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All Journal Medical Journal of Indonesia Majalah Obstetri dan Ginekologi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Ilmiah Kesehatan Jurnal Ilmiah Kebidanan Indonesia (Indonesian Midwifery Scientific Journal) Indonesian Journal of Cancer Makara Journal of Health Research
Gatot Purwoto
Devisi Onkologi, Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Indonesia - RSUPN Cipto Mangunkusumo, Fakultas Kedokteran, Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Correlation Between Chemotherapy-Induced Nausea and Vomiting with Quality of Life in Patients with Ovarian Cancer at Dr. Cipto Mangunkusumo Hospital Madjid, Veinardi; Calvin, David; Purwoto, Gatot; Utami, Tofan Widya; Anggraeni, Tricia Dewi; Vidiawati, Dhanasari; Winarto, Hariyono
Makara Journal of Health Research Vol. 28, No. 2
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: Nausea and vomiting (NV) remain as side effects of chemotherapy, which has a detrimental effect on patients’ quality of life (QOL) and treatment adherence. This study aimed to determine the effect of chemotherapy-induced NV (CINV) on the QOL of patients with ovarian cancer treated with chemotherapy at Dr. Cipto Mangunkusumo Hospital (CMH). Methods: We conducted a cross-sectional study in patients with ovarian cancer receiving first-line chemotherapy regimens of carboplatin and paclitaxel. The European Organisation for Research and Treatment helped translate the Quality-of-Life Questionnaire-OV28 (QLQ-OV28) into Indonesian and tested it in a preliminary study. The approved Indonesian version of the QLQ-OV28, with the Quality-of-Life Questionnaire-C30 (QLQ-C30), was then used to evaluate QOL before and 1 week after chemotherapy. Results: Several symptom scales increased, whereas function scales decreased. Moreover, 72.5% had an increase in the NV symptom scale, whereas 67.5% had a decrease in patients’ scale after chemotherapy. CINV had a significant partial effect on reducing QOL (p = 0.047 and y = 12.208–0.432). Conclusions: CINV has a significant influence on lowering the QOL of patients with ovarian cancer undergoing first-line chemotherapy regimens with carboplatin and paclitaxel in CMH.
The Age as a Risk Factor for Advanced Stage in Cervical Cancer Patients at RSUPN Cipto Mangunkusumo 2019-2022: A Retrospective Multivariate Study Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Purwoto, Gatot; Wulandari, Anisa Saphira; Soloan, Garry; Sini, Kieran Pasha Ivan; Utami, Tofan Widya; Anggaraeni, Tricia Dewi; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Winarto, Hariyono
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2366

Abstract

Abstract Introduction: In 2020, cervical cancer ranked as the fourth most common cancer in women globally, with an incidence of 604,000 cases. In Indonesia, cervical cancer holds the second position among the most prevalent cancers in women. This study aims to evaluate the relationship between age and the occurrence of advanced-stage cervical cancer as a step towards effective prevention, early detection, and management. Methods: This research adopts a retrospective study design based on the Cancer Registration database of RSUPN Cipto Mangunkusumo, focusing on cervical cancer patients from 2019 to 2022. Multivariate analysis was conducted with age as the primary independent variable, considering parity and employment status in the analysis. The FIGO classification of cervical cancer stages was used to categorize patients into early and advanced stages. Results: Out of 512 cervical cancer cases, 492 were included in this study. The distribution of cervical cancer stages and the age distribution of patients is depicted in Figure 1 and Figure 2. The analysis of the relationship between cervical cancer stage, age, parity, and employment status is presented in Table 2. The association between age and cervical cancer stage is statistically significant (p<0.05) with an odds ratio of 2.13, particularly in individuals aged >54 years. Conclusion: Age over 54 years is a significant risk factor for advanced-stage cervical cancer. Although there is no significant association with parity and employment history, these findings support preventive and early detection efforts in the older population. Increased screening programs and education are expected to reduce cases of advanced-stage cervical cancer in the future.
Conservative surgery for stage IC2 mucinous borderline ovarian tumor: a five-year follow-up case report Utami, Tofan Widya; Nasution, Hiro Hidaya Danial; Oktalia, Arisda; Kusuma, Fitriyadi; Purwoto, Gatot
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.257637

