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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Indonesian Journal of Cancer Indonesian Journal of Cancer

Chaidir Arif Mochtar

Department Of Urology, Cipto Mangunkusumo Hospital - Faculty Of Medicine, Universitas Indonesia, Jakarta

Author-ID : 321027

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Articles

Title

R.E.N.A.L. Nephrometry Score Profile of Kidney Cancer Patients in Cipto Mangunkusumo Hospital Rinto Hariwibowo; Agus Rizal AH Hamid; Chaidir Arif Mochtar
Indonesian Journal of Cancer Vol 13, No 3 (2019): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: The variation of sizes, shapes, and location of kidney cancer complicates the choices of surgical treatment.To determine which technique to use, R.E.N.A.L. nephrometry scoring systems were established. This study was conducted to evaluate R.E.N.A.L.-NS profile in kidney cancer patients at CMHMethod: The data were collected retrospectively from patients that underwent both open and laparoscopic Radical (RN) and Partial Nephrectomy (PN) procedure from 2014-2017. R.E.N.A.L.-NS was calculated based on (R)adius, (E)xophytic/ Endophytic properties, (N)earness to the collecting system, (A)nterior or Posterior position of the tumor, and (L)ocation of the tumor. It was categorized into three complexity: low (4-6 points), medium (7-9 points), and high (10-12 points). Subjects then divided based on the procedure given. Profile of R.E.N.A.L.-NS was shown based on each procedure.Result: In this study, 63 patients were included. 52 underwent RN and 11 underwent PN. In low complexity tumors, all patients received PN. In medium complexity tumors, 22 (78.5%) patients received RN and 6 (21.5%) received PN. All high complexity tumors received RN. Mean renal score in all patient 9.03 (+1.72), RN 9.59 (+1.11), PN 6.36 (+1.6). Higher (R), (N), and (L) scores mean a higher prevalence of RN.Conclusion: Higher complexity tumors were more likely to be treated with RN. Furthermore, (R), (N), and (L) score can be useful to determine RN or PN as a treatment of choice. This study could be used as a reference to another study regarding R.E.N.A.L.-NS in Indonesia.

Terapi Sistemik Terkini pada Karsinoma Sel Ginjal Metastatik Dodi Hami Seno; Chaidir Arif Mochtar; Rainy Umbas
Indonesian Journal of Cancer Vol 5, No 3 (2011): Jul - Sep 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Kurang lebih sepertiga pasien dengan karsinoma sel ginjal (KSG) telah mengalami metastasis pada saat pertama kali didiagnosis dan 40-50% akan mengalami metastasis jauh setelah diagnosis awal. Karsinoma sel ginjal resistan terhadap sebagian besar kemoterapi dan obat sitotoksik konvensional. Namun demikian, selama beberapa tahun terakhir pengobatan kanker ini menunjukkan kemajuan yang spektakuler karena berkembangnyatargeted therapybagi karsinoma sel ginjal metastatik (KSGm). Tujuan dari penulisan makalah ini adalah untuk menelaah tata laksana terkini KSGm. Hingga saat ini, terdapat enam obat yang telah disetujui oleh FDA dan beberapa asosiasi urologi internasional untuk digunakan sebagai terapi KSGm lini pertama dan kedua. Lini pertama terdiri dari sunitinib (progression-free survival, PFS, 11 bulan dibandingkan dengan 5 bulan pada IFN-?, danoverall survival, OS, 26,4 bulan dibandingkan dengan 21,8 bulan pada IFN-?), kombinasi bevacizumab dan IFN-? (PFS 10,2 bulan dibandingkan dengan 5,4 bulan pada kombinasi plasebo dan IFN-?, OS 23,3 bulan dibandingkan dengan 21,3 bulan pada kombinasi plasebo dan IFN- ?), pazopanib (PFS 9,2 bulan dibandingkan dengan 4,2 bulan pada plasebo), serta temsirolimus (OS 10,9 bulan dibandingkan dengan 7,3 bulan pada IFN-?), sedangkan lini kedua terdiri dari sorafenib (PFS 5,5 bulan dibandingkan dengan 2,8 bulan pada plasebo) dan everolimus (PFS 4,0 bulan dibandingkan dengan 1,9 bulan pada plasebo).Katakunci: Karsinoma sel ginjal metastatik terapi target, terapi sistemik

