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All Journal Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Lianda Siregar

Department Of Gastroentero-hepatology, Dharmais Hospital, Indonesian National Cancer Center, Jakarta

Author-ID : 381851

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

Published : 7 Documents Claim Missing Document

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Articles

Real-World Experience of Telbivudine and Lamivudine as Antiviral Prophylaxis for Chemotherapy-Related Hepatitis B Reactivation Lianda Siregar; Imelda Maria Loho; Agus Sudiro Waspodo; Siti Nadliroh; Rahmanandhika Swadari; Rizka Andalusia; Leovinna Widjaja
Indonesian Journal of Cancer Vol 15, No 1 (2021): March
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: There is currently no data regarding the efficacy of prophylactic telbivudine in hepatitis B patients undergoing chemotherapy. This study aims to describe the results of preemptive telbivudine and lamivudine to prevent chemotherapy-related HBV reactivation.Methods: The medical records of all patients with HBsAg positive or HBs-Ag negative, anti-HBc positive, who were referred to the hepatology clinic between May 2014 and December 2016, were retrospectively reviewed. As this is a descriptive study, no statistical analysis was done.Results: A total of 52 patients with prophylactic telbivudine or lamivudine therapy were included, with 26 patients in each group. Rituximab-based treatment was given in nine and five patients in the telbivudine and lamivudine group, respectively. The number of patients who completed antiviral treatment up to six months after chemotherapy was 17 patients in each group. There was less incidence of HBV reactivation in the telbivudine group (2 of 17 patients, 11.8%) than in the lamivudine group (7 of 17 patients, 41.2%). Delayed reactivation was noticed in 1 of 2 patients in the telbivudine group and 3 of 7 patients in the lamivudine group. The median log10[HBV DNA] at reactivation was 4.52 (1.70 – 8.35) IU/mL. Severe hepatitis was observed in two patients in the lamivudine group and one patient in the telbivudine group. Of 34 patients who completed antiviral treatment, two patients died due to primary cancer. No interruption of chemotherapy or mortality due to hepatitis was noticed in both groups.Conclusions: Preemptive telbivudine or lamivudine in HBsAg positive or HBsAg negative, anti-HBc positive patients seems to be a good treatment option.

Signet-Ring Cell Carcinoma of the Ampulla of Vater Lianda Siregar; Imelda M Loho; Agus Sudiro Waspodo; Dwi Sri Rejeki; Fajar Firsyada; Rahmanandika Swadari; Getty Inash Nandika; Muhammad Iqbal Siregar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Signet-ring cell carcinoma (SRCC) of the ampulla of Vater is a very rare case and only 28 cases have beed reported in the English literature. Herein, we report a 59-year-old woman with SRCC of the ampulla of Vater. She developed symptoms of obstructive jaundice at early stage of disease and underwent pylorus-preserving Whipple procedure as definitive treatment. Histopathology examination showed numerous tumor cells with intracytoplasmic mucin and eccentric nuclei. Her tumor has already invaded the serosa of duodenum, but no infiltration to the stomach, pancreas, and lymphovascular structure. Her surgical margins and regional lymph nodes were free of tumor. She was diagnosed with T2N0M0 (stage IB) SRCC of the ampulla of Vater. No adjuvant treatment was given and she has been doing well for five months after surgery.

