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KRAS and BRAF Mutation in Borderline Epithelial Type Ovarian Tumor Suardi, Dodi
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (99.322 KB)

Objective: To understand the molecular profile by identifying the mutation of KRAS and BRAF in borderline type ovarian tumor. Method: In the study, we examined paraffin tissue sample from Department of Pathology Anatomy, University of Indonesia/Dr. Cipto Mangunkususmo Hospital, Jakarta, that was diagnosed as borderline epithelial ovarian tumor. Seventeen samples were taken to Sandya Laboratory in Bandung for examination of PCR BRAF exon 15 codon 600, and KRAS in exon 2 codon 12 and 13, as well as exon 3 codon 61. Result: Mutation of KRAS occurred in 94% of subjects (serous borderline 62.5%, mucinous bordeline 37.5%), of which 70.6% mutation happened in exon 2 codon 12 (serous borderline 33.3%, mucinous borderline 66.7%), 52.9% mutation in exon 2 codon 13 (serous borderline 33.3%, mucinous borderline 66.7%), and 76.5% mutation in exon 3 codon 61 (serous borderline 30.8%, mucinous borderline 69.2%). Mutation of BRAF occurred only in 47% of subjects, but the results of Exact Fisher test showed that mutation in BRAF gave significant result, while other variables did not give significant result (p=0.009). Conclusion: Molecular pathology in borderline ovarian tumor related with BRAF mutation is more likely to occur in serous borderline type, while KRAS mutation is more likely to occur in mucinous borderline type. [Indones J Obstet Gynecol 2013; 37-2: 107-12] Keywords: borderline ovarian tumor, BRAF, KRAS

Peran Serum IL-6 dan CA-125 Prabedah sebagai Prediktor Resektabilitas Tumor pada Kanker Ovarium Tipe Epitel KURNIADI, ANDI; HIDAYAT, YUDI M; SUARDI, DODI; SUSANTO, HERMAN; N.A.W, GATOT; PRAYITNO, HERU
Indonesian Journal of Cancer Vol 11, No 4 (2017): October- December 2017
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1245.528 KB)

