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All Journal Damianus Journal of Medicine The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Indonesian Journal of Cancer Jurnal Penyakit Dalam Indonesia
Jeo, Wifanto Saditya
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Validasi Kuesioner EORTC QLQ-CR29 untuk Menilai Kualitas Hidup Pasien Kanker Kolorektal di Indonesia Pramaningasih, Maelissa; Basir, Ibrahim; Jeo, Wifanto Saditya; Kekalih, Aria
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.19

Abstract

Latar Belakang: Saat ini di Indonesia tidak ada kuesioner standar untuk menilai kualitas hidup pasien dengan kanker kolorektal. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ColoRectal 29 (EORTC QLQ-CR29), adalah sebuah kuesioner yang terstandarisasi untuk menilai kualitas hidup yang umum digunakan pada negara maju. Penelitian ini mencoba membuktikan bahwa EORTC QLQ-CR29 adalah kuesioner yang valid dan reliabel untuk digunakan di Indonesia. Metode: Kuesioner EORTC QLQ-CR29 diterjemahkan kedalam bahasa Indonesia, dan diterjemahkan kembali ke bahasa Inggris. Dilakukan sebuah studi pilot terlebih dahulu, kemudian studi utama ke pasien kanker kolorektal pada poliklinik Bedah Digestif di RSUPN dr.Cipto Mangunkusumo. Desain studi cross-sectional, digunakan intraclass correlation coeficient (ICC) untuk menilai test-retest realiability. Konsistensi internal dievaluasi menggunakan Cronbach’s α coefficient. Validitas konvergen dan diskriminan dianalisa dengan multi-trait scaling. Validitas klinis dievaluasi berdasarkan perbedaan klinis yang telah diketahui sebelumnya menggunakan known-group comparisons. Hasil: Sebanyak lima puluh dua pasien yang berpartisipasi pada penelitian ini. Proses penterjemahan membutuhkan sedikit perubahan akibat adanya perbedaan budaya. Uji test-retest dilakukan pada 17 subjek, yang menunjukkan nilai yang dapat diterima (0.67-1.00). Nilai Cronbach’s α coefficient 0,77-0,86, nilai ini melebihi kriteria 0,7. Pada multi-trait scaling analysis menunjukkan skala multi-item memenuhi standar validitas konvergen dan diskriminan. Pada uji known group comparison menunjukkan kualitas hidup yang berbeda berdasarkan lokasi tumor. Simpulan: Dibutuhkan adaptasi budaya dalam proses penterjemahan. Kuesioner EORTC QLQ-CR29 yang telah diterjemakan merupakan kuesioner yang valid dan reliabel untuk menilai kualitas hidup pasien kanker kolorektal di Indonesia.
Perbandingan Insiden Komplikasi Pascaoperasi Herniorafi dengan Mesh Teknik Lichtenstein dengan Teknik Laparoskopi Di RSCM Ulfandi, Devby; Jeo, Wifanto Saditya
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.23