Luaran Klinis Orkhidektomi Bilateral pada Kanker Prostat Metastasis: Pengalaman Indonesia Syarif Bakri; Rainy Umbas; Chaidir Arif Mochtar
Indonesian Journal of Cancer Vol 5, No 4 (2011): Oct - Dec 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Kanker prostat merupakan kanker yang lebih banyak ditemukan di negara Barat dibandingkan Asia. Berbagai faktor prognostik telah diteliti untuk memprediksi angka kesintasan pasien yang diterapi hormonal. Pada penelitian ini dievaluasi peranan usia, PSA, jumlah lesi metastasis, skor Karnofsky, hemoglobin, dan kreatinin sebagai faktor prognostik untuk menilai angka kesintasan pada kanker prostat metastasis di Indonesia yang dilakukan kastrasi dengan orkhidektomi. Penelitian dilakukan secara retrospektif dengan mengumpulkan data rekam medik penderita kanker prostat dengan metastasis yang dilakukan orkhidektomi subkapsular dan belum mengalamihormone resistance prostate cancer(HRPC) di Klinik Khusus Urologi RSCM dan RS Kanker Dharmais Jakarta, periode Januari 1995- Desember 2008 denganfollow-up24 bulan. Selama periode penelitian, terdapat 194 pasien yang memenuhi kriteria dan 99 pasien di antaranya memiliki data lengkap untuk dianalisis. Dari analisis multivariat didapat kekuatan hubungan dari yang terbesar sampai yang terkecil, yaitu jumlah lesi (HR=8,56), kreatinin (HR=3,24), hemoglobin (HR=0,94), dan skor Karnofsky (HR=0,28). Disimpulkan bahwa jumlah lesi dan kreatinin secara statistik signifikan mempengaruhi kesintasan.Kata kunci: jumlah lesi, kanker prostat, kesintasan, kreatinin, metastasis

Evaluasi Hasil Onkologi Radikal Retropubik Prostatektomi Johan -; Chaidir Arif Mochtar; Rainy Umbas
Indonesian Journal of Cancer Vol 5, No 4 (2011): Oct - Dec 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Penelitian ini bertujuan melaporkan hasil Retropubik Radikal Prostatektomi (RRP) oleh Tim Urologi FKUI/RSCM, mengevaluasi hasil onkologi pasca-operasi, serta menganalisis hubungan antara data klinis sebelum operasi dan data onkologi setelah operasi denganbiochemical failuresatu tahun pasca-RRP.Materi dan metode: antara Januari 1995 sampai Juli 2009 dikumpulkan 41 pasien pasca-RRP yang telah memenuhi kriteria inklusi. Data pre-operasi meliputi: usia pasien,Prostate Specific Antigen(PSA) pre-operasi, volume prostat,stagingtumor secara klinis,Gleason Score(GS), dan riwayatTrans Urethral Resection of Prostate(TURP) pre-operasi. Data pasca-operasi meliputi: lama pemasangan kateter, lama rawat pasca-operasi, hasil onkologi pasca-operasi (invasi vesikula seminalis, batas sayatan,stagingtumor, keterlibatan kelenjar getah bening pasca-RRP menurut klasifikasi TNM 2002, danGleason Scorepasca-RRP), migrasi staging, migrasiGleason Scoredanbiochemical failuresatu tahun pasca- RRP. Dilakukan analisis hubungan antara data pre-operasi dan data onkologi terhadapbiochemical failuresatu tahun pasca-RRP.Hasil: rerata usia pasien adalah 62,44 tahun; rerata volume prostat 41,16 cc; median PSA pre-operasi 15,9 ng/ml; 61% cT1 dan 39% cT2 atau lebih. Setelah dilakukan RRP, pasien denganstagingklinis cT1 dan cT2 didapatkan 45% memilikistagingpatologis ? pT3.Kesimpulan: dari data onkologi pasca-operasi kita dapat memprediksi kemungkinan akan terjadinyabiochemical failurepada tahun pertama pasca-RRP, namun dari data pre-operasi kita belum bisa memprediksi kemungkinan tersebut.Kata kunci: radikal retropubik prostatektomi,oncologycal result,biochemical failure

