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All Journal Nusantara Medical Science Journal Universa Medicina Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Ilmiah Kesehatan Cermin Dunia Kedokteran Indonesian Journal of Cancer Cermin Dunia Kedokteran
Kartiwa Hadi Nuryanto
Department Of Obstetrics And Gynecology, Faculty Of Medicine, University Of Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health

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Socio-demographic Profiles of Cervical Cancer Patients at Cipto Mangunkusumo Hospital - 2009-2019 and Its Association with Cancer Stages at Diagnosis Fitriyadi Kusuma; Kemal Akbar Suryoadji; Michael Adrian; Tofan Widya Utami; Hariyono Winarto; Tricia Dewi Anggraeni; Kartiwa Hadi Nuryanto; Muhammad Haekal
Cermin Dunia Kedokteran Vol 49, No 5 (2022): Jantung dan Saraf
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i5.1846

Abstract

Objective: To determine the socio-demographic profile of cervical cancer patients at Cipto Mangunkusumo Hospital in 2009-2019 based on educational level, parity, age, residence, and employment status and their relationship to cervical cancer stage at diagnosis. Methods: Comparative analytical study was conducted retrospectively based on medical records in Cipto Mangunkusumo Hospital. The selection was based on data completeness: cervical cancer stages, sociodemographic profiles consisting of education level, parity, age, Java or non-Java Island resident, and occupation. Multivariate analysis calculated the association between socio-demographic factors and cervical cancer stages. Data were analyzed using SPSS v.22.0 and Microsoft Excel. Results: This study included 4,584 patients with complete data. Only 19.3% patients were in the early stage, 63.3% had less than three parities, 82.8% of patients had formal primary school education or less, 80.9% patients were aged 18-65 years, 88.3% patients resided in Java Island, and 80.5% didn’t have the occupation. There was a significant association (p <0.05) between cervical cancer stage and educational level (aOR= 0.86; 95% CI= 0.78-0.94) and age (aOR= 1.46; 95% CI= 1.18-1.40). There is no significant association (p >0.05) between cervical cancer stage and parity, residence, and employment status. Conclusion: Low education and old age (> 65-year-old) were associated with the advanced stage of cervical cancer at diagnosis. Tujuan: Mengetahui profil sosiodemografi pasien kanker serviks di Rumah Sakit Cipto Mangunkusumo tahun 2009-2019 berdasarkan tingkat pendidikan, jumlah paritas, usia, status kependudukan, pekerjaan, serta hubungannya terhadap stadium kanker serviks saat diagnosis. Metode: Penelitian analitik komparatif retrospektif berdasarkan data rekam medis Rumah Sakit Cipto Mangunkusumo. Pemilihan sesuai kelengkapan data: stadium kanker serviks, profil status sosiodemografi yang terdiri atas tingkat pendidikan, paritas, usia, penduduk pulau Jawa atau non-Jawa, dan status pekerjaan. Hubungan antar variabel dianalisis multivariat untukmencari hubungan berbagai faktor sosiodemografi terhadap stadium kanker serviks. Analisis data menggunakan program SPSS versi 22.0 dan Microsoft Excel.Hasil: Terdapat 4.584 pasien kanker serviks yang memenuhi kriteria inklusi. Sebanyak 19,3% pasien dengan stadium awal. Selanjutnya 82,8% pasien memiliki pendidikan formal sekolah dasar atau kurang, 63,3% pasien memiliki jumlah paritas kurang dari tiga, 80,9% pasien berusia antara 18-65 tahun, 88,3% pasien berdomisili di pulau Jawa, dan 80,5% tidak bekerja. Didapatkan asosiasi bermakna (p<0,05) antara stadium kanker serviks dan tingkat pendidikan (aOR = 0,86; 95% CI= 0,78-0,94) dan usia (aOR= 1,46; 95% CI= 1,18-1,40). Tidak ditemukan asosiasi bermakna (p>0,05) antara stadium kanker serviks dengan paritas, domisilikependudukan, dan status pekerjaan. Simpulan: Tingkat pendidikan rendah dan usia lanjut (>65 tahun) berasosiasi dengan stadium lanjut kanker serviks saat diagnosis. 
Blood Pressure Elevation Timing Following Hysterectomy Kartiwa Hadi Nuryanto; Kanadi Sumapraja; Marcel Elian Suwito; Eka Rusdianto Gunardi; Seno Adjie; Tofan Widya Utami
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.901