Abstract

Latar Belakang: Angka komplikasi dan kekambuhan pascaoperasi herniorafi cukup tinggi dan menuntut teknik operasi terbaik. Teknik Lichtenstein merupakan gold standard untuk openherniorafi hernia inguinalis. Saat ini teknik laparoskopi minimal invasive semakin berkembang dan banyak studi menunjukkan hasil lebih baik dibandingkan Lichtenstein. Studi ini bertujuan membuktikan perbedaan insidensi komplikasi pascaoperasi herniorafi dengan mesh teknikLichtenstein dan teknik laparoskopi pada pasien hernia inguinalis di RS dr. Cipto Mangunkusumo dalam 5 tahun (2011-2015). Metode: Studi ini bersifat potong lintang/cross sectional deskriptif analitik terhadap 62 subjek dewasa yang telah menjalani operasi elektif herniorafi dengan mesh di RS dr. Cipto Mangunkusumo. Dengan stratified random sampling subjek dibagi dua kelompok,Lichtenstein dan laparoskopi, kemudian dilakukan analisis statistik dengan Chi square atau uji Fisher, dan regresi logistik multivariat. Didapatkan hubungan apabila ditemukan nilai p < 0,05 dengan interval konfidensi 95%. Hasil: Insidensi terjadinya komplikasi pascaoperasi herniorafi dengan mesh teknik Lichtenstein dan laparoskopi dari 62 subjek secara signifikan berhubungan (p = 0,006 , OR 7,229 , IK 95% 2,33–22,35) sehingga berisiko 7,2 kali menimbulkan komplikasi pada teknik Lichtenstein.Juga didapatkan bahwa variabel lama rawat dan jenis operasi berhubungan secara signifikan dengan terjadinya komplikasi pascaoperasi (p = <0,001). Variabel usia, lama operasi, dan indeks masa tubuh tidak memiliki hubungan secara signifikan dengan komplikasi pascaoperasi kedua teknik tersebut (p = >0,05). Simpulan: Terdapat perbedaan insidensi komplikasi pascaoperasi herniorafi dengan mesh teknik Lichtenstein dan teknik laparoskopi pada penderita hernia inguinalis di RS dr. Cipto Mangunkusumo, yang menunjukkan insidensi komplikasi lebih banyak muncul pada tindakan Lichtenstein dibandingkan laparoskopi dengan faktor lama rawat dan jenis operasi yang bermakna secara signifikan terhadap insidensi komplikasi pascaoperasi.
External Validation Of 10 Points Intraoperative Gallbladder Scoring System (G10) In Laparoscopic Cholecystectomy at RSUPN dr. Cipto Mangunkusumo Mazni, Yarman; Jeo, Wifanto Saditya; -, Rony
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Laparoscopic cholecystectomy has become a standard treatment for symptomatic cholecystolithiasis in dr. Cipto Mangunkusumo Hospital (RSCM). This study aims as a preliminary study to externally validate the 10-point intraoperative gallbladder scoring system (G10), an assessment system of laparoscopic cholecystectomy's difficulty. Method. A cross-sectional study was carried out. Enrolling subjects who underwent laparoscopic cholecystectomy from January 2019 to December 2019. Data of the subjects were collected from medical records. We assessed each of the subjects' G10 scores and operation techniques based on the intraoperative images and surgical reports. The surgical technique divided into two groups, those are the Critical View of Safety (CVS) technique and bailout procedure group, consisting of fundus–first cholecystectomy, subtotal cholecystectomy, and conversion. The correlation of G10 score between CVS and bailout was analysed using the Mann-Whitney nonparametric test. A Kendall's tau was performed to measure the correlation between the G10 score and the bailout procedure. Statistical power was calculated by G-power application. A ROC test was performed to calculate the sensitivity and specificity of the G10 scoring system to predict bailout procedure, then the cut-off value was determined. Results. There was a significant and positive correlation between the G10 score with the bailout procedure (2 indicate subjects at high risk of bailout procedure (72.2% vs. 20.98%). Conclusion: This study showed that the G10 score has good accuracy in predicting a bailout procedure. The use of G10 scores intraoperatively is "essential" to provide valid and objective assessment in determining the difficulty of surgery. When the G10 score is 1 or 2, it's safe to perform the CVS technique. Whereas, if the G10 score is three or greater, surgeon should consider bailout procedure.
Prediction Model of 30-Days Postoperative Pneumonia in Elderly Patient Undergoing Abdominal Surgery Dwimartutie, Noto; Oktadiana, Harini; Singh, Gurmeet; Jeo, Wifanto Saditya; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Physiologic changes in respiratory tract in elderly increase incidence of post-operative pneumonia. Post-operative pneumonia in non-thoracic surgery was found higher in abdominal surgery. This study aimed to develop a prediction model of 30-day post-operative pneumonia in elderly patients undergoing abdominal surgery. Methods. A retrospective cohort study was conducted using elderly patient’s medical records who underwent abdominal surgery in Cipto Mangunkusumo General Hospital. Multivariate analysis using logistic regression was used to determine Odds Ratio (OR). Model’s calibration performance was determined by Hosmer-Lameshow test and its discrimination performance was determined by calculating area under the curve (AUC). Results. Of 753 subject who underwent abdominal surgery, postoperative pneumonia was found in 9.2% subjects. Independent predictors for 30-day postoperative pneumonia were functional status [ADL Barthel 0-11, odds ratio (OR) 6.908 (95% confidence interval (CI) 2.933-16.273); ADL Barthel 12-19, OR 3.191 (95%CI 1.53-6.657)], upper abdominal surgery [OR 4.869 (95%CI 1.805-13.132)], chronic obstructive pulmonary disease [OR 6.888 (95%CI 2.001-23.709)], and albumin level /dl [OR 2.54 (95%CI 1.404-4.596)]. Prediction model of pneumonia was stratified into lower risk (score 3; probabililty 60.42%). Hosmer-Lemeshow test revealed p-value 0.452 and the AUC value is 0.811 (95%CI 0.87-0.97). Conclusion. A simple prediction model of 30-day post-operative pneumonia for elderly patients undergoing abdominal surgery consisted of 4 predictors (functional status, upper abdominal surgery, COPD and albumin level /dl) has a good performance.
Biopsi cair pada kanker kolorektal: Harapan dan tantangan Angka, Rebecca Noerjani; Lumban Tobing, Demak; Sudoyo, Aru Wisaksono; Siregar, Nurjati Chairani; Jeo, Wifanto Saditya
Bahasa Indonesia Vol 21 No 3 (2022): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v21i3.3575

