Hariyono Winarto
Faculty Of Medicine Universitas Indonesia/ Dr. Cipto Mangunkusumo General Hospital Jakarta

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Plasma MicroRNA-200c as A Prognostic Biomarker for Epithelial Ovarian Cancer Addin Trirahmanto; Hariyono Winarto; Aria Kekalih; Ferry Sandra
The Indonesian Biomedical Journal Vol 11, No 3 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i3.761

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BACKGROUND: Ovarian cancer is the 8th most prevalent cancer in women in the world. Current biomarker prognosis for ovarian cancer has numerous limitations, thus new biomarkers are needed. MicroRNAs (miRs) are considered as potential biomarkers in ovarian cancer as they are stable in blood. One candidate is miR-200c, the main regulator in epithelial transition to the mesenchyme. The aim of this study is to determine the role of miR-200c as prognostic biomarker for epithelial ovarian cancer (EOC).METHODS: This is a prospective cohort study conducted at Dr. Sardjito Central General Hospital in Yogyakarta from September 2015 to July 2018. Sampling was done using consecutive sampling method. Forty plasma samples of EOC subjects were included in this study. miR-200c expression was quantified using Reverse Transcriptase Quantitative Quantitative Polymerase Chain Reaction (RTqPCR) with miR-16 as the reference gene.RESULTS: The expression of miR-200c was significantly higher in the group of subjects with preoperative CA-125 levels >500 U/mL (p=0.009) than the group of subjects with preoperative CA-125 levels <500 U/mL. Subjects with higher miR-200c expression had lower survival rate than subjects with lower miR-200c expression, although not statistically significant.CONCLUSION: The miR-200c could be a promising biomarker for EOC. Further studies with larger sample sizes are needed to clarify the prognostic value of miR200c.KEYWORDS: miR-200c, epithelial ovarian cancer, prognosis, overall survival
Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Unedo H Markus; Hariyono Winarto; Andrijono Andrijono; Bambang Sutrisna
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (156.824 KB) | DOI: 10.32771/inajog.v3i2.37

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Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p
Caspase-3 can not be Used to Predict the Response to Neoadjuvant Chemotherapy Regiment PVB in Cervical Cancer Stage IB-IIA Ediwibowo Ambari; Hariyono Winarto; Bambang Sutrisna; Budiningsih Siregar
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (101.064 KB) | DOI: 10.32771/inajog.v1i3.357

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Objectives: To determine the factors that may be used as the prognostic parameter for the therapeutic efficacy of neoadjuvant chemotherapy, which can be used to revising the management of early stage cervical cancer patients with large lesions. Methods: This was a retrospective cohort study. The study was conducted in the Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia. The subjects were 15 cervical cancer stage IB2 and IIA patients with lesions’ size of > 4 cm, who would be treated with neoadjuvant chemotherapy, consisted of cisplatin 50 mg/m2, vincristine 2 mg/m2 and bleomycin 15 mg regiment. The patients’ response would be evaluated after completing 3 series of chemotherapy. Data was retrieved from medical records and cervical biopsy paraffin blocks and examined histopathologically using IHC staining to see expression of caspase-3 with histoscore assessment score. Data was analyzed by univariate, bivariate analysis. Results: Response to PVB neoadjuvant chemotherapy was found in 5 out of 15 patients. None of the clinicopathology variables can be used to predict response to therapy. Expression of caspase-3 as a marker of apoptosis, can not predict the response of the therapy before administrating neoadjuvant chemotherapy either. There is a significant difference between the levels of caspase-3 in epidermoid carcinoma with adenocarcinoma, with p value of 0.02 (RR 6;95% CI 1.69-21.26). Conclusion: Clinicopathologic factors and the expression of caspase-3 before getting chemotherapy neoadjuvant can not predict the succeed of the therapy. [Indones J Obstet Gynecol 2013; 1-3: 156-60] Keywords: caspase -3, clinicopathologic, early-stage cervical cancer lession in large, neoadjuvant chemotherapy response to therapy
HE4 has a High Diagnostic Value to Detect Epithelial Ovarian Cancer: HE4 Memiliki Nilai Diagnostik yang Tinggi untuk Mendeteksi Keganasan Ovarium Tipe Epitel Bismarck J. Laihad; Hariyono Winarto; Bambang Sutrisna
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 4, October 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (128.209 KB) | DOI: 10.32771/inajog.v1i4.368