Argon plasma coagulation for the treatment of chronic radiation proctitis – real-world data from Indonesian National Cancer Center Lianda Siregar; Imelda Maria Loho; Agus Sudiro Waspodo; Rahmanandhika Swadari; Benedicta Audrey Maharani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Background: This study aimed to evaluate the endoscopic features and clinical outcome of patients with chronic radiation proctitis (CRP) at one year after argon plasma coagulation (APC) treatment. Method: Between March 2016 and September 2019, a total of 48 female patients with CRP were treated with APC and their medical records were retrospectively reviewed. APC treatment was done every 3 to 54 weeks, with a median of 8 weeks. Number of APC was decided by the treating physician according to the severity of illness. Endoscopic and clinical features at one year after the final APC were recorded as the effectiveness of APC.Results: Of 48 patients, 26 patients were included in this study. Number of APC sessions varied between 1 to 5 sessions of APC for each patient. Of 26 patients, 22 patients achieved clinical improvement and four patients did not achieve clinical improvement at one year after the last APC session. Of the four patients who failed to achieve clinical improvement, two patients underwent surgery, one patient had occasional mild rectal bleeding, and one patient required regular transfusion. Of 22 patients with clinical improvement at one-year after the last APC, improvement of endoscopic features was found in 20 patients. Of four patients who did not achieve endoscopic improvement, diagnostic colonoscopy showed telangiectasis of more than 50% of rectal surface in 1 patient, presence of blood in 2 patients, and presence of ulceration of 1 cm in 1 patient.Conclusion: APC is an effective treatment option for CRP.

Clinical Profile and Outcome of Non-Variceal Upper Gastrointestinal Bleeding in Relation to Timing of Endoscopic Procedure in Patients Undergoing Elective Endoscopy Lianda Siregar; Abdul Aziz Rani; Chudahman Manan; Marcellus Simadibrata; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Endoscopy is the most accurate method for diagnosing the source of upper gastrointestinal bleeding. This study was aimed to evaluate the correlation between the timing of elective endoscopy and the length of hospital stay, the amount of transfusion given and incidence of recurrent bleeding or patient mortality. Method: A retrospective study was conducted in all patients with non-variceal upper gastrointestinal bleeding who had experienced elective endoscopy at Cipto Mangunkusumo Hospital between January 2007 and August 2008. Identification of clinical risk using clinical Rockall score was performed at the emergency room. Persistent bleeding, recurrent bleeding, surgical treatment and death were the outcome variables. Statistical analysis was performed using Chi-square/fisher exact test and linear regression. Results: There were 40 eligible cases with mean age of 53 ± 13 years; the greatest occurrence was at the age group of 50-59 years (12%), male (52.5%) and those who had clinical symptom of melena (52.5%). Twenty seven (67.5%) patients had Rockall score of 1-3 points and 13 (32.5%) had 4-6 points. There was only one patient who had adherent clots (Forrest grade II B). Endoscopy results revealed that the most common cause of bleeding was gastric ulcer, which occurred in 12 (30%) patients. There was no correlation between the timing of endoscopic procedures and outcome variable; however the length of hospital stay had a significant correlation with timing of endoscopic procedures. Conclusion: Elective endoscopy does not affect the variables of mortality and recurrent bleeding; however, it affects the length of hospital stay. Further prospective studies are required to find causal relation between them. Keywords: non-variceal upper gastrointestinal bleeding, Rockall score, elective endoscopy, outcome variables

Gastrointestinal Bleeding, Jejunum Perforation and Intussusceptions Ileo-Jejunal Segment with Multiple Polyposis Due to Metastasic Melanoma with Out Primary Cutaneus Melanoma? Lianda Siregar; Mangalindung Ompusunggu
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 3, December 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/532004105-108

Approximately 60% of patients who die due to melanoma have gastrointestinal metastases at autopsy, yet ante mortem diagnosis is uncommon. The small bowel is the most frequent intestinal site of metastasis and prognosis is very poor with a median survival after operation was 6.2 months (range: 1–42 months). Bowel metastases may appear radiologically as polypoid mucosal lesions, submucosal nodules, diffuse infiltration with thickening of the intestinal wall, or serosal implants. Bowel obstruction due into intussusceptions is common clinical presentation of gastrointestinal metastasis; other presentation include gastrointestinal bleeding, perforation and large masses.We reported a case of metastatic melanoma to small bowel, whose had hematemesis melena, abdominal pain, diarrhea and weight loss without primary cutaneus melanoma. Gastroduodenoscopy appeared normal. The ultrasonography of bowel showed a”doughnut” configuration with concentric rings of bowel wall. Left lateral decubitus abdominal radiographies showed free air appearances. Laparatomy reported three location of invagination (intussuception) with multiple polyposis at ileo–jejunal segment (29 pieces of polyp) and jejunum perforation. Resection and end–to end anastomosis of the affected segment had been performed with no serious complication after this. Miscroscopical examination of specimen showed metastatic melanoma malignant in 3 lymph nodes. Eight weeks later patients died with distant metastases to brain. Keywords: Intussesception and perforation, multiple polyposis, metastase melanoma without primary cutaneus melanoma

