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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana JBN (Jurnal Bedah Nasional) Majalah Kedokteran Andalas ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Cermin Dunia Kedokteran Indonesian Journal of Cancer Eduvest - Journal of Universal Studies
Putu Anda Tusta Adiputra
Bedah Onkologi, Fakultas Kedokteran, Universitas Udayana
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Bilateral Giant Fibroadenoma of The Breast: A Case Report Jasmine Stephanie Christian; Putu Anda Tusta Adiputra; INW Steven Christian
JBN (Jurnal Bedah Nasional) Vol 2 No 2 (2018): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (176.406 KB) | DOI: 10.24843/JBN.2018.v02.i02.p04

Abstract

Background: fibroadenoma of the breast is one of the ANDI (Aberration of the Normal Development and Involution of the Breast) groups. Benign breast disorders are common in females younger than 30 years, but such masses are not common in juvenile or pre-menarche age groups. The exact pathological diagnosis can be investigated after surgery. For treatment, surgical procedures are needed to remove the lump. Case: a 30-year-old girl visited the outpatient clinic with psychological distress due to the presence of lumps in her both breasts. The lumps have been growing bigger and bigger in the last 3 years. On the physical examination both breasts are huge. FNAB showed the interpretation of atypical ductal hyperplasia and excisional biopsy examination confirmed the presence of bilateral giant fibroadenoma of breast. In this patient, the treatment was carried out in two-staged surgery due to her initial rejection to undergo total breast lumps and tissue removal. Several lumps still remained in the right breast which was indicated for the second surgery. The following surgery was done to remove all of the lumps and breast tissue with reduction breast surgery. Conclusion: conducting breast surgery on the young girl or un-married is not easy as many physical and psychology problems should be considered. Therefore, conducting breast surgery, in this case, should be performed wisely as the recurrence of the lumps was still possible.
Dampak Pandemi COVID-19 pada Pelayanan Pasien Kanker di Rumah Sakit Tersier di Indonesia: Serial Kasus Putu Anda Tusta Adiputra
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): Special Issue COVID-19 - JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (227.915 KB) | DOI: 10.24843/JBN.2020.v04.is01.p07

Abstract

Latar belakang: Sejak diumumkan pertama kali pada Desember 2019, jumlah penderita COVID-19 terus meningkat. Seiring dengan perkembangan penyakit ini yang begitu pesat, berbagai masalah pun mulai bermunculan. Serial kasus ini ditulis untuk mengangkat pengalaman dalam penanganan pasien keganasan dalam keterbatasannya pada masa pandemi COVID-19. Kasus: Pertama, pasien peripheral T-cell lymphoma yang sudah kemoterapi CHOP 4 siklus di Singapura dan akan melanjutkan siklus selanjutnya bulan April 2020. Kedua, pasien dengan pleomorphic spindle cell sarcoma regio toraks posterior metastasis ke paru dan tulang sudah mendapatkan kemoterapi lini kedua dengan regimen Gemcitabine/Docetaxel di Singapura, dan akan melanjutkan kemoterapi selanjutnya akhir Maret 2020, akan tetapi pasien mengalami neutropenia dan menolak ke rumah sakit untuk injeksi karena takut. Ketiga, pasien dengan karsinoma payudara Her-2 type yang sedang menjalani terapi target Kadcyla di London. Pasien pertama dan ketiga tidak dapat melanjutkan terapi di luar negeri karena pandemi COVID-19. Simpulan: Pandemi COVID-19 secara langsung menyebabkan perubahan besar dalam layanan rumah sakit. Penundaan pengobatan pada pasien kanker yang dapat dilakukan atau melanjutkan pengobatan dengan peningkatan kewaspadaan akan transmisi COVID-19 merupakan opsi yang dapat dilakukan dan dipertimbangkan secara matang oleh klinisi.
Skoring Prognostik Survival Pasien Triple Negative Breast Cancer Berbasis Immunoscore Putu Anda Tusta Adiputra; I Wayan Sudarsa
JBN (Jurnal Bedah Nasional) Vol 5 No 2 (2021): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2021.v05.i02.p05