Abstract

Background: Hysterectomy is the most common non-obstetric surgery in adult, reproductive-age women. Hysterectomy with or without ovarian conservation is known to increase the risk of cardiovascular disease. However, only a few studies regarding its immediate and short-term effects on hypertension are available. This study aimed to determine changes in blood pressure after a hysterectomy procedure.Methods: This study is a prospective cohort study of patients who underwent a total hysterectomy procedure with or without ovarian conservation at Cipto Mangunkusumo Hospital, Indonesia, from July 2018 to July 2020. Samples were grouped into patients with total hysterectomy only or hysterectomy with ovarian conservation (HT/HTSOU) and bilateral salpingo-oophorectomy hysterectomy (HTSOB). Statistical analysis was done using paired t-test and Wilcoxon test. Results: There were 80 patients included in this study (40 for each group). A significant increase in all blood pressure components occurred at 12 months after the HT/HTSOU and HTSOB procedures (p < 0.05). After six months of the HTSOB procedure, the increase in blood pressure components only occurred in systolic blood pressure and mean arterial pressure (MAP) (p < 0.05).Conclusions: There was a significant increase in all blood pressure components in the HT/HTSOU and HTSOB group at 12 months following hysterectomy while there was a significant increase in systolic blood pressure and MAP in the HTSOB group at 6 months following hysterectomy.
Molecular and Host Lifestyle Factors Associated with Persistent Human Papillomavirus Infection and Progression into Cervical Cancer: A Literature Review Yo, Edward Christopher; Nuryanto, Kartiwa Hadi
Indonesian Journal of Cancer Vol 18, No 2 (2024): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i2.1068

Abstract

Background: Human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI) worldwide, especially among low- and middle-income countries. The virus can establish persistent infection in the cervical epithelium, thereby increasing the risk of progression into cervical cancer. Since cervical cancer is one of the leading causes of cancer death among women worldwide, it is important to understand more about persistent HPV infection and potential therapeutic targets to suppress it. This study aims to summarize current insight into various molecular and host lifestyle factors that contribute to persistent HPV infection and ultimately cervical cancer. Methods: This study adopts a literature review design by conducting a journal search through Google Scholar, PubMed, and ScienceDirect. The keywords used included “human papillomavirus”, “persistent infection”, “cervical cancer”, “immune evasion”, and “lifestyle”. Results: Several diverse mechanisms are believed to facilitate persistent HPV infection, which can be classified under molecular and host lifestyle factors. Molecular factors include compartmentalization of HPV replication and gene expression as well as immune evasion, whereas host lifestyle factors include alcohol consumption, smoking, multiple sexual partners, STI coinfection, and certain contraceptive agents. Conclusion: Persistent HPV infection acts as the intermediate phenotype before developing into cervical cancer. Understanding the molecular factors as well as host lifestyle factors underlying it can lead to more specific therapeutic options as well as better prevention and education programs. Future research is needed to better clarify the exact mechanisms underlying persistent infection. 
Prognostic Factors of Recurrent Cervical Cancer Stage IA2–IIA2: A Post-Surgical Treatment Analysis Argy, Gabriella; Nuryanto, Kartiwa Hadi; Hellyanti, Tantri
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1141

Abstract

Background: Cervical cancer is the most common female reproductive organ malignancy. Despite the prompt diagnosis and proper management based on the disease’s stage, the recurrent rate remains high, ranging from 18 to 44.3%. Prognostic factor detection may be the first step in reducing recurrent disease. To our knowledge, there are no studies that report the recurrence rate of cervical cancer and the prognostic factors in Indonesia yet. This study aims to report the recurrent rate of cervical cancer stage IA2–IIA2 and the prognostic factors.Methods: This is a retrospective cohort study. Histopathology results from 382 cervical cancer stage IA2–IIA2 patients who underwent radical hysterectomy and pelvic lymphadenectomy were reviewed. Bivariate analysis was performed to compare recurrent disease based on 7 prognostic factors: lymph node status, tumor size, depth of stromal invasion, lymphovascular space invasion (LVSI), parametrial involvement, histology type, and vaginal resection margin status.Results: Most cervical cancer patients with stage IA2–IIA2 were more than 40 years old, with a mean age was 52 years. The recurrent rate was 12%. Prognostic factors that were significantly associated with recurrence were tumor size ≥ 4 cm; RR 2.242 (95% CI 1.161–4.332) and LVSI; RR 2.037 (95% CI 1.039–3.994).Conclusions: The recurrence rate of cervical cancer stage IA2–IIA2 in Dr. Cipto Mangunkusumo National Hospital was 12%. Prognostic factors that were significantly associated with recurrence were tumor size ≥ 4 cm and LVSI.
Comparison of natural versus artificial cycles for endometrial preparation prior to frozen embryo transfer Tyagitha, Galuh Anindya; Nuryanto, Kartiwa Hadi; Pratama, Gita; Maidarti, Mila; Harzif, Achmad Kemal; Sumapraja, Kanadi; Lestari, Silvia Werdhy; Ampri, Irfan Arieqal Hatta; Talya, Natasha; Yanfaunas, Atika Mahira
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.304-312

