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"Pendahuluan: Tesis ini bertujuan untuk mengetahui efek myelosupresi padapasien kanker ovarium dengan kemoterapi ajuvan carboplatin dan paclitaxel diRSUPN dr. Cipto Mangunkusumo melalui analisis kadar hemoglobin, leukosit,dan trombosit. Kemoterapi ajuvan kombinasi carboplatin dan paclitaxelmerupakan rejimen kemoterapi yang paling efektif pada kanker ovarium. Namunpemberian kemoterapi tersebut memiliki efek samping myelosupresi sepertianemia, neutropenia, dan trombositopenia yang berdampak besar terhadapkualitas hidup pasien. Metode: Penelitian ini adalah penelitian hystorical cohort yang dilaksanakan diRSUPN Dr. Cipto Mangunkusumo dengan mengambil sampel penelitian pasienkanker ovarium yang mendapatkan kemoterapi ajuvan dengan carboplatin danpaclitaxel sebanyak enam seri mulai dari Januari 2010 sampai dengan Desember2014. Hasil: Dari 41 subjek penelitian yang memenuhi kriteria inklusi didapatkan usiapasien berkisar antara 25 sampai dengan 64 tahun (median: 49 tahun), terbanyakadalah multipara (43,9%), premenopause (61,0%), dengan stadium terbanyakadalah stadium IIIC (58,5%), histopatologi terbanyak adalah kistadenokarsinomaserosum (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 myelosupressioneffect on ovarian cancer patient with carboplatin and paclitaxel adjuvantchemotherapy based on haemoglobin, leucocyte, and thrombocyte level.Carboplatin and paclitaxel combination as an adjuvant chemotherapy is the mosteffective regiment for ovarian cancer. Otherwise this regiment hasmyelosuppression effect (hematologic toxicity) as anemia, neutropenia, andthrombocytopenia which have impact on quality of life of the patients. Methods: This is an hystorycal cohort study on ovarian caner patients whounderwent six series of adjuvant chemotherapy from January 2010 untilDecember 2014 at RSUPN Dr. Cipto Mangunkusumo. Results: From 41 patients range at 25 until 64 years old (median: 49 years), mostof them are multiparity (43,9%), premenopausal women (61,0%), with the largeststadium was IIIC (58,5%), the largest pathologic type was serouscystadenocarcinoma (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 myelosupressioneffect on ovarian cancer patient with carboplatin and paclitaxel adjuvantchemotherapy based on haemoglobin, leucocyte, and thrombocyte level.Carboplatin and paclitaxel combination as an adjuvant chemotherapy is the mosteffective regiment for ovarian cancer. Otherwise this regiment hasmyelosuppression effect (hematologic toxicity) as anemia, neutropenia, andthrombocytopenia which have impact on quality of life of the patients. Methods: This is an hystorycal cohort study on ovarian caner patients whounderwent six series of adjuvant chemotherapy from January 2010 untilDecember 2014 at RSUPN Dr. Cipto Mangunkusumo. Results: From 41 patients range at 25 until 64 years old (median: 49 years), mostof them are multiparity (43,9%), premenopausal women (61,0%), with the largeststadium was IIIC (58,5%), the largest pathologic type was serouscystadenocarcinoma (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). "

"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).

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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."

"Latar Belakang: Kanker serviks berdasarkan data WHO merupakan kanker paling mematikan keempat pada wanita yang berasal dari serviks. Kanker ini merupakan kanker kedua terbanyak di Indonesia. Proyek penelitian ini dilakukan untuk melihat kejadian kekambuhan kanker serviks dengan hubungan faktor prognostiknya dan untuk mengembangkan penelitian tentang topik ini di Indonesia, dimana penelitian mengenai tingkat kekambuhan kanker serviks masih kurang.Metode: Penelitian ini menggunakan analisis univariat dan bivariat dengan jumlah sampel 156 yang memenuhi kriteria dengan stadium IA-IIA dan faktor prognostik yang dialami oleh pasien dari Rumah Sakit Cipto Mangunkusumo diambil dengan memeriksa data rekam medis dan data yang diperoleh dari daftar kanker Himpunan Onkologi Ginekologi Indonesia. Metode ini dilakukan untuk mengetahui tingkat kekambuhan kanker serviks stadium IA-IIA. Analisis data dilakukan dengan menggunakan SPSS. Hasil: Analisis dilakukan dengan uji Chi-square, ada hubungan antara kekambuhan kanker serviks dengan ukuran tumor primer. (P=0,05)Kesimpulan: Penelitian ini menunjukkan hubungan antara faktor prognostik dengan kejadian kanker serviks.