Abstract

Kanker payudara adalah salah satu masalah kesehatan utama di dunia. Data Globocan tahun 2018, terdapat lebih dari 2 juta kasus kanker payudara baru dengan angka mortalitas lebih dari 600.000 jiwa. Salah satu subtipe kanker payudara yang memiliki prognosis yang buruk adalah Triple Negative Breast Cancer (TNBC) yang terjadi sekitar 15% hingga 20% dari seluruh kanker payudara invasif yang telah terdiagnosis. Subtipe ini memiliki sifat yang lebih agresif yang ditandai dengan nilai disease-free and overall survival yang rendah. Hingga saat ini prediktor dan prognosis pasien kanker payudara secara umum dan TNBC pada khususnya dilakukan berdasarkan evaluasi demografi, klinis, dan histopatologi. Namun, berbagai penelitian menunjukkan bahwa sistem skoring yang didasarkan pada parameter tersebut tidak terlalu efektif dan hanya memberikan informasi yang terbatas dalam prediksi survival dan mortalitas TNBC. Salah satu potensi sistem prediktor dan prognosis pasien TNBC adalah berbasis sistem imun yaitu immunoscore. Dalam review ini akan dibahas lebih lanjut mengenai skoring prognostik survival pasien TNBC berbasis immunoscore.
Eccrine Spiradenokarsinoma: Keganasan Adneksa Kulit yang Jarang Yulan Permatasari; Pande K. Aditya Prayudi; Hendra P. Setiawan; Putu Anda Tusta Adiputra
Cermin Dunia Kedokteran Vol 42, No 11 (2015): Kanker
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v42i11.949

Abstract

Eccrine spiradenokarsinoma merupakan tumor ganas adneksa kulit yang sangat jarang dijumpai namun dapat bersifat agresif. Keganasan ini sering dijumpai pada ekstremitas bawah, dapat terjadi pada pria dan wanita di usia enam puluhan atau tujuh puluhan. Hampir semua kasus berkaitan dengan transformasi ganas eccrine spiradenoma yang sudah ada sebelumnya. Namun, transformasi ganas merupakan fenomena yang sangat jarang dijumpai. Sampai saat ini belum terdapat kesepakatan dalam penatalaksanaan eccrine spiradenokarsinoma dengan kasus yang masih jarang terdokumentasi dalam literatur. Pada laporan ini akan dibahas kasus seorang perempuan berusia 60 tahun dengan diagnosis eccrine spiradenokarsinoma.Eccrine spiradenocarcinoma is an extremely rare but aggressive malignant tumor originating from eccrine sweat glands. Eccrine spiradenocarcinoma is almost always results from malignant transformation of a benign pre-existing eccrine spiradenoma. However, malignant transformation is a rare phenomenon. Due to the rarity of the case, there is not yet an agreement on the management of eccrine spiradenocarcinoma.. This case is a 60-year-old female with a diagnosis of eccrine spiradenocarcinoma.
A PRELIMINARY STUDY ON THE EXTRAVASATION OF INTRAVENOUS CHEMOTHERAPY IN SANGLAH GENERAL HOSPITAL, BALI – INDONESIA Inge Kurniawati; Putu Anda Tusta Adiputra
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (178.888 KB)

Abstract

Background: Extravasation of intravenous chemotherapeutic agents is one of the most devastating complications, which unacceptable condition neither to patient nor to medical services. Many healthcare providers realize that even one extravasation injury is too many since this injury is preventable. Published incidence rates of chemotherapy extravasation range from 0,01% to 6%, but in our institution, chemotherapy extravasation was not well recorded, so the incidencerate is unclear and the number of injuries is underestimated. Method: We observed chemotherapy extravasation occurrence during a 6 months period in our institution, from September 2013 until March 2014. We recorded the chemotherapy agents, patient’s clinical presentations, and extravasation management. Result: During our observation, 1374 chemotherapies administered, and 10 cases of chemotherapy extravasation occur, particularly doxorubicine was the main chemotherapy agent. Almost all treated conservatively, only 10% handled with surgical management. Eventually, 20% of cases have implanted port placed. Conclusion: Extravasation of cytotoxic agents is a serious problem, it causes tissue damage, prolongs the length of stay, increases hospital cost and psychological damage to cancer patients who under chemotherapy. It preventable but always underestimate by some clinicians, the use of central venous access device is one of the solutions to minimize the damage.
Survival Analysis of Patients with Luminal and Non-Luminal Subtype Breast Cancer Receiving Vinorelbine Therapy at Sanglah General Hospital, Denpasar, Bali Dewa Putu Satria Juristiasa; Putu Anda Tusta Adiputra; Dewa Made Sukrama
Indonesian Journal of Cancer Vol 16, No 2 (2022): June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.915 KB) | DOI: 10.33371/ijoc.v16i2.899