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Objective: To find out the diagnostic value of CA125 and HE4 as a tumor marker, and also RMI and ROMA as a malignancy predictor in patients with ovarian tumors. Methods: This study was a diagnostic study using cross-sectional design.This study was performed in Jakarta from November 2010 to May 2011. One hundred and twenty eight serum samples of patients diagnosed with ovarian tumors were collected before undergoing surgery in Dr. Cipto Mangunkusumo General Hospital. The CA125 and HE4 levels were then examined. The histopathological examination of tissue specimens were performed in Department of Pathology Anatomy in RSCM. For statistical analysis, we used a 2x2 table to produce ROC-AUC curve. Results: The median value of HE4 and CA125 serum concentrations was higher and more significant on patients with ovarian malignancy than patients with benign ovarian tumor (p<0.05). Using the cut-off standard, HE4 had the highest accuracy value (76.5%). On the premenopausal group, HE4 and ROMA had the same AUC value, that is 85.0 % (95% CI: 0.73-0.96), whereas on the postmenopausal group, ROMA had the highest AUC value of 96.9 % (95% CI: 0.92-1.00). Conclusion: HE4 has a high diagnostic value as a single tumor marker to detect epithelial ovarian cancer and its combination with CA125 (ROMA) gives an even better result. Keywords: epithelial ovarian cancer, human epididymis protein 4, risk of ovarian malignancy algorithm, tumor marker
Papsmear Examination for Diagnosing PreCancer Lesion in Invisible SquamoColumnar Junction Laila Nuranna; Sulaeman Daud; Gatot Purwoto; Hariyono Winarto; Kartiwa H Nuryanto
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (105.731 KB) | DOI: 10.32771/inajog.v4i3.439

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Objective: To know the concealed pre-cancer lesion in women with invisible squamo-columnar junction (SCJ) by Papsmear examination. Method: This study was a descriptive cross-sectional design starting from August 2014 to March 2015 at several Public Health Cares in Jakarta. A total of 1,682 subjects were screened by Acetoacetate Visual Inspection (AVI) examination. After the data was collected, the process was continued by verification, editing, and coding. The descriptive analysis showed the percentage of SCJ in age distribution, the percentage of AVI examination based on SCJ, and the percentage of Papsmear examination in invisible SCJ according to negative AVI result. Result: There were 1,484 (88.2%) women with the visible SCJ and 198 (11.8%) women with invisible SCJ. The percentage of invisible SCJ in the menopausal women group was 122 (61,6%); meanwhile, in the non-menopausal women group, it was 76 (38.4%). Almost half of the percentage from visible SCJ was found in menopausal women group 45.8% (103/225 women). The positive AVI result was 4 (7.1%) in the menopausal women group and 52 (92.9%) in non-menopausal women group. The result of Papsmear examination with invisible SCJ were 197 (100%) normal. Conclusion: Almost half of visible SCJ was found in menopausal women group. Most of positive AVI result was found in the nonmenopausal women group. All women with the invisible SCJ have a normal Papsmear result. Keywords: acetoacetate visual inspection, papsmear, pre-cancer lesion, squamo-columnar junction
Radiotherapy Response of Cervical Cancer Patients at a Tertiary Referral Hospital in Indonesia: Respon Terapi Radiasi Pasien Kanker Serviks pada suatu Rumah Sakit Rujukan Tersier Hariyono Winarto; Erwin Rahakbauw; Nana Supriana
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.804 KB) | DOI: 10.32771/inajog.v5i4.567