The success of ovarian cancer therapy is determined by optimal cytoreduction performed prior to chemotherapy. Maximum residual tumor after cytoreduction and before chemotherapy is essential for prognosis. Factors affecting tumor mass resectability are the surgeon, location of the mass, ascites more than 1000 mL, carcinomatosis, mass in lymph nodes more than 1 cm, mass at the liver parenchym, large mass up to diaphragm and pre-operative CA-125 > 500 MIU / L will increase the likelihood of suboptimal cytoreduction. IL-6 and CA-125 play a role in the occurrence of those factors, so both examinations are expected to improve the prediction of cytoreduction resectability and determine the appropriate choice for the treatment of ovarian cancer, either cytoreduction or neoadjuvant chemotherapy.The design of this study is cross sectional that is by examining patients suspected of ovarian malignancy, checking for their preoperative IL-6 and CA-125 levels and their resectability. Data analysis done by univariat and bivariate. For categorical data tested by chi-square test or Exact Fisher test, significance test used unpaired T test or Mann Whitney test. Analysis of numerical variables by numerical using Pearson correlation analysis or Spearman correlation analysis as well as correlation between numerical variables with nominal variables using Eta Correlation test. The data obtained is recorded in a special form and then processed with SPSS version 24.0 for WindowsPatients collected during the study period were 54, where only 36 people met the inclusion and exclusion criteria. It was found that most subjects were aged 40-64 years (77.8%), mean value of CA-125 for suboptimal cytoreduction group was higher than optimal cytoreduction (1099,75 + 1242,555 vs 311,23 + 160,165), which is statistically significant, p = 0,000 (p value <0,05), CA 125 cut off point in this research was 432 with sensitivity value of 72,2% and specificity value of 77,88%. The mean value of IL-6 for the suboptimal cytoreduced group was greater than the optimized cytoreduction (137.72 + 107.658 VS 62.20 + 66.330), which is statistically significant, p = 0.009 (p value <0.05), IL-6 cut off point at this study was 64.9 with a sensitivity of 72.2% and a specificity of 72.2 %. There was a positive correlation with a strong correlation strength between CA-125 levels and the operating outcome, p = 0.012 (p <0.05), there was a positive correlation with a small correlation strength between IL-6 levels and the outcome of surgery, p = 0,016 (p <0,05) and there was correlation between IL-6 and CA-125 presurgery with operating outcome (suboptimal and optimal cytoreduction) with cut off point 418,5 with sensitivity value 88.9% and specificity value 72,2% .Conclusion: There is a correlation between the levels of IL-6 and CA-125 and ovarian cancer resectability.Â ABSTRAKKeberhasilan terapi kanker ovariumÂ ditentukan oleh optimalnya sitoreduksi yang dilakukan sebelum pemberian kemoterapi. Maksimal residual tumor setelah sitoreduksi dan sebelum kemoterapi sangat penting untuk prognosis. Faktor -faktor yang mempengaruhi resektabilitas massa tumor adalah operator, lokasi massa,Â asites lebih dari 1000 mL, karsinomatosis, massa di limfa lebih dari 1 cm, massa diparenkim hati, massa yang besar sampai ke diafragma dan kadar CA-125 pre-operatif > 500 mIU/L akan meningkatkan kemungkinan sitoreduksi suboptimal. IL-6 dan CA-125 berperan peran dalam terjadinya faktor â faktor tersebut, sehingga pemeriksaan kedua-duanya diharapkan dapat meningkatkan prediksi resektabilitas sitoreduksi dan menentukan pilihan tatalaksana kanker ovarium yang tepat yaitu sitoreduksi atau kemoterapi neoajuvan.Rancangan penelitian ini adalah cross sectional yaitu dengan melakukan pemeriksaan kadar IL-6 dan CA-125 prabedahÂ penderita tersangka keganasan ovarium kemudian dilihat resektabilitasnya.. Analisis data dilakukan secara univariat dan bivariate. Untuk data kategorik diuji dengan uji chi-square atau uji Exact Fisher , Uji kemaknaanÂ digunakan uji T tidak berpasangan atau uji Mann Whitney. Analisis variabel numerik dengan numerik menggunakan analisis korelasi Pearson atau analisis korelasi Spearman serta korelasi antara variabel numerik dengan variabel nominal menggunakan uji Korelasi Eta. Data yang diperoleh dicatat dalam formulir khusus kemudian diolah dengan program SPSS versi 24.0 forWindowsPasien yang berhasil dikumpulkan selama periode penelitian sebanyak 54 orang, yang memenuhi kriteria inklusi dan ekslusi hanya 36 orang. diperoleh data bahwa subjek terbanyak adalah usia 40 â 64 tahun (77,8%), Nilai rerata CA-125 untuk kelompok sitoreduksi suboptimal lebih besar dibandingkan dengan sitoreduksi optimal (1099,75 + 1242,555Â VS 311,23 + 160,165 ) bermakna secara statistik Â Â Â Â p = 0,000 (nilai p < 0,05), cut off point Â CA 125 pada penelitian ini adalah 432 dengan nilai sensitivitas 72,2% dan nilai spesifisitas 77,88%. Nilai rerata IL-6 untuk kelompok sitoreduksi suboptimal lebih besar dibandingkan dengan sitoreduksi optimal (137,72 + 107,658 VS 62,20 + 66,330) bermakna secara statistik p = 0,009 (nilai p < 0,05), cut off point Â IL-6 pada penelitian ini adalah 64,9 denganÂ sensitivitas 72,2% danÂ spesifisitas 72,2%%. Terdapat korelasi positif dengan kekuatan korelasi yang cukup kuat antara kadar CA-125 dengan luaran operasi p = 0,012 (p < 0,05), terdapat korelasi positif dengan kekuatan korelasi yang kecil (tidak erat) antara kadar IL-6 dengan luaran operasi, p = 0,016 (p < 0,05) dan terdapat korelasi antara kadar IL-6 dan CA-125 prabedah dengan luaran operasi (sitoreduksi suboptimal dan optimal ) dengan cut off point 418,5 dengan nilai sensitivitas 88.9% dan nilai spesifisitas 72,2%.Simpulan : Terdapat korelasi antara kadar IL-6 dan CA-125 prabedah dengan resektabilitasÂ kanker ovarium

KRAS and BRAF Mutation in Borderline Epithelial Type Ovarian Tumor Suardi, Dodi
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (99.322 KB)

