2 – IIA2 in RSCM was 12%. Prognostic factors that were significantly associated with recurrence were tumor size ≥4 cm and LVSI.

Abstrak :
Infeksi HPV merupakan penyebab penyakit menular seksual terbanyak. Meskipun HPV sering dikaitkan dengan perempuan dan kanker serviks, data menunjukkan insiden yang tinggi pada kalangan pria dan perempuan. Tetapi, kesadaran mengenai infeksi dan vaksinasi HPV masih rendah pada kalangan pria. Mahasiswa kedokteran sejak tahap preklinik memiliki peran dalam manajemen HPV masa mendatang. Studi ini bertujuan untuk mengeksplorasi hubungan pengetahuan dengan perilaku mahasiswa preklinik laki-laki terkait infeksi dan vaksinasi HPV. Studi potong lintang ini meneliti mahasiswa preklinik laki-laki di Fakultas Kedokteran Universitas Indonesia. Subjek diberikan kuesioner daring tentang pengetahuan dan perilaku terhadap infeksi dan vaksinasi HPV. Kemudian, dilakukan uji statistik chi-square untuk mengetahui hubungan pengetahuan dengan perilaku mahasiswa laki-laki preklinik FKUI terhadap infeksi dan vaksinasi HPV. Terdapat 120 mahasiswa FKUI tingkat 1, 2, dan 3 yang terlibat dalam studi ini. Sebanyak 90,8% sampel memiliki pengetahuan baik mengenai infeksi dan vaksinasi HPV, sedangkan 38% sampel menunjukkan perilaku tepat terkait vaksinasi HPV. Analisis bivariat menunjukkan tidak terdapat hubungan signifikan (p>0,05) antara tingkat pengetahuan dan perilaku mahasiswa FKUI preklinik mengenai infeksi serta vaksinasi HPV. Namun, diperlukan penelitian lebih lanjut untuk mengeksplorasi hubungan antara pengetahuan dan perilaku tersebut. ......HPV infection is the leading cause of sexually transmitted diseases. While HPV is often associated with women and cervical cancer, data show a high incidence among men and women. However, awareness about HPV remains low among men. Medical students in the pre-clinical phase play a critical role in the future management of HPV. This study explores the relationship between knowledge and practice among male pre-clinical students concerning HPV infection and vaccination. This cross-sectional study examined male pre-clinical students from Faculty of Medicine Universitas Indonesia. Subjects were given an online questionnaire regarding their knowledge and practice towards HPV infection and vaccination. The chi-square statistical test was used to determine the correlation between knowledge and practice of male pre-clinical students at FKUI regarding HPV infection and vaccination. A total of 120 students from FKUI in first, second, and third year participated in this study. 90.8% of the sample showed good knowledge about HPV infection and vaccination, while 38% exhibited appropriate practice regarding HPV vaccination. Bivariate analysis indicated no significant correlation (p>0.05) between the knowledge and practice of pre-clinical students at FKUI regarding HPV infection and vaccination. However, further research is needed to explore the relationship between knowledge and practice on this topic.

Abstrak :
Latar Belakang: Infeksi Human Papillomavirus (HPV) merupakan salah satu infeksi virus paling umum pada manusia. Virus ini dapat menyebabkan berbagai masalah kesehatan. Untuk itu, tindakan pencegahan seperti vaksinasi HPV diperlukan. Namun, pengetahuan masyarakat terkait HPV masih perlu ditingkatkan. Mahasiswa kedokteran sebagai calon pelayan kesehatan diharapkan dapat berkontribusi pada peningkatan kesadaran masyarakat terkait HPV. Sehingga, pada studi ini dieksplorasi hubungan antara pengetahuan dengan sikap mahasiswa preklinik laki-laki FKUI terhadai infeksi dan vaksinasi HPV. Metode: Penelitian ini bersifat deskriptif analitik dengan desain cross-sectional. Penelitian menggunakan instrumen kuesioner yang kemudian diolah menggunakan uji statistik chi-square untuk menilai hubungan antara pengetahuan dengan sikap mahasiswa laki-laki preklinik FKUI terhadap infeksi dan vaksinasi HPV. Hasil: Subjek penelitian memiliki pengetahuan yang baik tentang infeksi HPV (90%) dan vaksinasi HPV (77,5%). Mayoritas juga memiliki sikap positif terhadap infeksi HPV (89,2%) dan vaksinasi HPV (86,7%). Analisis bivariat antara pengetahuan dan sikap terhadap infeksi dan vaksinasi HPV menunjukkan tidak ada korelasi signifikan antara keduanya (p>0,05). Kesimpulan: Tidak terdapat hubungan signifikan antara pengetahuan dengan sikap mahasiswa preklinik laki-laki FKUI terhadap infeksi dan vaksinasi HPV. Diperlukan penelitian lebih lanjut untuk mengetahui faktor-faktor yang dapat memengaruhi pengetahuan dan sikap tersebut. ......Introduction: Human Papillomavirus (HPV) infection is one of the most common viral infections in humans. This virus can lead to various health issues. Therefore, preventive actions like HPV vaccination are crucial. However, public knowledge regarding HPV still needs improvement. Medical students, as future healthcare providers, are expected to contribute to raising awareness about HPV. Hence, this study aims to explore the relationship between knowledge and attitudes of pre-clinical male medical students at FMUI towards HPV infection and vaccination. Method: This study employs a descriptive-analytical approach with a cross-sectional design. Data was collected using a questionnaire and analyzed using the chi-square test to assess the association between knowledge and attitudes of pre-clinical male FMUI students towards HPV infection and vaccination. Results: The research subjects demonstrated good knowledge about HPV infection (90%) and HPV vaccination (77.5%). The majority also exhibited positive attitudes towards HPV infection (89.2%) and HPV vaccination (86.7%). Bivariate analysis on knowledge and attitudes towards HPV infection and vaccination showed no significant correlation between the two (p>0.05). Conclusion: There is no significant relationship between knowledge and attitudes of pre-clinical male FMUI students towards HPV infection and vaccination. Further research is needed to understand the influencing factors on knowledge and attitudes.