Abstract

Pendahuluan: Global Cancer Statistics 2020 menunjukkan angka kejadian kanker kolorektal menduduki peringkat ketiga dengan urutan kedua angka kematian. Pemeriksaan biopsi cair pada kanker kolorektal mulai dilakukan untuk mempelajari sel-sel tumor yang ada di dalam sirkulasi yaitu circulating tumor cells (CTCs) dan cell-free circulating tumor DNA (ctDNA/cfDNA). Tujuan dari penulisan artikel ini adalah untuk menemukan dan menelaah penelitian-penelitian yang telah dilakukan mengenai biopsi cair baik dari sisi metode, hasil maupun manfaat klinik pada kanker kolorektal. Metode: Metode pencarian literatur dilakukan melalui Embase, Scopus dan PubMed. Dari 143 artikel yang ditemukan saat pencarian awal, setelah melalui tahap seleksi akhir ditentukan 15 artikel yang memenuhi kriteria inklusi. Hasil: Biopsi cair dapat digunakan untuk mendeteksi mutasi yang tidak ditemukan pada tumor primer pasien kanker kolorektal serta analisis kombinasi circulating cell-free DNA (ccfDNA) dan ctcDNA dapat meningkatkan jumlah mutasi yang terdeteksi. Analisis ctDNA dalam plasma yang dikumpulkan secara serial, memungkinkan mendeteksi ctDNA mutan yang muncul, sehingga dapat digunakan untuk memantau perkembangan penyakit pasien serta menemukan mekanisme resistensi. Pengambilan sampel pasien secara serial menunjukkan bahwa penurunan metilasi terjadi pada pasien yang berespon baik terhadap pengobatan, baik operasi maupun kemoterapi. Sebaliknya pasien yang tidak diobati atau mengalami kekambuhan menunjukkan peningkatan metilasi. Status MSI pada kanker kolorektal yang terdeteksi melalui cfDNA relatif konsisten dengan yang ada di sampel jaringan tumor. Simpulan: Keuntungan biopsi cair adalah darah lebih mudah didapat, efektif dan tidak invasif dibandingkan dengan biopsi terutama pada tumor yang sulit dijangkau dengan biopsi. Biopsi cair dapat dilakukan berulang secara serial sehingga dapat digunakan untuk memantau perkembangan penyakit, mengetahui respon pengobatan dan menentukan prognosis.
The Accuracy of Immunoscore and Neutrophil Lymphocyte Ratio in Predicting 5 years Recurrence of Stage I-III Colorectal Cancer Kristianto, Yusak; Jeo, Wifanto Saditya
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1240

Abstract

Background: It is estimated about 30-50% of colorectal cancer (CRC) patients experience recurrence even after definitive therapy. Immune-based tests, such as immunoscore (IS) and Neutrophil-Lymphocyte Ratio (NLR) are independent predictors of CRC recurrence and survival. NLR examination is more affordable, simple, and feasible compared to oncological panel examination IS. To this date, there have been no studies measuring the accuracy of both in predicting recurrence rates in CRC.Methods: This retrospective cohort study was conducted at Siloam Kebon Jeruk Hospital and Mochtar Riady Comprehensive Cancer Centre (MRCCC) from July to December 2023, utilizing secondary data from medical records of stage I-III CRC patients, focusing on NLR and IS results, and outcomes. Statistical analysis comprised descriptive analysis, accuracy test, and hypothesis testing (bivariate) using the Statistical Package for the Social Sciences (SPSS) version 25. NLR cut-off value was computed using the ROC curve. The comparison of NLR and IS test values was assessed through a comparison of ROC area (AUC). Measure of agreement between the two tests (NLR and IS) was done using Kappa statistics.Results: Out of 80 CRC patients, 26 patients experienced recurrence (32.5%), mostly in the first two years (53%), while 54 patients did not recur (67.5%). NLR (cut-off 6.6) showed sensitivity (46.2%), specificity (81.5%), and diagnostic accuracy value of 70%. Chi-square analysis indicated a significant relationship between NLR and recurrence (p-value = 0.020). IS showed sensitivity (7.7%), specificity (96.3%), and diagnostic accuracy value of 67.5%. Fisher’s Exact analysis showed no significant relationship between IS and recurrence (p-value = 0.592). The AUC value of both tests indicated that the accuracy to predict recurrence in CRC patients is not different/ same (p-value = 0.064). The Kappa statistic indicates a very high agreement between high IS and low NLR tests in predicting recurrence cases (p-value = 0.001).Conclusions: NLR and IS have the same weak accuracy in predicting stage I-III CRC recurrences, but NLR has a statistically significant association compared to IS. A combination of both tests showed a strong predictive role in tumor recurrence after curative surgery and can be applied in daily practice (postoperative surveillance).
Low Anterior Resection Syndrome (LARS) and Related Factors Variation Pattern in Indonesian Tertiary Hospital: Case-Controlled Study Jeo, Wifanto Saditya; Mazni, Yarman; Putranto, Agi Satria; Primadhani, Wendy; Ananti, Anggini T.; Yoladifa, Safira Farah
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1318

