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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Sigit Purbadi
Faculty of Medicine University of Indonesia/ Dr. Cipto Mangunkusumo General Hospital Jakarta
Health Professions Medicine & Pharmacology Public Health

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Recurrence-Free Survival Stage IB1-IIA2 Intermediate Risk Group (Based on Kartu Delgado) Cervical Carcinoma after Radical Surgery and Adjuvant Radiotherapy: Kesintasan Bebas Kekambuhan Kelompok Risiko Menengah Berdasarkan Kartu Delgado pada Kanker Serviks Stadium IB1-IIA2 Pascaoperasi Radikal dan Radioterapi Ajuvan Andi Friadi; Sigit Purbadi; Budiningsih Siregar; Bambang Sutrisna
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.542 KB) | DOI: 10.32771/inajog.v2i3.397

Abstract

Objective: To evaluate the benefits of adjuvant radiotherapy (ART) based on Kartu Delgado (simple form of Gynecologic Oncology Group (GOG) scoring system) aimed at women with early stage cervical cancer after radical surgery. Method: Fifty patients were enrolled for this study. Twenty one patients from 2011-2012 were given ART following surgery based on their Kartu Delgado score from as follows: score <120 were designated for observation; score >120 were given ART. Their score and recurrence were compared with 29 patients who were treated in 2009-2010 (based on single prognostic factor). Result: We observed eighteen recurrences for the duration this study. Thirteen patients from the period of 2009-2010 and five patients from the period of 2011-2012. Most recurrences occurred in patients from 2009-2010 with score > 120 but were not designated ART. Two-years recurrence-free survival (RFS) for subjects with score <120 who were designated observation was 76.23% while for score >120 with ART was 64.29%. Conclusion: Adjuvant radiotherapy given based on Kartu Delgado reduced the number of recurrences in women with stage IB-IIA cervical cancer after treated by surgery. Keywords: cervical carcinoma, intermediate risk, prognostic factor, radical hysterectomy
Uterine Perforation on Invasive Hydatidiform Mole during EMACO Treatment: Perforasi Uterus pada Mola Hidatidosa Invasif saat Tatalaksana EMACO Bram Pradipta; Andrijono Andrijono; Sigit Purbadi; Tofan W Utami
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (213.341 KB) | DOI: 10.32771/inajog.v2i3.400

Abstract

Objective: Improving skill and knowledge to recognize and manage a rare case of uterine perforation on invasive hydatidiform mole. Method: Case report. Result: A 42 years old Indonesian woman, Parity 2 Abortus 2 with history of 2 c-sections and 2 curettage, came with chief complaint of recurrent vaginal bleeding since 4 months before admission. Patient had a history of previous curettage with indication of hydatidiform mole and recurrent bleeding with no histopathology results. On examination we found a vesicular mass with infiltration, destroying the right-front uterine corpus, size 8x6 cm with an internal echo mass. Chest x-ray showed multiple nodules in the lung. The patient, considered as low risk Gestational Trophoblastic Neoplasia patient with FIGO Score of 6, underwent chemotherapy with 2 series of methotrexate . Due to the non-declining level of -hCG, the regimen was added with EMACO. In the process of chemotherapy, the pa-tient’s-hCG declined but then she complained of major abdominal pain. Exploratory laparotomy was performed and we found a mass sized 5x5x5 cm on the right side of the uterus at the broad ligament with a rupture at the posterior part of the mass sized 0.5x0.5 cm. Upon incision of the uterus, we found a mass from the right side protruding to the isthmus of the uterus. Histopathology showed necrosis, blood and chorionic villi in myometrium corresponding to invasive mole. Patient was then given another 5 series of EMACO and her condition was unremarkable during the remaining course of treatment. Conclusion: Invasive mole treatment is determined based on the risk factors. Uterine perforation still occurred in this case regardless of the decreasing hCG level during EMACO treatment. It emphasizes the importance of clinical examination as chemotherapy responsiveness. Long-term treatment can have a good prognosis but good collaboration between the gynecologist and the patient is essential. Keywords: EMACO, invasive mole, perforation
Co-Authors Andi Friadi ANDRIJONO ANDRIJONO Bambang Sutrisna Bram Pradipta Budiningsih Siregar Tofan W Utami