Objective: To understand the molecular profile by identifying the mutation of KRAS and BRAF in borderline type ovarian tumor. Method: In the study, we examined paraffin tissue sample from Department of Pathology Anatomy, University of Indonesia/Dr. Cipto Mangunkususmo Hospital, Jakarta, that was diagnosed as borderline epithelial ovarian tumor. Seventeen samples were taken to Sandya Laboratory in Bandung for examination of PCR BRAF exon 15 codon 600, and KRAS in exon 2 codon 12 and 13, as well as exon 3 codon 61. Result: Mutation of KRAS occurred in 94% of subjects (serous borderline 62.5%, mucinous bordeline 37.5%), of which 70.6% mutation happened in exon 2 codon 12 (serous borderline 33.3%, mucinous borderline 66.7%), 52.9% mutation in exon 2 codon 13 (serous borderline 33.3%, mucinous borderline 66.7%), and 76.5% mutation in exon 3 codon 61 (serous borderline 30.8%, mucinous borderline 69.2%). Mutation of BRAF occurred only in 47% of subjects, but the results of Exact Fisher test showed that mutation in BRAF gave significant result, while other variables did not give significant result (p=0.009). Conclusion: Molecular pathology in borderline ovarian tumor related with BRAF mutation is more likely to occur in serous borderline type, while KRAS mutation is more likely to occur in mucinous borderline type. [Indones J Obstet Gynecol 2013; 37-2: 107-12] Keywords: borderline ovarian tumor, BRAF, KRAS

Faktor Risiko Kejadian Tumor Trofoblas Gestasional Pasca Evakuasi Molahidatidosa di RSUP Dr. Hasan Sadikin Bandung Periode Agustus 2013 – Agustus 2018 Indah Permata Noer Islami; Dodi Suardi; Hanom Husni Syam; Mulyanusa A. Ritonga
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 2 September 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v3n2.201

Tujuan: Penelitian bertujuan mengetahui faktor risiko kejadian TTG pasca evakuasi, untuk memprediksi penderita molahidatidosa yang berkembang menjadi TTG atau kembali normal.Metode: Menggunakan studi case control retrospektif dalam waktu 1 Agustus 2013 - 1 Agustus 2018. Populasi penelitian, penderita molahidatidosa yang datang dan dirawat pada Obstetri dan Ginekologi RSUP Hasan Sadikin.Hasil: Terdapat 59 pasien high risk, dan 67 pasien low risk. Probabilitas <0,05 terdapat hubungan signifikan antara usia dengan kejadian TTG. Probabilitas 0,031, terdapat hubungan signifikan antara paritas dengan kejadian TTG. Dengan uji Fisher Exact terdapat hubungan bermakna antara kadar βHCG praevakuasi dengan kejadian TTG (p value =<0,001), dan hubungan bermakna antara gambaran PA dengan kejadian TTG (p value =<0,001). Dengan uji Spearman Correlation terdapat hubungan yang bermakna antara kadar βHCG Praevakuasi dengan gambaran PA (p value <0, 001).Kesimpulan: Terdapat hubungan yang bermakna antara usia, paritas, BHCG, Patologi Anatomi, dengan kejadian TTG pasca evakuasi molahidatidosa. Dari analisis multivariat dengan uji regresi logistic didapatkan bahwa BHCG dan PA yang merupakan faktor risiko TTG.Risk Factors Trofoblas Tumor of Post Evacuation Of Hydatidiform Mole in Dr. Hasan Sadikin General Hospital Bandung Period August 2013−August 2018 PeriodAbstractObjective: This study aims to determine the risk factors for GTT events after HM evacuation, used to predict patients who will develop into GTT or return to normal.Methods: Case control study (retrospective) was conducted from August 1st 2013 −August 1st 2018. Population of this study was all patients with HM who came and treated at the RSHS Obstetrics and Gynecology Department. Result: There are 59 high risk, 67 low risk patients. The probability value is 0.015, (<0.05) there is a significant relation between age and the incidence of GTT. The probability value of 0.031, there is a significant relationship between parity and the incidence of GTT. Fisher Exact test, significant relation between pre-evacuated βHCG levels and GTT events (p value = <0,001), and significant relation between Pathology Anatomy result and GTT events (p value =<0,001) was found. Spearman Correlation test, there was significant relation between levels of βHCG pre-evacuation with Pathology Anatomy result (p value <0, 001). Conclusion: There is a significant relation between age, parity, BHCG, Pathology Anatomic result, and the incidence of GTT after evacuation of HM. From multivariate analysis with logistic regression test, it was found that BHCG and pathology anatomic were risk factors for GTT.Key words: Molahidatidosa, Gestational Trophoblast Tumor.