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Background: Cervical cancer based on data from WHO is the fourth most deadly cancer in women that originates from the cervix. This cancer is the second most common cancer in Indonesia. This research project was conducted to see the incidence of cervical cancer recurrence with its prognostic factor relationship and to develop research on this topic in Indonesia, where there are still lack of research regarding the rate of recurrence of cervical cancer.

Method: This research uses univariate and bivariate analysis with 156 samples who meet the criteria with the stage of IA-IIA and the prognostic factors that experienced by the patients from Cipto Mangunkusumo Hospital is taken by check the medical record data and data obtained from Indonesian gynecological oncology association cancer registry. This method done to determine the recurrence rate of cervical cancer stage IA-IIA. Data analysis done by using SPSS.

Result: The analysis done by applying Chi-square test, there was relationship between the recurrence of cervical cancer and the primary tumor size. (P=0,05)

Conclusion: This research points out a relationship between prognostic factors and the incidence cervical cancer."

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Latar Belakang: Radioterapi merupakan tatalaksana utama kanker serviks, baik dalam bentuk Concurrent Cisplatin-based Chemoradiation Therapy (CCRT) maupun Radiation Therapy (RT). Radioterapi dapat menyebabkan toksisitas terutama pada sistem gastrointestinal dan genitourinarius. Namun, belum ada data mengenai insidensi, derajat, durasi, dan keluhan tersering toksisitas, serta faktor risiko yang mendasarinya di Indonesia.

Tujuan: Mengevaluasi insidensi, derajat, keluhan terkait, dan durasi toksisitas radioterapi pada sistem gastrointestinal dan genitourinarius, serta faktor risiko yang mendasarinya.

Metode: Studi kohort retrospektif ini dilakukan pada subjek kanker serviks stadium lanjut (stadium FIGO ≥IIB) yang menjalani radioterapi, baik CCRT maupun RT, selama tahun 2018. Data dikumpulkan secara randomisasi rekam medis Departemen Radioterapi selama berlangsungnya radioterapi. Uji prevalensi dilakukan untuk mendapatkan angka insidensi, derajat, durasi, dan keluhan tersering toksisitas. Uji Chi-Square dilakukan untuk mendapatkan hubungan faktor risiko dengan terjadinya toksisitas, serta perbedaan toksisitas antara penerima perlakuan CCRT dan RT.

Hasil: Dari 106 subjek, didapatkan 58% insidensi toksisitas, dengan sebaran 42% toksisitas gastrointestinal, 5% toksisitas genitourinarius, dan 12% keduanya. Dari 54% toksisitas gastrointestinal, terdapat 45% toksisitas derajat 1 dan 9% toksisitas derajat 2, dengan keluhan 34% mual-muntah, 34% diare, 11% diare berdarah, serta 2% diskezia. Seluruh toksisitas genitourinarius merupakan derajat 1, dengan keluhan 86% disuria dan 14% hematuria. Toksisitas mulai timbul pada hari ke-17 (95% IK; 5-84 hari) dan dirasakan selama 15 hari untuk toksisitas gastrointestinal (95% IK; 5-65 hari) dan selama 13 hari untuk toksisitas genitourinarius (95% IK; 2-65 hari). Toksisitas radioterapi lebih tinggi pada subjek dengan IMT ³18 kg/m² (p 0,378), pendidikan SMP ke bawah (p 0,065), pekerjaan usaha kecil/ibu rumah tangga (p 0,366), dan paparan rokok (p 0,027). Toksisitas muncul terutama pada CCRT dibandingkan dengan RT (75% vs 56%, p 0,265) dengan adanya korelasi kuat antara terjadinya kedua toksisitas (Sperman’s Rho 1,0 vs 0,264; p 0,006).

Kesimpulan:  Insidensi toksisitas radioterapi pada sistem gastrointestinal dan genitourinarius adalah 56% yang bersifat sementara dan tidak berat. Besar IMT, status ekonomi rendah, dan paparan rokok meningkatkan terjadinya toksisitas. Tindakan CCRT memiliki toksisitas lebih tinggi dibandingkan RT. 

Key Words: CCRT, RT, toksisitas gastrointestinal, toksisitas genitourinarius, faktor risiko toksisitas, kanker serviks

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Background: Regardless the toxicity effect of radiotherapy (CCRT/RT) mainly to gastrointestinal and genitourinary system, there is no data of the toxicity in Indonesia.

Objective: Evaluate the incidence, degree, duration, and most frequent complaints, as well as the contributing risk factors. 

Methods: This retrospective cohort study was conducted on FIGO stage ≥IIB) cervical cancer, who underwent radiotherapy in 2018. Data were randomly collected from the Radiotherapy Department's medical records. 