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Objective: To investigate the response of radiotherapy and related clinicopathologic characterictics on cervical cancer patients. Methods: This was a retrospective study. Subjects were patients diagnosed with cervical cancer stage IIA-IIIB who had undergone radiation therapy based on standard protocol in our hospital, during the period of January 2014 to December 2015. The clinical factors ofthose patients, such as age, Body Mass Index, blood pressure, hemoglobin level, blood leucocyte count, serum albumin, largest tumor diameter, the International Federation of Gynecology and Obstetrics (FIGO) staging, as well as pathologic characteristic, i.e histopathology and grading were recorded. During radiation protocol until 3months post radiation, we also noted any side effects of gastrointestinal tract, genitourinary tract, and hematologic. Evaluation of radiotherapy response was based on Response Evaluation Criteria in Solid Tumors (RECIST). Results: A total of 123 subjects were enrolled in this study. 84 cases or 68.29% was complete response, 30 cases or 24.39% was partial response, 6 cases or 4.88% was stabile response, and 3 cases or 2.44% was progressive. Based on gastrointestinal side effect, there was no side effect or grade 0 on 99 cases (80.49%), grade 1 on 20 cases (16.26%), grade 2 on 4 cases (3.25%), grade 3 on 0 case (0%). Based on side effect of genitourinary, there was no side effect or grade 0 on 105 cases (85.37%), grade 1 on 17 cases (13.82%), grade 2 on 1 case (0.81%), grade 3 on 0 case (0%). Based on hematologic side effects, there was no side effecton 108 cases (87.80%), grade 1 on 15 cases (12.20%), grade 2 on 0 case (0%), grade 3 on 0 case (0%). Largest tumor diameter was statistically significant, with p=0.036 (RR 2.64 (1.07-6.56)). Conclusion: The majority of definitive-curative radiotherapy response on cervical cancer stage IIA-IIIB was complete (68.29%). Acute side effects involving the gastrointestinal, genitourinary, and hematologic system were commonly can be tolerable during and 3 months post radiation therapy. Clinicopathologic characteristics significantly associated with the complete response of radiotherapy was the largest tumor diameter. Keywords: largest tumor diameter, radiation response, radiationside effect
The Prevalence of Occult Omental Metastases in Patients with Epithelial Ovarian Cancer Hariyono Winarto; Ken Indra
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (79.632 KB) | DOI: 10.32771/inajog.v6i2.773

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Objective: Studies regarding omentectomy on epithelialovarian cancer are scarce with conflicting results; this study isaimed to investigate the prevalence of occult metastases inpatients with epithelial ovarian cancer of the omentum.Methods: A cross-sectional study design was used by evaluating themedical records of surgically staged ovarian cancer patients in Dr.Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the periodof January 2009 to December 2015.Results: A total of 51 subjects were involved in this study. One(2%) of 51 subjects was found to have occult metastases in theomentum. The prevalence of metastases of early stage epithelialovarian cancer in 2009-2015 is 33.3% (17 out of 51 subjects),whereas the omental involvement is found only in 2% subjects(1 out of 51).Conclusion: The prevalence of occult metastases of early stageepithelial ovarian cancer in Dr. Cipto Mangunkusumo Hospital,Jakarta, Indonesia, from 2009-2015 in 2% (1/51 subjects).[Indones J Obstet Gynecol 2018; 6-2: 119-122]Keywords: cancer, epithelial, metastases, omentum, ovarian cancer,ovary, prevalence
The Role of Thrombocytosis as a Prognostic Factor for Epithelial Ovarian Cancer: Peran Trombositosis sebagai Faktor Prognostik pada Kanker Ovarium Jenis Epitelial Andrijono; Heru Prasetyo; Eka R Gunardi; Gatot Purwoto; Hariyono Winarto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1275

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Objective: To determine whether thrombocytosis is a prognostic factor for epithelial ovarian cancer and its relationship with 3-year overall survival in epithelial ovarian cancer patients.Methods: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer registered in cancer registry of Oncology Division in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo National General Hospital from January 2014 - July 2016. Data were collected when subjects were first until diseases outcomes identified in 3 years.Results: : Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42.7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0.005; OR=2.329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0.555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups (p = 0.399).Conclusion :Thrombocytosis is not a prognostic factor in patients with epithelial ovarian cancer. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis.Keywords: epithelial ovarian carcinoma, prognosis, thrombocytosis. Abstrak Tujuan: Membuktikan bahwa trombositosis sebagai faktor prognosis kesintasan pada pasien kanker ovarium jenis epitelial dan hubungannya terhadap kesintasan 3 tahun pasien kanker ovarium jenis epitelial.Metode: Penelitian ini merupakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014-Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis akhir pengamatan selama 3 tahun.Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Trombositosis secara statistik tidak bermakna pada kesintasan 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399).Kesimpulan : Trombositosis bukan merupakan faktor prognostik pada pasien kanker ovarium jenis epitelial dan tidak terdapat hubungan antara trombositosis dan 3 tahun pada pasien dengan kanker ovarium jenis epithelial.Kata kunci: karsinoma ovarium epithelial, prognosis, trombositosis
Quality of Life Assessment in Patient who Underwent Chemotherapy in Gynaecologic Oncology Division: Penilaian Kualitas Hidup pada Pasien yang menjalani Kemoterapi di Divisi Onkologi Ginekologi Hariyono Winarto; William Halim
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 4 October 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i4.1353

