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

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IS INFLAMMATION AN AGE-RELATED CAUSE OF BPH PROGRESSION Herman, Hendra; Hamid, Agus Rizal AH; Mochtar, Chaidir Arif
Indonesian Journal of Urology Vol 18 No 1 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i1.78

Abstract

Objective: To find the role of inflammation in BPH progression represented by prostate enlargement compared between age group. Material & method: Tissue samples of BPH were collected from biopsy, transurethral resection or open surgery. Clinical information was collected including such as patient age, prostate volume, serum prostate specific antigen (PSA) and history of retention before procedure. Patients were divided into three groups, below 63 years old (young adult), 63 - 69 years old (older adult) and equal or above 70 years old (elderly). The samples were analyzed to define the microscopic structure of the hyperplasia (stromal or glandular) and to detect prostatic intraepithelial neoplasia, atypical stromal acinic proliferation, atypical acinar hyperplasia or prostate cancer. Prostate cancer was excluded from study samples. Grade of inflammation was determined by a pathologist depending on number of inflammatory cells. Grade of inflammation was classified in two groups, with mild inflammation or moderate-to-severe inflammation. Results: A total of 1189 patients were reviewed, 1172 were diagnosed with BPH. There were 381 patients (32,5%) with age below 63 years old (young adult), 380 (32,4%) between 63-69 years old (older adult) and 411 (35,1%) in equal or above 70 years old (elderly). In young-adult group, median of prostate volume between mild and moderate to severe inflammations was 42,56 and 45,75 (p = 0,500), for older adult group median was 45,00 and 51,00 (p = 0,038), for elderly group median was 49,00 and 51,98 (p = 0,621). Conclusion: Inflammation has a role in progression of prostate enlargement especially for the older adult group. Keywords: inflammation in BPH progression, prostate volume, age, PSA.
Laparoscopic Live Donor Nephrectomy: Comparison of Left-sided and Right-sided Approach in Our First 50 Cases Marcelino, Albertus; Mochtar, Chaidir Arif; Wahyudi, Irfan; Baskoro, Bagus; Rodjani, Arry; Rasyid, Nur
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.89

Abstract

Objectives: To compare the operative results and outcomes between right and left laparoscopic live donor nephrectomy (LLDN). Methods: We retrospectively analyzed the first 50 consecutive LLDN in Indonesia performed between November 2011 and February 2013. Of these patients, 6 underwent right LLDNs and 44 left LLDNs. All patients underwent LLDNs in Cipto Mangunkusumo Hospital. All LLDNs were done by the same surgical teams. Intraoperative, post-operative donor and recipient data results were compared.Results: There were no significant differences of intraoperative, post-operative and recipient data results in both groups.  The first warm ischemic time (mean±SD, 6min 55sec±145sec vs 7min 37sec±177 sec, p>0.05), the second warm ischemic time (41min 35sec ± 7min 45sec vs 48min 36sec ± 8min 41sec, p>0.05), and the operative time (4hour 41min ± 31min vs 4hour 32min ± 49 min, p>0.05) showed similar results in the right and left LLDN, respectively. Active mobilization on 72-hour post-operation was found in 83,3% in the right LLDN compared to 95,5% (p>0.05). There were no delayed graft function and post-operative hemodialysis within one week in the recipients of right LLDN group. Conclusion: Right LLDN has equal operative results and outcomes compared to left LLDN. Right-sided LLDN may be a judicious approach for donors with unfavorable characteristics of the left kidney.
UROLOGY RETROPERITONEOSCOPY: INITIAL EXPERIENCE IN CIPTO MANGUNKUSUMO HOSPITAL Siregar, Ginanda Putra; Wahyudi, Irfan; Mochtar, Chaidir Arif; Hamid, Agus Rizal Ardy Hariandy
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.178

Abstract

Objective: This study was conducted to evaluate the initial experience of retroperitoneoscopy surgery. Material & method: This is a descriptive study with cross-sectional design. Data was collected from medical records of Urology Department in Cipto Mangunkusumo General Hospital Jakarta, from March 2013 until February 2014. Subjects were all patients who performed retroperitoneoscopic surgery between the time periods. Results: Patients consisted of 9 males (42.85%) and 11 females (57.14%). Mean age was 38.95 + 21.88 years old. Proportion based on diagnosis were 5 renal failures (23.8%), 5 ureteral stones (23.8%), 3 renal cysts (14.3%), 2 PUJOs (9.5%), double 3 collecting systems (14.3%), 1 tumor (4.8%), 1 ureteral tumor (4.8%), and 1 renal diverticle (4.8%). Proportion based on kind of retroperitoneoscopy were ureterolithotomy (23.8%), nephrectomy 3 (14.3%), nephroureterectomy 3 (14.3%), renal cyst unroofing 3 (14.3%), heminephrectomy 3 (14.3%), pyeloplasty 2 (9.5%), partial nephrectomy 1 (4.8%), and diverticle coagulation 1 (4.8%). Mean operating time was 178.81 + 55.72 minutes with mean length hospitalization 8.05 + 4.4 days. Mean amount of bleeding was 98 + 69.47 cc, wound operation infection 0 (0%), peritoneal perforation 1 (4.76%), open surgery conversion 2 (9.52%), and transperitoneal laparoscopy conversion 1 (4.76%). Conclusion: In this study, total number of retroperitoneoscopy surgery cases still less than others abroad. Demographic characteristic showed variety than other study. Compared to other studies, the operating time was comparable but the length of stay was longer. We had higher open surgery conversion rate, while another complication was relatively the same.
EXTRAPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMY: INITIAL EXPERIENCE AND LEARNING CURVE OF A VERY LOW VOLUME CENTER Yunir, Peri Eriad; Hamid, Agus Rizal AH; Umbas, Rainy; Mochtar, Chaidir Arif
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.319