Abstract

Introduction: Breast cancer is the most common type and lethal cancer affecting women. Meanwhile, vinorelbine is one of the chemotherapy agents used for luminal and non-luminal breast cancer. Therefore, this study aims to determine the survival difference between patients with luminal and non-luminal subtype breast cancer treated with vinorelbine.Methods: This study was a retrospective cohort. Women with breast cancer treated with vinorelbine were classified based on estrogen receptor (ER), progesteron receptor (PR), human epidermal growth factor receptor-2 (HER-2) markers, and subtypes. The subjects were followed up to chemotherapy visits with vinorelbine recorded in the medical record. The survival analysis between subtypes was analyzed by the Kaplan-Meier curve.Results: : One hundred women were obtained with a mean age of 52.36 ± 10.45 years. Based on immunohistochemistry, 60% were ER-positive, 53% were PR positive, and 57% were HER-2- positive. Based on the subtype, 67% were luminal, while 33% were non-luminal. All subjects had a mean survival duration of 155.38 days (95% CI 128.05-182.71). The stratified survival analysis showed a significant difference in survival duration based on HER-2 marker and subtype. The subjects with HER-2 positive survived longer with a mean of 203.37 days (190.72–216.02) than those with HER-2 negative with a mean of 90.10 days (65.68-114.53) (p<0.001). In addition, the subjects with the luminal subtype survived longer with a mean of 174.84 (142.72-206.94) than those with non-luminal with a mean of 90.10 (65.68-114.53) (p = 0.04).Conclusion: There was a significant difference in survival duration between women with breast cancer treated with vinorelbine chemotherapy who were HER-2 positive, HER-2 negative, and luminal and non-luminal subtypes.
Karakteristik kanker payudara usia muda di Subbagian Bedah Onkologi Rumah Sakit Umum Pusat Sanglah tahun 2014-2016 Putu Diahpradnya Oka Partini; I Wayan Niryana; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 9 No. 1 (2018): (Available online: 1 April 2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.631 KB) | DOI: 10.15562/ism.v9i1.163

Abstract

Latar Belakang: Kanker payudara merupakan jenis kanker yang paling sering terjadi pada wanita. Kasus kanker payudara pada usia muda (dibawah 40 tahun) cenderung memiliki presentase yang lebih rendah diantara usia tua, namun memiliki prognosis yang lebih buruk. Penelitian ini dilakukan untuk mengetahui karakteristik kanker payudara usia muda di Sub Bagian Bedah Onkologi Rumah Sakit Umum Pusat Sanglah tahun 2014-2016 berdasarkan stadium, subtipe, dan jenis histopatologi.Metode: Penelitian ini merupakan penelitian deskriptif dengan desain cross sectional, yang datanya diperoleh dari data register pasien kanker payudara di RSUP Sanglah dan diolah menggunakan aplikasi SPSS.Hasil: Hasil penelitian menunjukkan, jumlah pasien kanker payudara usia muda (<40 tahun) adalah sekitar 72 orang (14%) dari total 514 pasien kanker payudara. Rentang usia muda terbanyak adalah pada rentang usia 35-39 tahun yaitu sekitar 34 orang (47.2%). Stadium kanker payudara usia muda terbanyak adalah stadium IIIB dan IV masing-masing sebesar 19 orang (26.4%). Jenis histopatologi kanker payudara usia muda terbanyak adalah karsinoma duktal invasif sebesar 61 orang (84.7%). Subtipe kanker payudara usia muda terbanyak adalah Luminal B sebesar 31 orang (43.1%).Simpulan: Karakteristik Kanker Payudara Usia Muda di Subbagian Bedah Onkologi Rumah Sakit Umum Pusat Sanglah cenderung mirip dengan penelitian-penelitian yang pernah dilakukan sebelumnya, meskipun beberapa variabel yang menunjukkan angka persentase yang berbeda dengan penelitian-penelitian sebelumnya.
Gambaran stadium dan jenis histopatologi kanker payudara di Subbagian Bedah Onkologi RSUP Sanglah Denpasar tahun 2015-2016 I Gde Made Satya Wangsa Satya Wangsa; I Wayan Niryana; Putu Anda Tusta Adiputra Anda Tusta Adiputra; Ni Putu Ayu Pande Arista Dewi
Intisari Sains Medis Vol. 9 No. 1 (2018): (Available online: 1 April 2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.336 KB) | DOI: 10.15562/ism.v9i1.165