Abstract

Background: Dysfunctional bowel movement, also referred to as low anterior resection syndrome (LARS), is a regular issue correlated with rectal cancer, which significantly impacts overall wellbeing. Thisstudy intended to look for the LARS incidence in patients with colorectal cancer where rectal preservation was not possible and identify factors affecting major LARS incidence in Indonesia. Method: This study follows a case-control design. Patients with rectal cancer over 18 years old who underwent tumour removal with mesorectal excision and colorectal anastomosis at Dr. Cipto Mangunkusumo General Hospital, Indonesia, from January to March 2019. The control group includes patients of eligible age who had anal sphincter preservation, stoma closure, and fall into the No LARS or Minor LARS category. Data were collected from medical records and scored with a validated LARS questionnaire. Results: Among 40 patients included, 42.5% had major LARS. The surgical procedure of low anterior resection (LAR) was significantly associated with 31.7% of major LARS patients (p = 0.04). Preoperative radiotherapy [OR 0.1 (0.02–0.49)] and anastomosis levels [OR 0.07 (0.01–0.39)] were associated with major LARS. The ROC curve revealed an AUC of 0.77, indicating significant results with the threshold for anastomosis level was 5 cm. Biofeedback revealed group differences in resting anal and maximal squeeze pressures, indicating sphincter impairment and preoperative treatment impact LARS progression. Conclusion: Major LARS development was heightened by surgical methods, preoperative radiotherapy, and lower anastomotic levels, emphasizing the role of sphincter dysfunction and preoperative interventions in LARS development.
Tumor Microenvironment in Colorectal Cancer Development: A Review of 3D Study Analysis Angka, Rebecca Noerjani; Sudoyo, Aru Wisaksono; Siregar, Nurjati Chairani; Jeo, Wifanto Saditya; Antarianto, Radiana Dhewayani
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1089

Abstract

Background: Colorectal cancer is the third most common cancer in 2020, with a high mortality rate. Colorectal cancer treatment has made many advances. However, many factors in the tumor microenvironment still have not been reached but significantly affect the success of treatment. This literature review was conducted to search for research articles that analyze factors in the tumor microenvironment, how they interact through studies primarily conducted in 3D, and how to prepare for 3D research on colorectal cancer will be briefly discussed. The aim of this systematic review is to study the components of the tumor microenvironment in colorectal cancer development as assessed by 3D studies. Methods: Article searches were conducted through Embase, Scopus and PubMed. From the 110 articles found at the beginning of the search, after going through several screening stages, 27 articles were determined that met the inclusion criteria. The inclusion criteria used were journals containing research articles on colorectal cancer in the last five years with topics regarding the tumor microenvironment and according to keywords. Results: Microenvironment components in colorectal cancer, consisting of cellular and noncellular components, have the most significant effect on cancer development and ultimately affect metastasis, response to treatment, and prognosis.  Conclusions: This literature review proves that the components of the tumor microenvironment are very diverse, making colorectal cancer heterogeneous. It still requires a lot of research to prove the existence of other components that affect the effectiveness of the treatment.
Co-Authors Agi Satria Putranto Ananti, Anggini T. Angka, Rebecca Noerjani Antarianto, Radiana Dhewayani Aria Kekalih Gurmeet Singh Harini Oktadiana, Harini Ibrahim Basir Kuntjoro Harimurti Lumban Tobing, Demak Mazni, Yarman Noto Dwimartutie Nurjati Chairani Siregar Pramaningasih, Maelissa Primadhani, Wendy Rony - Sudoyo, Aru Wisaksono Ulfandi, Devby Yoladifa, Safira Farah Yusak Kristianto