Perbandingan Nilai Prediktif antara Risk-of-Malignancy Index (RMI) dan Klasifikasi IOTA Simple Rules dalam Prediksi Keganasan pada Kasus Tumor Ovarium di RSUP Dr. Hasan Sadikin Bandung Huda Toriq; Yudi Mulyana Hidayat; Dodi Suardi
Indonesian Journal of Obstetrics & Gynecology Science Volume 4 Nomor 1 Maret 2021
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v4n1.223

Tujuan: Penelitian ini bertujuan untuk mengevaluasi dan membandingkan penerapan dua metode diagnostik yang telah digunakan di RSHS, yaitu skor RMI dan Klasifikasi IOTA Rules untuk memprediksi keganasan suatu tumor ovarium selama periode 2017−2018Metode: Penelitian ini merupakan penelitian komparatif dengan pengambilan data secara retrospektif. Sumber data diperoleh dari rekam medis pasien yang menjalani operasi pengangkatan dan pemeriksaan histopalogis tumor ovarium. Dilakukan pengumpulan informasi mengenai data USG, kadar CA125, skor RMI, klasifikasi IOTA Simple Rules, dan membandingkannya dengan luaran histopatologis.Hasil: 190 kasus tumor ovarium diteliti. 156 kasus (82,1%) memiliki luaran histopatologis ganas dan 34 kasus lainnya (17.9%) jinak. 178 kasus (93,68%) memiliki skor RMI ≥200 dan 12 kasus (6,32%) <200. sebanyak 78 kasus diklasifikasikan sebagai Malignant, 42 kasus Benign, dan 70 kasus lainnya Inconclusive dengan kriteria IOTA Simple Rules. Distribusi CA125 dan Skor RMI pada kedua kelompok luaran histopatologis berbeda secara bermakna (P<0,05). Sensitivitas dan spesifisitas klasifikasi IOTA Simple Rules di RSHS masing-masing 94,23% dan 97,06%, dengan menggabungkan kelompok IOTA inkonklusif dengan kelompok ganas. Penghitungan sensitivitas dan spesifisitas skor RMI memberikan nilai 95,51% dan 14,71% dengan menggunakan cut-off-point skor RMI 200.Kesimpulan: Sensitivitas dan spesifisitas klasifikasi IOTA Simple Rules lebih baik dibandingkan dengan skor RMI dalam memprediksi keganasan suatu tumor ovarium.Predictive Value Comparison of Risk-of-Malignancy Index (RMI) and IOTA Simple Rules in Predicting Ovarian Tumor Malignancy in Dr. Hasan Sadikin Hospital BandungAbstractObjective: This study was done to evaluate and compare the use of RMI score & IOTA Simple Rule which has been routinely used in Hasan Sadikin Hospital to predict ovarian malignancy in 2017-2018Method: This is a comparative study that collects data retrospectively. Data was obtained from medical record of patient who underwent ovarian tumor surgery, including USG report, CA125, RMI score, IOTA Simple Rules, and compared it with histopathological outcome. Result: 190 ovarian tumor cases was studied. 156 cases (82.1%) have malignant histopathological result and the other 34 cases (17.9%) were benign. 178 (93.68%) cases have RMI score ≥ 200 and 12 cases (6.32%) <200. As much 78 cases were classified as malignant, 42 cases (22.11%) were classified benign, and the other 70 cases were classified inconclusive using IOTA Simple Rules. CA125 and RMI Score distribution on both histopathological group differs significantly (P<0.05). IOTA Simple Rules shows sensitivity and specificity of 94.23% and 97.06% respectively, when inconclusive and malignant results were grouped together. RMI Score showed sensitivity and specificity of 95.51% and 14.71% respectively using cut-off point of 200.Conclusion: IOTA Simple Rules performs better than RMI in predicting ovarian tumor malignancy.Key words: Ovarian cancer, IOTA, RMI, USG, CA125

Pengaruh Vaksin BCG dalam Meningkatkan Proses Segresi Seluler pada Lesi Prakanker Serviks Uteri Derajat Rendah Yudi Mulyana Hidayat; Putu Giri Saputro; Dodi Suardi; Gatot N. A. Winarno; Siti Salima; Ali Budi Harsono
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 2 September 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v3n2.82

