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All Journal Indonesian Journal of Urology Indonesian Journal of Cancer
Rainy Umbas
Sub Bagian Urologi/Bagian Bedah, FK Universitas Indonesia/RSUPN Cipto Mangunkusumo, Jakarta
Health Professions Medicine & Pharmacology Public Health

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Penanganan Terkini Metastasis Kelenjar Getah Bening pada Karsinoma Sel Skuamus (KSS) Penis RAKHMAN, MOCHAMMAD REZA ARIEF; UMBAS, RAINY
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (157.11 KB)

Abstract

Recently, the incidence of penile cancer were increased. Two tertier hospital in Jakarta reporting an escalation in the average penile cancer patients from 1,8 to 6,2 per year in the last 16 years (1988-2005). The incidence of regional lymph node metastases was affected by the tumour grading. Only 2 out of 47 cases (4%) in Tis or Ta, 5 out of 73 cases in pT1 (G1/G1-2) and 9 out of 24 cases (38%) in pT1 (G2). 59% inguinal metastase was discovered in pT2. 5 years survival rate was 95% in negative lymphatic nodes, 76% in positive lymphatic node and 0% when pelvic metastatic was found.This study provides information about recent treatments for lymph node metastase in penile squamus cell carcinoma (SCC). Treatment for regional lymph node metastase by NCCN guidelines depends on tumour grade, palpability, nodul size, mobility, unilateral or bilateral. The treatment itself can be surgical (ILND,PLND), radiotherapy and chemotherapy
Current Status of Prostate Cancer in Asia Umbas, Rainy; Mochtar, Chaidir Arif; Rahardjo, Harina
Indonesian Journal of Cancer Vol 5, No 1 (2011): Jan - Mar 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (68.806 KB) | DOI: 10.33371/ijoc.v5i1.95

Abstract

Kanker prostat adalah salah satu keganasan yang paling sering ditemukan pada pria di seluruh dunia, termasuk Asia. Insiden kanker prostat di Asia lebih rendah dibandingkan dengan negara-negara barat, tetapi saat ini terdapat kecenderungan peningkatan insiden di negara-negara berkembang. Walaupun colok dubur, PSA, dan biopsi prostat dengan bimbingan TRUS masih merupakan metode diagnostik standar, masih banyak ahli urologi yang menggunakan TUR-P sebagai metode diagnostic, terutama di negara-negara berkembang. Pilihan terapi untuk kanker prostat stadium dini terdiri dari prostatektomi radikal, baik secara terbuka maupun robotik dan radioterapi. Kebanyakan pasien datang dengan kanker prostat stadium lanjut dan terapi yang diberikan adalah hormonal dan TUR-P. Pada beberapa kasus stadium dini, terapi radikal juga masih jarang dikerjakan. Hal ini disebabkan oleh kurangnya fasilitas (mesin radioterapi) atau tenaga ahli yang dapat mengerjakan prostatektomi radikal secara baik. Masalah-masalah ini dapat diatasi dengan memperbanyak tenaga ahli, fasilitas medic, dan edukasi pasien.Kata kunci: Prostat, kanker, asia.
Karakteristik dan Faktor-faktor Prediktif pada Tumor Testis Dewasa di Jakarta Suprabawati, Tri Endah; Umbas, Rainy
Indonesian Journal of Cancer Vol 1, No 3 (2007): Jul - Sep 2007
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v1i3.17