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Abstract Objective: To determine the quality of life in cancer patients who underwent chemotherapy treatment.Methods: A cross-sectional study was conducted from June to August 2019. Patients with cancer, who had undergone chemotherapy and willing to participate were included in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ–30) questionnaire was used as the measurement tool. The patients were grouped into three groups based on the cycles of chemotherapy.Results: Sixty three responders participated in the study. As the treatment progressed, there was a signifi cant decrease in Global Health Status (GHS) and social function. In symptom scales, there was a signifi cant increase in nausea and vomiting, pain, and insomnia.Conclusions: There was a decrease in the quality of life in patients with gynecological cancer who underwent chemotherapy in dr. Cipto Mangunkusumo National General Hospital. This result should be an evaluation for the healthcare provider to implement a holistic approach in managing cancer patients.Keywords: chemotherapy, gynaecological cancer, quality of life. Abstrak Tujuan: Untuk menilai kualitas hidup pasien kanker yang menjalani kemoterapi.Metode: Penelitian dilakukan dengan metode potong lintang, dilakukan dari Juni hingga Agustus 2019. Semua pasien dengan kanker yang menjalani kemoterapi dan bersedia mengikuti penelitian diikutsertakan dalam penelitian ini. Penilaian dilakukan menggunakan kuisioner dari The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ- 30) digunakan. Pasien dikelompokkan menjadi 3 kelompok berdasarkan siklus kemoterapinya.Hasil: Terdapat 63 pasien yang berpartisipasi dalam penelitian ini. Seiring pengobatan, terdapat penurunan signifikan pada global health status (GHS) dan fungsi sosial. Gejala yang meningkat secara signifi kan antara lain mual dan muntah, nyeri, dan insomnia.Kesimpulan: Terdapat penurunan kualitas hidup pada pasien kanker ginekologi yang menjalani kemoterapi di Rumah Sakit Dr. Cipto Mangunkusumo. Hasil penelitian ini menjadi evaluasi untuk penyedia layanan kesehatan agar dapat menangani pasien kanker secara holistik.Kata kunci: kanker ginekologi, kemoterapi, kualitas hidup.
Small cell neuroendocrine carcinoma of the uterine cervix (SCNEC): a case report and review Puja Agung Antonius; Hariyono Winarto
Jurnal Ilmu Kesehatan Indonesia Vol 2 No 1 (2021): Maret 2021
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1292.711 KB) | DOI: 10.25077/jikesi.v2i1.528

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Objective: Improving skill and knowledge to diagnose and manage a rare case of small cell neuroendocrine uterine cervical cancer Method: a Case report Result: A 51 years old, para 2, Indonesian woman with chief complaint post-coital vaginal bleeding. Gynecology examination revealed cervical exophytic fragile mass size 3x3x3,5 cm, easily bleeding, with a necrotic part, infiltrated both parametria but not reach the pelvic wall correspond to stage IIB. Initially, the histopathology result from punch biopsy was an adenocarcinoma well-differentiated, with no lymph vascular invasion, DD/ adenosquamous, neuroendocrine tumor. We did the histopathology review continued with immunohistochemistry examination. Immunohistochemistry result showed that although all the sample was not typical, immunohistochemical outward patterns can support morphological features of high-grade neuroendocrine carcinoma, small cell type. We proceed here for chemoradiation therapy. Conclusion: Small cell neuroendocrine carcinoma of the uterine cervix is a rare case. Histopathology and immunohistochemistry examination has an important role to develop the diagnosis. Although the prognosis is poor, adjuvant chemotherapy or chemoradiation was associated with improved survival in patients with advance staged. Keywords: SCNEC, immunohistochemistry, chemoradiation