Tujuan: Penelitian ini adalah untuk menganalisis peranan pemberian vaksin bacille calmette-guerin (BCG) terhadap proses regresi seluler pada lesi prakanker serviks uteri derajat rendahMetode: Penelitian ini merupakan penelitian eksperimental dengan rancangan pretest (IVA dan Histopatologi) - posttest (IVA dan Test HPV DNA) with control design di Poliklinik Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Desember 2017-Maret 2018. Hasil: Untuk pemeriksaan IVA bulan ke-0 pada kelompok BCG kategori positif sebanyak 9 (100.0%) sedangkan untuk pemeriksaan IVA bulan ke-3 pada kelompok BCG kategori positif sebanyak 3 (33.3%) dan negatif menjadi sebanyak 6 (66.7%), pemeriksaan tes HPV DNA bulan ke 12 pada kelompok BCG kategori positif HPV DNA High Risk tidak ditemukan ( 0 % ). Hasil uji statistik pada kelompok perlakuan diperoleh nilai p<0.05. Untuk pemeriksaan IVA bulan ke-0 pada kelompok plasebo kategori positif sebanyak 9 (100.0%) sedangkan untuk pemeriksaan IVA bulan ke-3 pada kelompok plasebo kategori positif sebanyak 8 (88.9%) dan negatif menjadi sebanyak 1 (11.1%). pemeriksaan tes HPV DNA bulan ke 12 kelompok BCG kategori positif HPV DNA High Risk sebanyak 1 orang ( 11,1%). Hasil uji statistik pada kelompok kontrol diperoleh informasi nilai p>0.05.Kesimpulan: Terdapat peranan pemberian vaksin BCG terhadap regresi seluler lesi prakanker serviks derajat rendah.The effect of Bacille Calmette-Guerin vaccine on regression of cervical intraepithelial neoplasia-1AbstractObjective: The aim of this study was to analyze the role of Baccile Calmete Guerin (BCG) vaccines delivery in low grade precancerous cervical lesions.Methods: The design of the study was a pretest and posttest experimental with control, done at Hasan Sadikin Hospital Bandung Outpatient Clinic during December 2017–March 2018. Result: Patients with positive VIA test in the intervention group in month-0 were 9 patients (100.0%), in month-3 were 3 patients (33.33%) and the other 6 patients (66.7%) changed into negative. Patients with positive VIA test in the control group in month-0 were 9 patients (100.0%), in month 3 were 8 patients (88.9%) and the other 1 patients (11.1%) changed into negative. The result of statistical analysis in the intervention group was p<0.05. The result of statistical analysis in the control group was p>0.05.Conclusion: : there is a role of BCG vaccine in low grade precancerous cervical lesions.Key words: BCG vaccine, VIA test, Low grade cervical precancerous lesions.

Evaluasi Tindakan Operatif pada Kanker Serviks, Endometrium, dan Ovarium di RSUP Dr. Hasan Sadikin Bandung Tahun 2015-2016 Rosita Indriani; Mulyanusa Amarullah Ritonga; Dodi Suardi
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 2 September 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