Terapi Hormonal Primer pada Penderita Kanker Prostat: Evaluasi Survival dan Faktor Prediksinya Johan -; Chaidir Arif Mochtar; Rainy Umbas
Indonesian Journal of Cancer Vol 5, No 3 (2011): Jul - Sep 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Tujuan: Mengevaluasi efektivitas terapi hormonal secaraorchidectomydan medikamentosa sebagai pengobatan primer pada penderita kanker prostat dan faktor prediksi terhadapsurvivalkedua modalitas pengobatan tersebut.Materi dan metode: Kami mengumpulkan seluruh data penderita kanker prostat yang mendapatkan terapi hormonal primer, baik berupaorchidectomybilateral maupun medikamentosa di RSCM dan RSKD periode Januari 1995Desember 2008.Follow upterakhir sampai Juni 2010. Data pra-terapi seperti usia,stagingklinik, volume prostat, PSA,gradingtumor dari WHO, serta metastasis tulang dianalisis sebagai faktor prediksi 5 tahunsurvival.Hasil: dalam periode empat belas tahun terdapat 693 penderita kanker prostat di RSCM dan RSKD. Sebanyak 465 di antaranya mendapatkan terapi hormonal primer, yang selanjutnya dibagi 2 kelompok, yaitu kelompokorchidectomydan medikamentosa yang berjumlah masing-masing 251 dan 214 penderita. Angkasurvivallima tahun secara keseluruhan adalah 51%, sedangkan pada kelompokorchidectomydan medikamentosa masing-masing adalah 53,6% dan 48,7% (p=0,481). Faktor prediksisurvival5 tahun tidak ada yang bermakna pada kelompokorchidectomy, sedangkan pada kelompok medikamentosa PSA<20 dangradingtumor ? 2 memiliki angkasurvival5 tahun lebih baik secara bermakna.Kesimpulan: angkasurvivallima tahun pada kelompokorchidectomydan hormonal medikamentosa secara statistik tidak ada perbedaan yang bermakna. Pada kelompokorchidectomy, tidak ada parameter yang berhubungan secara bermakna dengan 5 tahunsurvival, sedangkan pada kelompok hormonal medikamentosa PSA saat diagnosis <20 ng/mL ataugradingtumor ? 2 akan mempunyaisurvival5 tahun lebih baik.Katakunci:orchidectomy, hormonal medikamentosa,survivallima tahun, PSA, tumorgrading.

Profile of Radiation Therapy after Radical Prostatectomy: Experience in a Tertiary Hospital in Jakarta, Indonesia Rama Firmanto; Agus Rizal AH Hamid; Chaidir Arif Mochtar; Rainy Umbas
Indonesian Journal of Cancer Vol 14, No 1 (2020): March
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Despite the high recurrence rate, radical prostatectomy (RP) remains as a preferable surgical treatment of localized prostate cancer. Adjuvant radiotherapy (ART) and salvage radiotherapy (SRT) are available approaches in preventing biochemical progression after RP. We aim to investigate the use of radiotherapy, both ART and SRT, in those who underwent RP.Methods: We used a retrospective cohort study design, with samples recruited from prostate cancer patients who underwent RP between January 2008 and December 2016. Patients who had undergone RP at Cipto Mangunkusumo Hospital, Jakarta, Indonesia were included in the present study. More in detail, three and five subjects were treated with ART and SRT, respectively. We only included those who had a minimum of one year of follow-up. Variables including age, preoperative prostate-specific antigen (PSA), clinical staging, pathological staging, Gleason score, and death were recorded. We analyzed the overall survival time using the Kaplan-Meier method.Results: From 34 patients included in the study, 26 underwent RP alone, while 5 patients underwent adjuvant radiotherapy and 3 patients underwent salvage radiotherapy after RP. The mean ages in the three groups were 61.46 ± 5.76, 58.2 ± 4.86 and 62.67 ± 7.5, respectively. The preoperative PSA value was above 10 mg/dL in 61.5% in patients without RT, 100% in patients with ART after RP, and none in SRT. 17 (51.5%) out of 33 subjects were ≥T2 clinical stage and 24/30 (80%) subjects were ≥pT2. Timing for ART and SRT ranged from 1.07 to 6.3 and 5.27 to 21.43 months after RP, respectively. The 10-year survival rates were 84.6% in patients with RP alone, 80% in patients with ART+RP, and 66.7% in patients with SRT+RP. The average survivals of those who had RP alone as well as ART and SRT were 44.56 ± 32.64, 46.79 ± 24.02, and 71.71 ± 38.74 months.Conclusions: The average survival of those who received SRT is better than those who underwent ART and RP alone. Prospective studies with larger samples are needed to evaluate the efficacy of radiation therapy after radical prostatectomy.