Abstract

Penelitian ini bertujuan untuk mengetahui karakteristik dan faktor-faktor prediktif tumor testis dewasa di JakartaData dikumpulkan dari status khusus di departemen urologi RSCM dan RS kanker Dharmais. Data yang dikumpulkan adalah usia, tumor marker yaitu AFP, LDH, HCG, jenis operasi, jenis tumor, jenis terapi, dan stadium. Dilakukan analisa terhadap usia dengan stadium, Undescended Testicle (UDT) dengan stadium, tumor marker dengan stadium pada semua kasus, dan hubungan AFP dengan jenis nonseminoma dengan stadium menggunakan ANOVA pada SPSS 11,5 .Selama 10 tahun terdapat 149 kasus tumor testis, 129 kasus diantaranya adalah dewasa. Rentang usia yaitu 18-72 tahun, dengan usia rata-rata 33,03 tahun. Jenis tumor diantaranya seminoma 67 (51,9 %) pasien, nonseminoma 50 (38,8 %) pasien, non germinal 6 (4,7 %) pasien, tidak diketahui jenis tumornya 6 (4,7 %) pasien. Delapan puluh tujuh pasien (67,4 %) dilakukan orkhidektomi ligasi tinggi, 23 (17,8 %) pasien dilakukan orkhidektomi transscrotal. Insidens UDT terdapat pada 13 (10,1 %) pasien. Seminoma paling banyak ditemukan pada stadium 2c (36,9 %), dan non -seminoma pada stadium 3c (48,9 %). Kemoterapi dilakukan terhadap 51 (39,5 %) pasien, radioterapi pada 24 (18,6 %) pasien, dan 27 (20,9 %) pasien menolak dilakukan tindakan, dan 18 (14,0 %) pasien meninggal karena keadaan umum yang buruk. Pada penelitian ini tidak ditemukan hubungan bermakna antara usia dengan stadium. Tujuh puluh tujuh persen pasien dengan UDT ditemukan pada stadium lanjut, dibandingkan dengan 66,7 % pada pasien non-UDT, tetapi secara statistik tidak bermakna. Angka rata-rata LDH 1785,35 dan nilai LDH meningkat sesuai dengan stadium, tetapi tidak bermakna untuk memprediksi stadium. Angka rata-rata AFP pada pasien non-seminoma adalah 6421,13 dan mempunyai hubungan yang bermakna dengan stadium (p: 0,009).Jenis tumor yang paling banyak ditemukan di Jakarta adalah seminoma. Pada penelitian ini usia dan LDH tidak dapat memprediksi stadium tumor, tetapi AFP mempunyai hubungan yang bermakna dengan stadium pada penderita kanker testis non-seminoma.Kata kunci: tumor testis, undescended testicle, faktor prediktif ABSTRACTThe aim of this research is to determine characteristics and predictive factors in adult testicular tumor in JakartaAnalyzed the data were collected from urology departemen at Cipto Mangunkusumo hospital and Dharmais hospital medical records. The collected data were age, AFP, LDH, HCG, type of operation, type of tumor, type of therapy and staging and reviewed retrospectively. Data were analyzed by using ANOVA in SPSS 11.5 for correlation between age and stage, undescended testicle (UDT) and stage, serum marker in all cases as well as and stage, and correlation between AFP in non-seminomatous patients with stage.During 10 years, 149 testicular tumors patients were registered, among these cases, 129 cases are adult patients and the range of age was 18-72 years old with mean of age was 33.03 years old. Type of tumors were seminoma 67 (51,9 %) patients, non-seminoma 50 (38.8 %) patients, non germinal 6(4,7 %) patients, unidentified 6 (4,7 %) patients. Eighty seven patients (67,4 %) underwent high ligation orchidectomy ivhile 23 (17,8 %) patients underwent transcrotal orchidectomy. Incidence of UDT patients was 13 (10,1%) patients. Most of the seminoma patients were diagnosed as stage 2c (36,9 %), and in non-seminoma was 3c (48.9 %). Chemotherapy was performed in 51 (39,5 %) patients, radiotherapy 24 (18,6 %) patients and 27 (20,9 %) patients refused to be treated, and 18 (14,0 %) patients were died before treatment due to poor condition. In this study, there was no significant correlation between age and stage. Seventy seven percent patient with UDT had advance stage compare to 66,7 % in non-UDT patients, however this was not statistically significant. Mean for LDH was 1785,35, and the LDH
THE EFFECT OF CATHETER TRACTION DIRECTION ON HEMOSTASIS AND PAIN POST TURP Ariani, Devintha Tiza; Umbas, Rainy; Rasyid, Nur; Suprabawati, Tri Endah
Indonesian Journal of Urology Vol 19 No 2 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i2.59

Abstract

Objective: To compare the effect the direction of catheter traction to the abdomen with direction to the leg on hemostasis and pain degree post-TURP. Material & Method: 122 patients with BPH came to Cipto Mangunkusumo Hospital and Budi Asih Hospital, Jakarta during the period between January 2005 to January 2011. Results: 101 patients with retention and 21 patients without retention were included in this study. Resected tissue weight was 22,95 grams, irrigation time was 2,24 days, catheterisation time was 3,97 days, and post TURP hospitalization was 3,9 days. Hb decline was 1,17g/dl. There was no statistical difference on Hb decline between leg direction 1,23 g/dl and abdominal direction 1,12 g/dl. Resected tissue weight in abdominal direction group was 25 grams, while in leg direction group was 21 grams. Irrigation time in abdominal direction group was 2 days while in leg direction group was 2,4 days. Catheterisation time in abdominal direction group was 3,3 days while in leg direction was 3,4 days. Post TURP hospitalization in abdominal direction group was 3,7 days while in leg direction groups was 4,2 days. In this study resected tissue weight, irrigation time, catheterisation time, and hospitalization time. There were 64 patients with pain degree registration, patients with abdominal traction had mean pain degree scale 1,52 and 33 patients with leg traction had pain degree scale 2,97, in this study this differences were significant. Conclusion: Abdominal traction post TURP was statistically difference on shortened postoperative irrigation and catheterisation time, including reduced post TURP hospitalization and pain degree. Abdominal traction was recommended from this study to be used as the reference standard for changing leg traction. Keywords: Catheter traction, visual analog scale, hemostasis, transurethral resection of the prostate.
PRELIMINARY REPORT: LAPAROSCOPIC RADICAL PROSTATECTOMY IN JAKARTA Johan, Mohammad; Mochtar, Chaidir Arif; Umbas, Rainy
Indonesian Journal of Urology Vol 19 No 2 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i2.64