AbstrakTujuan: Mengetahui hasil luaran tindakan operatif pada kanker serviks, endometrium dan ovarium di RSUP Dr. Hasan Sadikin.Metode: Jenis penelitian dengan mengevaluasi data pasien kanker serviks, endometrium dan ovarium dengan tindakan operatif dari Bagian Rekam Medik RSUP Dr. Hasan Sadikin, Bandung dari Januari 2015−Desember 2016. Variabel yang dievaluasi berupa usia, BMI, paritas, asal kanker, jenis dan komplikasi tindakan operasi.Hasil: Terdapat 560 kasus yang sesuai dengan kriteria inklusi dari Januari 2015−Desember 2016. Nilai tengah usia pasien 45 tahun, dengan 222 pasien (39,6%) memiliki BMI normal dan 413 pasien (73,8%) dengan kanker ovarium. Perdarahan >2000 cc terdapat pada 141 kasus (25,2%). Durasi operasi terbanyak 3−4 jam pada 208 kasus (37,1%). Komplikasi saluran gastrointestinal sebanyak 40 kasus (7,1 %) dan saluran genitourinaria sebanyak 28 kasus (5%). Nilai tengah length of stay selama 7 hari, dengan 47 pasien (8,4%) memerlukan ICU dan kematian terjadi pada 20 kasus (3,6%).Kesimpulan: komplikasi tersering adalah perdarahan. Tindakan operatif pada kanker serviks lebih berkaitan dengan cedera saluran genitourinaria, sedangkan tindakan operatif pada kanker ovarium lebih berkaitan dengan cedera saluran gastrointestinal.Evaluation of Operative Procedures on Cervical, Endometrial and Ovarian Cancers in Dr. Hasan Sadikin General Hospital Bandung 2015 ̶̶̶ 2016Abstract Objectives: To evaluate the post-operative outcomes in patients with cervical, endometrial, and ovarian cancers in Dr. Hasan Sadikin General Hospital in 2015−2016.Method: We retrospectively evaluated cross-sectionally the charts of these three cancer patients who underwent operative procedures from January 2015 to December 2016 in Dr. Hasan Sadikin Hospital. The following study variables were noted for evaluation: age, BMI, parity, cancer origin, type of surgery, and operative complications. Results: A total of 560 oncologic surgery from these three cancers was undertaken and met the inclusion criteria from January 2015 to December 2016. Median age was 45 years old, with 222 (39,6%) patients had normal BMI and 413 (73,8%) patients belonged to ovarian cancer. Operative complications such as bleeding >2000cc were reported in 141 (25,2%) cases. The most common length of surgery time was 3−4 hours in 208 (37,1%) patients. A total of 40 (7,1%) gastrointestinal and 28 (5%) genitourinary tract injuries were encountered. Median length of stay was 7 days, post-operative staying at ICU was noted in 47 (8,4%) patients and 20 (3,6%) had intraoperative-related deaths.Conclusion: The most common complication is bleeding.The operative procedure of cervical cancer is more related to injury to the genitourinary tract, while gastrointestinal tract injury mostly occurs in the operative procedure of ovarian cancerKey words: Gynecological oncology, surgery and complication

Cervical Cancer Radiotherapy Response in Dr. Hasan Sadikin General Center Hospital Jaeni Pringgowibowo; Dodi Suardi; Ruswana Anwar
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 1 Maret 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n1.340

Objective: To determine the response to radiation therapy based on the characteristics of cervical cancer patients who were given radiotherapy at Hasan Sadikin Hospital in 2020.Methods: The study was conducted using an observational analytic study method with a cross-sectional design, involving 75 cases of cervical carcinoma who were given complete radiation therapy but were not given neoadjuvant chemotherapy or surgery, which were recorded in the medical record at the Central General Hospital (RSUP) Dr. Hasan Sadikin. Results: Response to therapy had a significant relationship (p< 0.05) with age (p 0.030), histopathological type (p 0.009), and tumor mass size (p 0.042), but had no significant relationship to cervical cancer stage (p 0.055). Further analysis found that the response to radiation therapy at stage III was highly dependent on the size of the tumor mass (p<0.001). Based on the odds ratio calculation, the response to therapy was better in patients aged 35 years 3.44 times compared to patients aged 18-34 years, cervical cancer with squamous type histopathology 5.23 times compared to adenocarcinoma type histopathology, and cervical cancer with tumor mass size. <4 cm 2.86 times compared to tumor mass size 4 cm.Conclusion: The therapeutic response was better in cervical cancer patients who underwent complete radiation therapy in patients aged 35 years, stage III cervical cancer with tumor mass size <4 cm, squamous type histopathology, and tumor mass size <4cm.Respon Radioterapi pada Kanker Serviks di Rumah Sakit Umum Pusat Dr. Hasan Sadikin BandungAbstrakTujuan: Untuk mengetahui respon terapi radiasi berdasarkan karakteristik pasien kanker serviks yang diberikan radioterapi di Rumah Sakit Hasan Sadikin tahun 2020. Metode: Penelitian dilakukan menggunakan metode studi analitik observasional dengan desain potong lintang, melibatkan 75 kasus karsinoma serviks yang diberikan terapi radiasi komplit tetapi tidak diberikan kemoterapi neoadjuvant maupun tindakan operasi, yang tercatat pada rekam medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin.Hasil: Respon terapi memiliki hubungan yang signifikan (p<0,05) terhadap usia (p 0,030), tipe histopatologi (p 0,009), dan ukuran massa (p 0,042), tetapi memiliki hubungan yang tidak bermakna terhadap stadium kanker serviks (p 0,055). Analisis lebih lanjut didapatkan bahwa respon terapi radiasi pada stadium III sangat bergantung kepada ukuran massa tumor (p<0,001). Berdasarkan penghitungan odd ratio respon terapi lebih baik didapatkan pada pasien berusia ≥35 tahun 3,44 kali dibandingkan pada usia 18-34 tahun, kanker serviks dengan histopatologi tipe skuamosa 5,23 kali dibandingkan histopatologi tipe adenokarsinoma, dan kanker serviks dengan ukuran massa tumor <4 cm 2,86 kali dibandingkan ukuran massa tumor ≥4 cm.Kesimpulan: Respon terapi lebih baik pada pasien kanker serviks yang dilakukan terapi radiasi komplit pada pasien berusia ≥ 35 tahun, kanker serviks stadium III dengan ukuran massa tumor <4 cm, histopatologi tipe skuamosa, dan ukuran massa tumor <4cm.Kata kunci : respon terapi, radiasi, kanker serviks