Abstract

Mucinous borderline ovarian tumors (MBOTs) represent a significant portion of all borderline ovarian tumors, including variants such as microinvasion and intraepithelial carcinoma, which have a higher recurrence risk. Conservative surgery is recommended for patients with MBOTs seeking fertility preservation, despite remaining a debated option to reduce recurrency. This case highlighted successful MBOT management using conservative surgery with unilateral salpingo-oophorectomy, providing insights into optimal recurrence control. A 30-year-old woman presented with abdominal enlargement, with imaging revealed a large right ovarian mass suspected to be malignant. A left salpingo-oophorectomy was performed, with final histopathology confirming MBOTs with microinvasion and intraepithelial carcinoma. No malignancy was found in the peritoneal fluid, and no adjuvant therapy was given due to fertility preservation reasons. No recurrence after 5 years of follow-up. This report highlights the potential of conservative surgery as a fertility-preserving option for young patients with stage IC2 MBOTs.
Prevalensi Infeksi Human Papilloma Virus Risiko Tinggi Pada Wanita dengan Positif Human Immunodeficiency Virus di Dunia: Tinjauan Sistematis Berdasarkan Studi Terkini Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Abdullah, Muhammad Raoul Taufiq; Fauzi, Ahmad; Ridwan, Alifaturrasyid Syafaatullah; Purwoto, Gatot; Winarto, Hariyono; Anggraeni, Tricia Dewi; Utami, Tofan Widya
Jurnal Ilmiah Kesehatan Vol 22 No 02 (2023): Jurnal Ilmiah Kesehatan terbitan Agustus Volume 22 Nomor 02 Tahun 2023
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikes.v22i02.2652

Abstract

Tipe Human Papilloma Virus (HPV) risiko tinggi merupakan etiologi dari kanker serviks yang menjadi kanker kedua terbesar pada wanita. Infeksi Human Immunodeficiency Virus (HIV) menjadi salah satu faktor risiko infeksi HPV. Pada pasien dengan HIV terjadi penurunan sistem imun yang dapat menyebabkan peningkatan risiko infeksi terlebih jika kadar CD4+ rendah. Untuk menelusuri seberapa banyak wanita dengan HIV yang terinfeksi virus HPV risiko tinggi pada berbagai penelitian terkini. Penelusuran dilakukan dengan metode systematic review menggunakan database Pubmed, Cochrane, dan ScienceDirect. Digunakan kata kunci “((HPV Positive) AND (HIV) AND (Cervical Cancer))”.Dalam systematic reviews ini, didapatkan hasil akhir 3 penelitian yang memenuhi kriteria inklusi. Di antaranya penelitian di Kenya tahun 2012 menunjukkan 52,6% dari 498 wanita dengan HIV terinfeksi HPV risiko tinggi, penelitian di Nigeria pada 2017 menunjukkan 29% dari 449 wanita dengan HIV terinfeksi HPV risiko tinggi dan juga terdapat hubungan signifikan antara HIV pada pasien wanita dengan infeksi HPV risiko tinggi dibandingkan dengan pasien wanita tanpa HIV dengan dengan OR 3,38 (95% CI 2,34–4,87, p < 0,001), dan penelitian di Nigeria tahun 2014 menunjukkan prevalensi HPV risiko tinggi lebih besar pada pasien dengan HIV positif (24,5%) dibandingkan HIV negatif (15,9%) secara bermakna (P<0,005; OR=1,7; 95% CI=1,1-2,7), serta terdapat penurunan dari prevalensi infeksi HPV risiko tinggi pada wanita dengan HIV positif apabila jumlah CD4 pasien lebih dari 500 sel/mm3 (OR = 0,7; 95% CI: 0,5-0,8). Prevalensi yang besar dan hubungan signifikan antara infeksi HPV risiko tinggi dengan HIV pada pasien wanita menunjukkan diperlukannya skrining HPV tipe risiko tinggi pada pasien wanita dengan HIV sebagai strategi pencegahan yang lebih awal terhadap kanker serviks dan dibutuhkan pemberian terapi yang rutin kepada wanita dengan HIV positif untuk memiliki angka CD4 >500 sel/mm3.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN TINGKAT KEHAMILAN PASIEN HIPERPLASIA DAN KANKER ENDOMETRIUM: TINJAUAN SISTEMATIS DAN META-ANALISIS Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Wulandari, Anisa Saphira; Binathara, Geraldus Sigap Gung; Soloan, Garry; Sini, Kieran Pasha Ivan; Purwoto, Gatot; Utami, Tofan Widya; Anggaraeni, Tricia Dewi; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Winarto, Hariyono
Jurnal Ilmiah Kesehatan Vol 23 No 03 (2024): Jurnal Ilmiah Kesehatan terbitan Desember Volume 23 Nomor 03 Tahun 2024
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikes.v23i03.3405