Abstract

Objective: To report initial experience of laparoscopic radical prostatectomy (LRP) in Jakarta and evaluate the functional and oncology outcome. Material & Method: Between June 2007 until September 2008, we had done 9 times LRP surgery. All data is retrospectively taken and divided in three groups, i.e. pre-operative data (patient demography, pre-operative PSA, prostate volume, Gleason Score, clinical and functional staging), intra-operative data (intra-operative complication, conversion to open surgery, bleeding volume, and operating time), and post-operative data (post-operative complication, duration of urine catheter usage, duration of hospitalization, functional and oncology status). Results: Among nine subjects who underwent LRP, five subjects (55,55%) did not converted into open surgery. There are 2 subjects who gain their sexual potency and urine continence in one year post op. Only one subject is proven without biochemical failure in 1 year. Conclusion: We confirmed that radical prostatectomy can be performed with transperitoneal laparoscopic technique by a team that has been experienced in laparoscopic. Keywords: Laparoscopic radical prostatectomy, functional result, oncological result.
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.
EFEK KATETER TERHADAP FUNGSI PSA SERUM SEBAGAI PREDIKTOR VOLUME PROSTAT PADA PASIEN YANG TERBUKTI BENIGN PROSTATIC HYPERPLASIA PADA PEMERIKSAAN HISTOPATOLOGIS Tranggono, Untung; Mochtar, Chaidir A; Umbas, Rainy
Indonesian Journal of Urology Vol 16 No 1 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i1.359

Abstract

Objective: To define the use of Prostate Specific Antigen (PSA) as a predictor of prostate volume in catheterized BPH patients. Material & methods: Data were collected from medical record of symptomatic BPH patients who underwent prostate biopsy at Cipto Mangunkusumo Hospital Urology Clinic since 1994 until 2006. Data of age, serum PSA, indwelling catheter, maximal flow, urine residue, and prostate volume were recorded as variables. Patients who had histopathological result of BPH with or without prostatitis were included; while who had prostate carcinoma, high grade prostatic intraepithelial neoplasm (HGPIN), and BPH with atypical small acinar proliferation (ASAP) were excluded. Subject were then divided into 2 groups, catheterized or not. Data were analyzed using Mann-Whitney test, analysis of variance, correlation test and linear regression test. Results: Of  2283 patients were performed prostate biopsy, 1036 patients had results of BPH with or without prostatitis, 766 patients had prostate carcinoma, while 581 patient’s biopsy result were not recorded. Of the 1036 patients, 347 were catheterized, 192 non-catheterized, and 457 were not recorded. In the catheterized group the average age were 67,04 years old, serum PSA 26,88 ng/ml, prostate volume 54,33 ml, PSA density 0,39. In non-catheterized group the average age were 66,32 years old, serum PSA 16,58 ng/ml, prostate volume 53,94 ml, PSA density 0,33. Regression test showed that serum PSA could be used as a predictor of prostate volume (F=12,830; p < 0,001); in non-catheterized group it was stronger (F=12,989; p<0,001) than in catheterized group (F=6,814; p<0,01). The accuracy of serum PSA as a prostate volume predictor based on Receiver Operating Curve (ROC) as indicated by Area Under the Curve (AUC), in the catheterized group was 0,678 - 0,725 (p<0,001); in non-catheterized group was 0,723 - 0,784 (p<0,001). Conclusion: Serum PSA could be used as a predictor of prostate volume in patients with BPH wether catheterized or not. This predictor function is stronger in non-catheterized patients. Catheter has the effect of lowering the function of serum PSA as a prostate volume predictor in patients with BPH.
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.
Co-Authors Adianti Khadijah, Adianti Agus Hamid Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Ahmad Zulfan, Ahmad Andika Afriansyah, Andika Ari Astram, Ari CHAIDIR A MOCHTAR, CHAIDIR A CHAIDIR ARIEF MOCHTAR, CHAIDIR ARIEF Chaidir Arif Mochtar CHAIDIR MOCHTAR, CHAIDIR Devinta Tirza Ariani, Devinta Tirza Devintha Tiza Ariani Doddy Hami Seno Dodi Hami Seno, Dodi Hami Egi Edward Manuputty, Egi Edward Fakhri Rahman, Fakhri Ferry Safriadi Hafizar Harina Rahardjo, Harina Hery Tiera ILHAM WAHYUDI MASFAR, ILHAM WAHYUDI Johan -, Johan Laksmi, Lidya Imelda Matondang, Sahat BRE MOCHAMMAD REZA ARIEF RAKHMAN, MOCHAMMAD REZA ARIEF Mohammad Johan Noor Riza Perdana, Noor Riza Nur Rasyid Prahara Yuri R. Danarto, R. RACHMAT BUDI SANTOSO, RACHMAT BUDI Rahmat Santoso, Rahmat Richard Monoarfa RIZAL A HAMID, RIZAL A Rumanter, Rainier Sutisna Himawan Syarif Bakri, Syarif Taufan Tenggara Tri Endah Suprabawati Untung Tranggono, Untung Warli, Syah Mirsya YEVRI ZULFIKAR, YEVRI Yunir, Peri Eriad