Metastatic Cervical Cancer Presenting as a Sessile Polyp in the Ascending Colon Loho, Imelda Maria; Siregar, Lianda; Iriani, Dewi; Faatinah, Tiyas Hasnaa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202494-97

Patients with metastatic cervical cancer, particularly hematogenous metastasis, have a worse prognosis compared to those with localized cervical cancer. Gastrointestinal involvement of cervical cancer occurs in approximately 8% of cases and most lesions are located in the recto-sigmoid area due to direct extension of the disease. Here, we present a case of cervical adenocarcinoma spreading to the ascending colon as a sessile polyp and mimicking a hyperplastic polyp. Histopathological evaluation followed by immunohistochemistry analysis is needed to confirm the diagnosis.

Treatment for Intermediate-Stage Hepatocellular Carcinoma: Current Practice and Outcome in Real World Study Hasan, Irsan; Loho, Imelda Maria; Lesmana, Cosmas Rinaldi A.; Gani, Rino Alvani; Siregar, Lianda; Waspodo, Agus Sudiro; Lesmana, Laurentius A
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Intermediate-stage hepatocellular carcinoma (HCC) is a very heterogeneous disease. The first line treatment for this group is transarterial chemoembolization (TACE), however, in clinical practice, not all patients are suitable for TACE. We aim to evaluate current treatment practice and outcome of patients with intermediate-stage HCC.Methods: HCC patients database from 2013 to 2016 in Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital were retrospectively analyzed. Patients with intermediate-stage HCC were included in this study.Results: A total of 456 patients were diagnosed with HCC, but only 151 (33.1%) patients with intermediate-stage HCC were included. Men outnumbered women in a ratio of 3:1. The most common etiology for HCC was hepatitis B virus (HBV) infection, which accounted for 55% of patients. Fifty-two patients (34.4%) were treated with TACE as first-line treatment. Sixty-seven patients (44%) were given best supportive care due to ineligibility for TACE. Frequency of TACE varied from one to eleven times. Overall median survival was 617 days (1.7 years). One-year survival for patients undergoing TACE and liver resection was 47% and 60%, respectively. We did not compare the survival between any treatment groups because the number of patient in each group is not sufficient to be statistically analyzed.Conclusion: Only 34.4% of patients with intermediate-stage HCC was treated with TACE as first-line treatment. An improvement in the treatment strategy should be done for HCC patients in Indonesia.

Co-Authors Abdul Aziz Rani Abdul Aziz Rani Agus Sudiro Waspodo Agus Sudiro Waspodo Agus Sudiro Waspodo Agus Sudiro Waspodo Benedicta Audrey Maharani C Rinaldi A Lesmana Chudahman Manan Chudahman Manan Dadang Makmun Dewi Iriani Dwi Sri Rejeki Faatinah, Tiyas Hasnaa Fajar Firsyada Firsyada, Fajar Getty Inash Nandika Imelda M Loho Imelda Maria Loho Imelda Maria Loho Imelda Maria Loho, Imelda Maria Irsan Hasan Laurentius A Lesmana, Laurentius A Leovinna Widjaja Mangalindung Ompusunggu Marcellus Simadibrata Marcellus Simadibrata Muhammad Iqbal Siregar Nandika, Getty Inash Rahmanandhika Swadari Rahmanandhika Swadari Rahmanandika Swadari Rejeki, Dwi Sri Rino Alvani Gani Rizka Andalusia Siregar, Muhammad Iqbal Siti Nadliroh Swadari, Rahmanandika

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