Abstract

Hiperplasia endometrium dan kanker endometrium adalah kondisi yang memengaruhi kesuburan wanita. Tujuan dari tinjauan sistematis dan meta-analisis ini adalah untuk mengevaluasi faktor-faktor yang berhubungan dengan tingkat kehamilan pada pasien dengan kondisi tersebut. Pencarian dilakukan di lima database utama: PubMed, Science Direct, Scopus, Embase, dan Cochrane Library. Dari 2.742 studi yang awalnya ditemukan, 7 studi memenuhi kriteria inklusi dan dianalisis lebih lanjut. Meta-analisis dilakukan untuk mengevaluasi efek terapi kombinasi Levonorgestrel-Releasing Intrauterine System (LNG-IUS) dengan progestin dan pengaruh indeks massa tubuh (BMI) terhadap tingkat kehamilan. Analisis gabungan dari dua studi yang membandingkan kombinasi LNG-IUS dengan progestin terhadap LNG-IUS saja menghasilkan Odds Ratio (OR) sebesar 1,54 [95% CI: 0,74–3,24], tanpa signifikansi statistik (p = 0,25). Untuk BMI, gabungan dua studi memberikan Risk Ratio (RR) sebesar 1,40 [95% CI: 0,93–2,10], juga tidak signifikan (p = 0,11). Heterogenitas yang rendah (I² = 0%) pada analisis terapi dan sedang (I² = 53%) pada analisis BMI menunjukkan konsistensi antarstudi. Meskipun ada tren peningkatan angka kehamilan dengan terapi kombinasi LNG-IUS dan progestin serta BMI ≥ 25, hasil meta-analisis ini belum menunjukkan signifikansi statistik. Penelitian lebih lanjut diperlukan untuk memperjelas faktor-faktor yang berhubungan dengan kehamilan pada pasien dengan hiperplasia dan kanker endometrium.
Estrogen receptor expression in type 1 endometrial cancer and its association with lymphovascular space invasion Fidiawati, Wiwit Ade; Andrijono; Siregar, Nurjati Chairani; Prihartono, Joedo; Purwoto, Gatot; Hellyanti, Tantri
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257842

Abstract

BACKGROUND Endometrial cancer (EC) ranks sixth in female genital malignancy and originates in the endometrial lining. Estrogen receptor (ER) expression is important in EC prognosis and recurrence, influenced by the presence of lymphovascular space invasion (LVSI). This study aimed to determine the association between ER expression and LVSI in type 1 EC. METHODS A retrospective analysis was conducted on 135 patients with type 1 EC who underwent surgery at the Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between January 2012 and December 2022. Immunohistochemistry (IHC) with ER antibodies was performed on all samples in April 2023. ER expression was evaluated using the Allred scoring system, and its association between ER expression (percentage and intensity stain) and LSVI was statistically analyzed. RESULTS Of 135 samples, 44 (32.6%) were LVSI-positive. No significant association was found between IHC percentage stain and LVSI (p = 0.994). However, a significant association was found between IHC stain intensity and LVSI-positive in patients with type 1 EC (p = 0.022). ER intensity score 2 had a higher LVSI risk compared to score 1 and score 3 (from 51%, 26%, and 26%, respectively). CONCLUSIONS ER expression is associated with LVSI of type 1 EC. While IHC stain percentage showed no correlation with LVSI, stain intensity was significantly linked to LVSI-positive in patients with type 1 EC. Regular assessment of ER expression can provide significant prognostic information, support hormonal therapy, and identifying clinical characteristics of tumors.
Comparison of USG and CT Scan Findings in Late Stage Ovarian Cancer in Dr. Cipto Mangunkusomo National Referral Hospital Sugianto, Sugianto; Purwoto, Gatot; Nuranna, Laila; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Shelly, Vannesa
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1369