Comparison Study Between Laparoscopic Radical Prostatectomy versus Robotic Radical Prostatectomy in Patient with TUR-P History Moamar Andar Roamare Siregar; Chaidir Arif Mochtar; Rainy Umbas; Agus Rizal Hamid
Indonesian Journal of Cancer Vol 13, No 4 (2019): December
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: The number of men with benign prostate hyperplasia undergoing transurethral resection of prostate (TURP) with the subsequent development of prostate cancer has been increasing. This study aimed to compare the surgical, oncological, and functional outcomes of robotic and laparoscopic radical prostatectomy techniques in patients with the history of TURP.Methods: Literature search of electronic databases was performed through Pubmed, Science Direct, SCOPUS, and CENTRAL databases. Cochrane Risk of Bias Tool was then employed to assess the risk of bias in each study. Grey literature was also searched from sources such as Cancer Care Ontario and conference abstracts. Critical appraisals of included studies were conducted using the Newcastle-Ottawa Scale.Results: The searches located 1258 citations, but only 11 studies were included in the final selection. Most studies had a good methodological quality based on the Ottawa Scale. The mean age of samples was varied among each study from 61.8 to 70.8 years. The TURP history significantly affects biochemical recurrences (OR 2.29, 95% CI 1.14–4.59), intraoperative blood loss (MD 57 ml; 95% CI 6–108 m), prolonged operative duration (MD 20 minutes; 95% CI 3–37 minutes), and surgical complications (OR 2.54, 95% CI 1.79–3.60) following radical prostatectomy for prostate cancer. In the subgroup analysis, only prolonged operative duration and surgical complications were significant both in laparoscopic and robotic radical prostatectomy. There was no association between the TURP history and the positive surgical margin rate in total and subgroup analyses. Conclusions: The previous TURP history affects the outcomes of patients who underwent radical prostatectomy, either laparoscopic or robotic.

The Pattern of Prostate Cancer Screening and Diagnosis among Indonesian Urologists: A Questionnaire Survey Muhammad Firman; Fakhri Rahman; Agus Rizal Ardy Hariandy Hamid; Chaidir Arif Mochtar
Indonesian Journal of Cancer Vol 17, No 2 (2023): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i2.970

Background: Prostate cancer (PCa) screening and diagnosis are mandatory to deliver optimal management in the early phase. Even though it has been discussed in many guidelines, the implementation of PCa screening and diagnosis in Indonesia remains unknown. This study aims to evaluate the pattern of PCa screening and diagnosis among Indonesian urologists and their adherence to guidelines. Methods: This cross-sectional study was conducted between February and July 2019. Respondents were Indonesian urologists registered as members of the Indonesian Urological Association (IUA) and had already practiced for at least six months. Data were collected using questionnaires, which were distributed at a national urology symposium and electronically via Google Form. Data were presented descriptively, and all data were processed using SPSS version 23. Results: Of 458 urologists, 195 (42.6%) gave full responses. Most of the respondents, 181 (92.8%) urologists, used the IUA guidelines. Among the 103 (52.8%) respondents who performed screening, nearly half (42.7%) agreed to screen patients aged ≥ 50 years or ≥ 45 years with a family history of PCa. Moreover, 76.8% would repeat screening annually, and 35.6% would stop when the patient’s age reached 70 years old. Digital rectal examination (DRE) was frequently performed for screening (74.5%), while prostate-specific antigen (PSA) tests were only performed in 52.3% of cases. The PSA test was available in 74.8% of hospitals. Transurethral resection of the prostate (TURP) was still used by 67.2% of respondents for diagnosis. Only 52.3 % of participants used transrectal prostate biopsy for diagnosis, using anesthesia (78.1%) during the procedure, and increased PSA level (98%) as its indication. However, Transrectal Ultrasound (TRUS) was only available in 49% of hospitals. This study found that Indonesian urologist adherence level toward guidelines was 63.3% (9–100%). Conclusions: PCa screening and diagnosis are still varied among Indonesian urologists, which might arise due to the different availability of diagnostic modalities.

Co-Authors Agus Rizal AH Hamid Agus Rizal AH Hamid Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Agus Rizal Hamid Albertus Marcelino Aria Kekalih Arry Rodjani Asmarinah Bagus Baskoro Bethy Suryawathy Hernowo Dodi Hami Seno Dodi Hami Seno, Dodi Hami Fakhri Rahman Fakhri Rahman, Fakhri Ginanda Putra Siregar, Ginanda Putra Hafizar Harina Rahardjo, Harina Irfan Wahyudi Johan - Johan -, Johan Lisnawati Matondang, Sahat BRE Meilania Saraswati Moamar Andar Roamare Siregar Mohammad Johan Muhammad Firman Nur Rasyid Rahadiani, Nur Rahmat Santoso, Rahmat Rainy Umbas Rainy Umbas Rainy Umbas Rainy Umbas Rama Firmanto Richard Arie Monoarfa Rinto Hariwibowo Rumanter, Rainier Syarif Bakri Syarif Bakri, Syarif Yunir, Peri Eriad

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