Abstract

Latar Belakang: Kanker payudara merupakan suatu penyakit neoplasma yang ganas dimana pada jaringan parekim terdapat pertumbuhan jaringan payudara abnormal yang bersifat infiltratif dan desktruktif serta dapat bermetastase. Tingginya kasus kanker payudara di Indonesia, tidak selalu diikuti oleh penentuan stadium klinis dan histopatologi secara lengkap, padahal penentuan stadium klinis dan histopatologi diperlukan untuk menentukan diagnosis dan tata laksana lebih lanjut. Pengetahuan mengenai gambaran stadium dan jenis histopatologi juga menjadi salah satu indikator penting dalam penentuan prognosis kanker payudara.Metode: Penelitian ini merupakan penelitian deskriptif dengan pendekatan potong lintang (cross-sectional), yang datanya didapatkan dari data rekam medis di RSUP Sanglah dengan subjek penelitian pasien yang terdiagnosis kanker payudara pada tahun 2015-2016 kemudian diolah dan dianalisis dengan bantuan software SPSS.Hasil: Berdasarkan stadium, pasien kanker payudara dengan stadium EBC (Early Breast Cancer) sebanyak 30,08% dengan 2,95% pasien stadium I, 13,39% stadium IIA, 13,73% stadium IIB. Pasien terdiagnosis dengan stadium LABC (Locally Advance Breast Cancer) berjumlah 273 (47,47%) pasien dengan secara berturut-turut 14,78%, 30,95% dan 1,73% pasien stadium IIIA, IIIB dan IIIC. Pada penelitian ini juga tercatat sebanyak 129 (22,43%) pasien dengan kanker payudara yang sudah metastasis (stadium IV). Berdasarkan histopatologi, sebanyak 483 (84%) pasien dengan karsinoma duktal invasif, 61(10,60%) pasien dengan karsinoma lobular invasif, dan 31 (5,40%) pasien dengan karsinoma tipe lain.Simpulan: Hasil penelitian ini didapatkan bahwa pasien yang terdiagnosis kanker payudara di RSUP Sanglah pada tahun 2015-2016 sebanyak 575 pasien dengan stadium kanker payudara terbanyak adalah Locally Advance Breast Cancer (LABC) (Stadium IIIA, IIIB, IIIC) dengan jumlah 273 (47,47%) pasien. Jenis histopatologi kanker payudara terbanyak adalah karsinoma duktal invasif dengan jumlah 483 (84%) pasien.
Karakteristik Pasien Melanoma Maligna di Subbagian Bedah Onkologi RSUP Sanglah Tahun 2015-2016 Gusti Ngurah Agung Adi Paramartha; I Wayan Niryana; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (193.962 KB) | DOI: 10.15562/ism.v10i2.242

Abstract

Background: Malignant melanoma (MM) is one of the skin malignancies derived from melanocyte cells. It is the most common cause of death, about 75% of all cases of skin cancer. Skin cancer is ranked fourth among the ten most common tumors in Bali.Aim: To know the characteristics of malignant melanoma patients in the sub-section of surgical oncology Sanglah Hospital Year 2015-2016.Method: This study is cross-sectional descriptive research conducted at Sanglah General Hospital in Denpasar. The data obtained in the form of secondary data, patient medical records, as of 2015 till 2016. Data were analyzed using the SPSS program.Result and Conclusion: The results showed that of 11 patients, incidence with the highest proportion of patients with age range 45-59 years number of 4 people (36.3%). The most top gender was women of 6 (54.5%). The highest subtype of Nodular Melanoma (NM) was 7 (63.6%).
Faktor risiko yang mempengaruhi length of stay pasien kanker solid dengan febrile neutropenia pasca kemoterapi neoadjuvant/terapeutik di Ruang Isolasi RSUP Sanglah, Bali Ronald Natawidjaja; Ida Bagus Tjakra Wibawa Manuaba; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (354.727 KB) | DOI: 10.15562/ism.v10i1.367