Abstract

Background: Ovarian cancer remains a leading cause of gynecological cancer mortality due to its typically late-stage diagnosis. Current diagnostic methods include ultrasonography (USG) and computed tomography (CT), with CT generally favored for its higher sensitivity and specificity. However, CT's limited availability in resource-poor settings raises the need to assess USG’s diagnostic viability in detecting advanced ovarian malignancies. This study aims to compare the diagnostic accuracy of USG and CT in detecting adnexal masses, ascites, lymph node involvement, omental cake, and distant metastasis in advanced-stage ovarian cancer.Method: A cross-sectional comparative study was conducted at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from January 2021 to December 2023. The study included 70 patients with histologically confirmed advanced ovarian cancer (FIGO stages III and IV) who underwent both USG and CT before surgical intervention. Diagnostic performance measures, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated for each modality, using surgical findings as the gold standard. Statistical analysis was performed using SPSS software, with significance set at p 0.05.Results: Both imaging methods demonstrated high specificity (100%) and PPV for adnexal mass detection, indicating reliability in confirming positive cases. However, CT showed superior sensitivity and accuracy across most parameters, particularly for ascites (sensitivity: 93.94%), lymph node involvement (56%), and distant metastases (36.67%). In comparison, USG had lower sensitivity, especially for distant metastases (6.67%), but maintained high specificity. These findings suggest that while USG is effective for initial assessment, CT is preferred for detailed staging.Conclusion: This study confirms CT’s superiority over USG in comprehensive ovarian cancer staging, particularly for detecting metastatic indicators. However, USG’s accessibility and affordability support its role as an initial diagnostic tool, especially in resource-limited settings. A multimodal approach, integrating USG for preliminary screening with CT for confirmation, may optimize diagnostic outcomes. Further research should focus on enhancing USG’s sensitivity to bridge the diagnostic gap in underserved regions.
Age at Sexual Debut as a Determinant of HPV Infection in Women with Clinically Normal Cervix in Indonesia Utami, Tofan Widya; Nuranna, Laila; Purwoto, Gatot; Indarti, Junita; Firdaus, Najmarani Devi; Oktalia, Arisda; Sulastri, Nuni; Kekalih, Aria
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 1 January 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i1.2745

Abstract

Objectives: This study examined the association between sexual debut and HPV infection in Indonesian women with a clinically normal cervix, contextualized within the Sustainable Development Goals (SDGs). Methods: This prospective cohort study utilized primary data from structured interviews and gynecological exams conducted by the Female Cancer Program (FCP) team across public and private health providers in Jakarta (January 2012–July 2018). Cervical cancer risk factors, including early sexual debut, were analyzed using odds ratios (ORs). Results: A total of 1,390 women with a clinically normal cervix were enrolled in this study, with 52 (3.7%) testing positive for HPV-DNA. Statistical analysis indicated an odds ratio (OR) of 1.176 (95% CI: 0.598–2.316, p = 0.601) for early sexual debut. Conclusion: This study showed that there was an insignificant association between sexual debut and HPV infection in clinically normal cervix. According to the SDGs, early sexual debut and cervical cancer are highly associated. In order to meet the SDGs by 2030, more research is required to validate this finding and assess additional co-factors connected to cervical cancer.
Co-Authors Abdullah, Muhammad Raoul Taufiq Alexander AW Peters Alexander AW Peters Alfu Nikmatul Laily Andi Darma Putra Andrijono Andrijono Andrijono Andrijono Anggaraeni, Tricia Dewi Aria Kekalih Binathara, Geraldus Sigap Gung Calvin, David Dhanasari Vidiawati Eka R Gunardi Faisha Rahma, Melly Fauzi Ahmad Muda Fera Ibrahim Firdaus, Najmarani Devi Fitriyadi Kusuma Gert J Fleuren Hariyono Winarto Hellyanti, Tantri Heru Prasetyo Joedo Prihartono Junita Indarti Kartiwa H Nuryanto Kartiwa Hadi Nuryanto Laila Nuranna Laila Nuranna Laila Nuranna Laila Nuranna Laila Nuranna Lestari, Linda Lex Peters Madjid, Veinardi Muhammad F Aziz Muhammad F Aziz Nasution, Hiro Hidaya Danial Nessyah Fatahan Nurjati Chairani Siregar Oktalia, Arisda Oni Khonsa Purnomo Hyaswicaksono Putra, Abdul Hafiidh Surya Renny Surya Wardany Ridwan, Alifaturrasyid Syafaatullah Rizky Humairah , Inas Sahat B. Matondang Shelly, Vannesa Sigit Purbadi Sini, Kieran Pasha Ivan Soloan, Garry Sugianto Sugianto Sulaeman Daud Sulastri, Nuni Suryoadji, Kemal Akbar Tiffani, Wely L Tofan W Utami Tofan W Utami Tofan W. Utami Tricia Dewi Anggraeni Utami, Tofan Widya Vivian Spaans Widya Utami, Tofan Wiwit Ade Fidiawati Wulandari, Anisa Saphira