Results: From 106 subjects, there was 58% toxicity. Of the 54% gastrointestinal toxicity, there are 45% grade 1 and 9% grade 2, with 34% complaint of nausea and vomiting, 34% diarrhea, 11% hematochezia, and 2% dyschezia. All of genitourinary toxicity was grade 1, with 86% complaint of dysuria and 14% hematuria. Toxicity occured on the 17th day (95% CI; 5-84 days) and disappeared in 15 days for gastrointestinal toxicity (95% IK; 5-65 days) and 13 days for genitourinary toxicity (95% IK; 2- 65 days). Toxicity was more exist in subjects with BMI ³18 kg/m² (p 0.378), low education (p 0.065), entrepreneur/housewife (p 0.366), and cigarette exposure (p 0.027). Toxicity appeared mainly in CCRT compared to RT (75% vs 56%, p 0.265) with a strong correlation between the occurrence of the two toxicities (Sperman’s Rho 1.0 vs 0.264; p 0.006).

Conclusion: The incidence of radiotherapy toxicity in the gastrointestinal and genitourinary systems was 56%, which was temporary and light. Large BMI, low economic status, and cigarette exposure increased the incidence of toxicity. Toxicity of CCRT treatment would be greater that RT alone.

Key Words: CCRT, RT, gastrointestinal toxicity, genitourinary toxicity, risk factors for toxicity, cervical cancer

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"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 krioterapiMetode: Penelitian ini merupakan studi kohort prosepektif. Populasi terjangkauadalah 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.

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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.

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"ABSTRAKLatar 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."

"Tujuan: Mengetahui bahwa indeks morfometrik USG merupakan metode yang baik dalam mendiagnosis keganasan ovarium tipe epitelial. Metode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di Rumah Sakit Cipto Mangunkusumo dengan mengambil data retrospektif dari Januari 2016 hingga Desember 2017. Pasien poliklinik rawat jalan ginekologi dengan kecurigaan memiliki neoplasma ovarium kistik direkrut. Standar baku emas adalah temuan histologi dari massa adneksa yang dioperasi. Karakteristik gambaran pola morfometrik ultrasonografi meliputi bilateralitas, jumlah lokus, regularitas dinding dalam (inner wall), tonjolan papiler (papillary projection), bagian padat (solid part), asites, dan doppler blood flow.  Analisis ROC dilakukan untuk menentukan seberapa baik model ini digunakan sebagai metode diagnostik keganasan ovarium tipe epitelial. Analisis statistik dihitung, untuk mendapatkan nilai akurasi, sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediksi negatif. Hasil: Penelitian ini melibatkan 178 pasien, sebanyak 101 kasus (56.74%) adalah k asusjinak dan 77 kasus (43.25%) adalah kasus ganas. Pola karakteristik USG, papillary projection (p-value = 0.000), solid part (p-value = 0.000), inner wall (p-value = 0.000), asites (p-value = 0.000) dan Doppler blood flow (p-value = 0.000) subjek penelitian memiliki hubungan yang bermakna dengan kejadian keganasan ovarium. Pola morfologi papillary projection memiliki nilai sensitifitas yang paling tinggi (83%), kemudian adanya asites (82%), dan iregularitas dinding (81%). Untuk kategori spesifisitas, didapatkan adanya bagian padat (solid part) memiliki nilai spesifisitas yang paling tinggi (93%).Analisis regresi multinomial digunakan untuk menilai gabungan pola karateristik yang bermakna untuk diagnostik keganasan ovarium tipe epitelial dengan AUC 89.40% (95%CI 84.70%-94.00%), Model ini akurat  secara statistik (p <0,05). Kesimpulan: Indeks morfometrik USG merupakan salah satu metode yang baik dalam memprediksi keganasan ovarium.

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Objective: To know whether the ultrasound morphometric index is a good method to diagnose epithelial ovarian malignancy.

Materials and methods: This study is a diagnostic test conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. All data were taken retrospectively from January 2016 to December 2017. Gynecological outpatient polyclinic patients with suspicion of having cystic ovarian neoplasms were recruited. Characteristics of ultrasound morphometric patterns include bilaterality, number of loci, inner wall regularity, papillary projection, solid part, ascites, and doppler blood flow.

Results: The study involved 178 patients, 101 cases (56.74%) were malignant and 77 cases (43.25%) were malignant cases. The characteristics of ultrasound, papillary projection, solid part, inner wall, ascites and Doppler blood flow patterns of the study subjects had a significant relationship with the incidence of ovarian malignancy. Multinomial regression analysis was used to assess the combined characteristic patterns for the diagnostic epithelial type ovarian malignancy with AUC 89.40% (95% CI 84.70% -94.00%), this model was statistically accurate (p <0.05).

Conclusion: Morphometric index of ultrasound is a good methods in predicting epithelial ovarian malignancy "

"[ABSTRAKPenelitian 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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ABSTRACTThe 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.]"

"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.

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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."

"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).

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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)."