Abstract

Background. Febrile neutropenia is a common complication in patient undergoing chemotherapy. Length Of Stay (LOS) is an important marker for disease severity and use of medical resources in febrile neutropenia. This study was done to find the risk factor affecting length of stay in solid cancer patients with febrile neutropenia post neoadjuvant/therapeutic chemotherapy.Method. This is a case control study without matching. Age ≥ 60 years, (Absolute Neutrofil Count) ANC level < 1,5 μL , comorbid,  Hb level <10 gr/dl, and albumin < 3 gr/dl, were related to LOS ( ≤ 5 days and > 5 days). Univariate (chi square) and multivariate (logistic regression) were used to analyse the statistic.Results. Forty six patients met inclusion-exclusion criteria were included in this study. ANC level in all patients were < 1,5 μL (100%). Hb level <10 gr/dl is statistically significant (P<0.05), whereas  age ≥ 60 years, and comorbid, albumin level < 3 gr/dl were not is statistically significant (P>0.05).Conclusion. Hb level < 10 gr/dl is the risk factor for LOS > 5 days in solid cancer patients with febrile neutropenia post neoadjuvant/therapeutic chemotherapy.
Co-Authors Agung Bagus S. Satyarsa and I. B. T. Wibawa-Manuaba Annisa Alviariza Aqilah, Nadya Zalfa Aryo Wibisono Ayu Nursantisuryani Jahya Ayu Sri Mahendra Dewi , I Gusti Chandrakirana, Anak Agung Ayu Hellin Desak Made Wihandani Dewa Putu Satria Juristiasa Dewi Prima Christian, Dewi Prima Gede Andry Nicolas Andry Nicolas Gusti Ngurah Agung Adi Paramartha Hendra P. Setiawan Hendra Sanjaya, I Gusti Putu Herman Saputra I Dewa Made Sukrama I G A Mirah K I G. P. Supadmanaba I Gde Made Satya Wangsa Satya Wangsa I Gusti Ayu M Prita Dewi I Gusti Ngurah Gde Dwi Aryanata I Ketut Wiargitha I Made Arya Winangun I Made Bagus Adhi Paramitha I Nengah Wiadnyana Steven Christian I W. Sudarsa I Wayan Niryana I. B. Tjakra Wibawa Manuaba Ida Bagus Yorky Brahmantya Inge Kurniawati Jasmine Stephanie Christian Jasmine Stephanie Christian K. Aditya Prayudi, Pande Kadek Santi Diahswari Widyadari Ketut Siki Kawiyana Made Agus Dwianthara Sueta Made Revina Chandradewi Manuaba, Ida Bagus Tjakra Wibawa Ni Gusti Ayu Agung Manik Yuniawaty Wetan Ni Ketut Hanny Puspita Ni Putu Ayu Pande Arista Dewi Ni Wayan Ariani Vitriasari Nirmala, Made Sinta Ayu Suci P. Setiawan, Hendra Pande K. Aditya Prayudi Permatasari, Yulan Putu Diahpradnya Oka Partini Putu Gupta Arya Gumilang Putu Hendra Sanjaya, I Gusti Reni Widyastuti Ronald Natawidjaja Roy R.H. Hamid, Agus Roy Rusly Hariantana Hamid, Agus Setiawan, I Gede Budhi Sri Mahendra Dewi, I Gusti Ayu Sri Maliawan Tham Hong Yuan Thomas Arie Satya Wardhana Trisye Septiawati W Steven Chr, W Steven Wetan, Ni Gusti Ayu Agung Manik Yuniawaty Widia Putri, Gracia Wisescistiati, Made Visvayoni Yulan Permatasari Yuniawaty Wetan, Ni Gusti Ayu Agung Manik Yusuf Alfi Mulia