Abstract

Objective: This study is aimed to report and evaluate the experience and learning curve of extraperitoneal Laparoscopic Radical Prostatectomy (LRP) performed in Cipto Mangunkusumo General Hospital Jakarta. Material & method: We collected all data of patients that had been performed extraperitoneal LRP from June 2013 until February 2016, retrospectively. We divided those data into 3 groups with equal number in each group. We compared the preoperative (age, prostate volume, PSA level and prostate cancer staging), intraoperative (surgery time, total blood loss, conversion to open surgery and other organ injury), and postoperative (postoperative length of stay) variables between those 3 groups using ANOVA and Kruskal-Wallis test. Results: We performed 15 extraperitoneal LRP from June 2013 until February 2016 with patient’s mean age was 64.40 (SD ± 5.30) years old and mean prostate volume was 42.39 (SD ± 29.21). In this study, we found significant differences in surgery time, total blood loss, and postoperative length of stay (LOS) in all group with decrease on each intraoperative and postoperative variables. We also found no conversion to open surgery or other organ injury in all patients. Conclusion: The increase of surgeon’s experience and the number of surgery, and the consistency undergo the procedure of LRP demonstrate a decrease in surgery time, intraoperative blood loss and LOS in LRP patients.
ROLE OF MAGNETIC RESONANCE IMAGING IN NODAL AND METASTATIC STAGING OF PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS Hafizar; Rahman, Fakhri; Rumanter, Rainier; Hamid, Agus Rizal Ardy Hariandy; Mochtar, Chaidir Arif; Umbas, Rainy; Matondang, Sahat BRE
Indonesian Journal of Urology Vol 29 No 1 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i1.733

Abstract

Objective: To evaluate the usage of MRI in prostate cancer staging, especially in nodal involvement (N-staging) and metastasis (M-staging) of prostate cancer. Methods: This is a systematic review and meta-analysis assessing role of MRI in nodal and metastasis staging of prostate cancer. Search of studies were done through search engine using Pubmed, Cochrane, and EBSCO Host and manual searching. Quality of eligible studies were assessed using a revised version of Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and analyzed in pooled analysis according to nodal involvement or metastasis staging, modality of diagnosis used as the index test and gold standard used using STATA version 13. Results: Total 26 studies corresponding with study’s eligibility criteria were found. Overall, usage of MRI has a sensitivity of 47% (95% CI 35% - 60%; I2 83.08%) and a specificity of 93% (95% CI 89% - 96%, I2 82.21%) in nodal involvement staging of prostate cancer, while using of MRI in M-staging of prostate cancer shows a sensitivity of 94% (95% CI 86% - 97%) and a specificity of 99% (95% CI 97% - 99%). Using lymphotrophic superparamagnetic nanoparticle (LSN) - enhanced MRI gives higher sensitivity than using MRI without LSN for N-staging of prostate cancer. Conclusion: The usage of MRI in prostate cancer staging has a moderate sensitivity and relatively high specificity in detecting lymph node. Moreover, it plays an important role and even can be used as a modality of choice in assisting bone metastatic prostate cancer detection.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.262 KB) | DOI: 10.33371/ijoc.v13i3.656

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (899.73 KB) | DOI: 10.33371/ijoc.v5i3.151

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (202.65 KB) | DOI: 10.33371/ijoc.v5i4.202

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.538 KB) | DOI: 10.33371/ijoc.v5i4.181

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (83.057 KB) | DOI: 10.33371/ijoc.v5i3.154

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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.
Co-Authors Agus Rizal AH Hamid Agus Rizal AH Hamid Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Agus Rizal Hamid Albertus Marcelino Arry Rodjani Bagus Baskoro 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 Matondang, Sahat BRE Moamar Andar Roamare Siregar Mohammad Johan Muhammad Firman Nur Rasyid 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