KRAS and BRAF Mutation in Borderline Epithelial Type Ovarian Tumor Dodi Suardi
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To understand the molecular profile by identifying the mutation of KRAS and BRAF in borderline type ovarian tumor. Method: In the study, we examined paraffin tissue sample from Department of Pathology Anatomy, University of Indonesia/Dr. Cipto Mangunkususmo Hospital, Jakarta, that was diagnosed as borderline epithelial ovarian tumor. Seventeen samples were taken to Sandya Laboratory in Bandung for examination of PCR BRAF exon 15 codon 600, and KRAS in exon 2 codon 12 and 13, as well as exon 3 codon 61. Result: Mutation of KRAS occurred in 94% of subjects (serous borderline 62.5%, mucinous bordeline 37.5%), of which 70.6% mutation happened in exon 2 codon 12 (serous borderline 33.3%, mucinous borderline 66.7%), 52.9% mutation in exon 2 codon 13 (serous borderline 33.3%, mucinous borderline 66.7%), and 76.5% mutation in exon 3 codon 61 (serous borderline 30.8%, mucinous borderline 69.2%). Mutation of BRAF occurred only in 47% of subjects, but the results of Exact Fisher test showed that mutation in BRAF gave significant result, while other variables did not give significant result (p=0.009). Conclusion: Molecular pathology in borderline ovarian tumor related with BRAF mutation is more likely to occur in serous borderline type, while KRAS mutation is more likely to occur in mucinous borderline type. [Indones J Obstet Gynecol 2013; 37-2: 107-12] Keywords: borderline ovarian tumor, BRAF, KRAS

Peran Serum IL-6 dan CA-125 Prabedah sebagai Prediktor Resektabilitas Tumor pada Kanker Ovarium Tipe Epitel ANDI KURNIADI; YUDI M HIDAYAT; DODI SUARDI; HERMAN SUSANTO; GATOT N.A.W; HERU PRAYITNO
Indonesian Journal of Cancer Vol 11, No 4 (2017): October- December 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

The success of ovarian cancer therapy is determined by optimal cytoreduction performed prior to chemotherapy. Maximum residual tumor after cytoreduction and before chemotherapy is essential for prognosis. Factors affecting tumor mass resectability are the surgeon, location of the mass, ascites more than 1000 mL, carcinomatosis, mass in lymph nodes more than 1 cm, mass at the liver parenchym, large mass up to diaphragm and pre-operative CA-125 > 500 MIU / L will increase the likelihood of suboptimal cytoreduction. IL-6 and CA-125 play a role in the occurrence of those factors, so both examinations are expected to improve the prediction of cytoreduction resectability and determine the appropriate choice for the treatment of ovarian cancer, either cytoreduction or neoadjuvant chemotherapy.The design of this study is cross sectional that is by examining patients suspected of ovarian malignancy, checking for their preoperative IL-6 and CA-125 levels and their resectability. Data analysis done by univariat and bivariate. For categorical data tested by chi-square test or Exact Fisher test, significance test used unpaired T test or Mann Whitney test. Analysis of numerical variables by numerical using Pearson correlation analysis or Spearman correlation analysis as well as correlation between numerical variables with nominal variables using Eta Correlation test. The data obtained is recorded in a special form and then processed with SPSS version 24.0 for WindowsPatients collected during the study period were 54, where only 36 people met the inclusion and exclusion criteria. It was found that most subjects were aged 40-64 years (77.8%), mean value of CA-125 for suboptimal cytoreduction group was higher than optimal cytoreduction (1099,75 + 1242,555 vs 311,23 + 160,165), which is statistically significant, p = 0,000 (p value <0,05), CA 125 cut off point in this research was 432 with sensitivity value of 72,2% and specificity value of 77,88%. The mean value of IL-6 for the suboptimal cytoreduced group was greater than the optimized cytoreduction (137.72 + 107.658 VS 62.20 + 66.330), which is statistically significant, p = 0.009 (p value <0.05), IL-6 cut off point at this study was 64.9 with a sensitivity of 72.2% and a specificity of 72.2 %. There was a positive correlation with a strong correlation strength between CA-125 levels and the operating outcome, p = 0.012 (p <0.05), there was a positive correlation with a small correlation strength between IL-6 levels and the outcome of surgery, p = 0,016 (p <0,05) and there was correlation between IL-6 and CA-125 presurgery with operating outcome (suboptimal and optimal cytoreduction) with cut off point 418,5 with sensitivity value 88.9% and specificity value 72,2% .Conclusion: There is a correlation between the levels of IL-6 and CA-125 and ovarian cancer resectability. ABSTRAKKeberhasilan terapi kanker ovarium ditentukan oleh optimalnya sitoreduksi yang dilakukan sebelum pemberian kemoterapi. Maksimal residual tumor setelah sitoreduksi dan sebelum kemoterapi sangat penting untuk prognosis. Faktor -faktor yang mempengaruhi resektabilitas massa tumor adalah operator, lokasi massa, asites lebih dari 1000 mL, karsinomatosis, massa di limfa lebih dari 1 cm, massa diparenkim hati, massa yang besar sampai ke diafragma dan kadar CA-125 pre-operatif > 500 mIU/L akan meningkatkan kemungkinan sitoreduksi suboptimal. IL-6 dan CA-125 berperan peran dalam terjadinya faktor – faktor tersebut, sehingga pemeriksaan kedua-duanya diharapkan dapat meningkatkan prediksi resektabilitas sitoreduksi dan menentukan pilihan tatalaksana kanker ovarium yang tepat yaitu sitoreduksi atau kemoterapi neoajuvan.Rancangan penelitian ini adalah cross sectional yaitu dengan melakukan pemeriksaan kadar IL-6 dan CA-125 prabedah penderita tersangka keganasan ovarium kemudian dilihat resektabilitasnya.. Analisis data dilakukan secara univariat dan bivariate. Untuk data kategorik diuji dengan uji chi-square atau uji Exact Fisher , Uji kemaknaan digunakan uji T tidak berpasangan atau uji Mann Whitney. Analisis variabel numerik dengan numerik menggunakan analisis korelasi Pearson atau analisis korelasi Spearman serta korelasi antara variabel numerik dengan variabel nominal menggunakan uji Korelasi Eta. Data yang diperoleh dicatat dalam formulir khusus kemudian diolah dengan program SPSS versi 24.0 forWindowsPasien yang berhasil dikumpulkan selama periode penelitian sebanyak 54 orang, yang memenuhi kriteria inklusi dan ekslusi hanya 36 orang. diperoleh data bahwa subjek terbanyak adalah usia 40 – 64 tahun (77,8%), Nilai rerata CA-125 untuk kelompok sitoreduksi suboptimal lebih besar dibandingkan dengan sitoreduksi optimal (1099,75 + 1242,555 VS 311,23 + 160,165 ) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point CA 125 pada penelitian ini adalah 432 dengan nilai sensitivitas 72,2% dan nilai spesifisitas 77,88%. Nilai rerata IL-6 untuk kelompok sitoreduksi suboptimal lebih besar dibandingkan dengan sitoreduksi optimal (137,72 + 107,658 VS 62,20 + 66,330) bermakna secara statistik p = 0,009 (nilai p < 0,05), cut off point IL-6 pada penelitian ini adalah 64,9 dengan sensitivitas 72,2% dan spesifisitas 72,2%%. Terdapat korelasi positif dengan kekuatan korelasi yang cukup kuat antara kadar CA-125 dengan luaran operasi p = 0,012 (p < 0,05), terdapat korelasi positif dengan kekuatan korelasi yang kecil (tidak erat) antara kadar IL-6 dengan luaran operasi, p = 0,016 (p < 0,05) dan terdapat korelasi antara kadar IL-6 dan CA-125 prabedah dengan luaran operasi (sitoreduksi suboptimal dan optimal ) dengan cut off point 418,5 dengan nilai sensitivitas 88.9% dan nilai spesifisitas 72,2%.Simpulan : Terdapat korelasi antara kadar IL-6 dan CA-125 prabedah dengan resektabilitas kanker ovarium

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