Abstract

BackgroundThe endometrial preparation phase preceding embryo transfer assumes pivotal significance in achieving optimal endometrial receptivity and ensuring the success of pregnancy. The natural cycle (NC) and artificial cycle (AC) are the preferred methods for many in vitro fertilization (IVF) specialists. The objective of this study was to compare the difference between NC and AC in women undergoing frozen-thawed embryo transfer (FET) after IVF. MethodsA cross-sectional study was conducted involving 150 adult women who underwent FET with a single autologous blastocyst stage embryo in a 5-year period (2014-2019). Bivariate analysis was conducted to discern implantation and pregnancy rates associated with NC and AC for endometrial preparation. Multiple logistic regression was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. ResultsOf the 150 subjects meeting study criteria, 19 underwent NC, while 131 underwent AC for endometrial preparation. Natural cycle exhibited a higher biochemical pregnancy rates compared to AC (89.5% vs. 53.4%; p=0.003). Artificial cycle is a significant determinant for biochemical pregnancy rates compared to NC (aOR: 0.132;95% CI: 0.028 – 0.623; p=0.010) ConclusionIn women undergoing FET, NC resulted in higher biochemical pregnancy rates compared to AC. However, clinical pregnancy rates and ongoing pregnancies rates did not exhibit significant disparities between NC and AC. Future studies will hopefully further illuminate which protocol is most suitable for the individual patient. Further multi-center randomized clinical trials are needed to confirm the relationship between biochemical pregnancy rates and NC.
The Age as a Risk Factor for Advanced Stage in Cervical Cancer Patients at RSUPN Cipto Mangunkusumo 2019-2022: A Retrospective Multivariate Study Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Purwoto, Gatot; Wulandari, Anisa Saphira; Soloan, Garry; Sini, Kieran Pasha Ivan; Utami, Tofan Widya; Anggaraeni, Tricia Dewi; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Winarto, Hariyono
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2366

Abstract

Abstract Introduction: In 2020, cervical cancer ranked as the fourth most common cancer in women globally, with an incidence of 604,000 cases. In Indonesia, cervical cancer holds the second position among the most prevalent cancers in women. This study aims to evaluate the relationship between age and the occurrence of advanced-stage cervical cancer as a step towards effective prevention, early detection, and management. Methods: This research adopts a retrospective study design based on the Cancer Registration database of RSUPN Cipto Mangunkusumo, focusing on cervical cancer patients from 2019 to 2022. Multivariate analysis was conducted with age as the primary independent variable, considering parity and employment status in the analysis. The FIGO classification of cervical cancer stages was used to categorize patients into early and advanced stages. Results: Out of 512 cervical cancer cases, 492 were included in this study. The distribution of cervical cancer stages and the age distribution of patients is depicted in Figure 1 and Figure 2. The analysis of the relationship between cervical cancer stage, age, parity, and employment status is presented in Table 2. The association between age and cervical cancer stage is statistically significant (p<0.05) with an odds ratio of 2.13, particularly in individuals aged >54 years. Conclusion: Age over 54 years is a significant risk factor for advanced-stage cervical cancer. Although there is no significant association with parity and employment history, these findings support preventive and early detection efforts in the older population. Increased screening programs and education are expected to reduce cases of advanced-stage cervical cancer in the future.
Socio-demographic Profiles of Cervical Cancer Patients at Cipto Mangunkusumo Hospital - 2009-2019 and Its Association with Cancer Stages at Diagnosis Fitriyadi Kusuma; Kemal Akbar Suryoadji; Michael Adrian; Tofan Widya Utami; Hariyono Winarto; Tricia Dewi Anggraeni; Kartiwa Hadi Nuryanto; Muhammad Haekal
Cermin Dunia Kedokteran Vol 49 No 5 (2022): Neuro-Kardiovaskular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i5.227

Abstract

Objective: To determine the socio-demographic profile of cervical cancer patients at Cipto Mangunkusumo Hospital in 2009-2019 based on educational level, parity, age, residence, and employment status and their relationship to cervical cancer stage at diagnosis. Methods: Comparative analytical study was conducted retrospectively based on medical records in Cipto Mangunkusumo Hospital. The selection was based on data completeness: cervical cancer stages, sociodemographic profiles consisting of education level, parity, age, Java or non-Java Island resident, and occupation. Multivariate analysis calculated the association between socio-demographic factors and cervical cancer stages. Data were analyzed using SPSS v.22.0 and Microsoft Excel. Results: This study included 4,584 patients with complete data. Only 19.3% patients were in the early stage, 63.3% had less than three parities, 82.8% of patients had formal primary school education or less, 80.9% patients were aged 18-65 years, 88.3% patients resided in Java Island, and 80.5% didn’t have the occupation. There was a significant association (p <0.05) between cervical cancer stage and educational level (aOR= 0.86; 95% CI= 0.78-0.94) and age (aOR= 1.46; 95% CI= 1.18-1.40). There is no significant association (p >0.05) between cervical cancer stage and parity, residence, and employment status. Conclusion: Low education and old age (> 65-year-old) were associated with the advanced stage of cervical cancer at diagnosis. Tujuan: Mengetahui profil sosiodemografi pasien kanker serviks di Rumah Sakit Cipto Mangunkusumo tahun 2009-2019 berdasarkan tingkat pendidikan, jumlah paritas, usia, status kependudukan, pekerjaan, serta hubungannya terhadap stadium kanker serviks saat diagnosis. Metode: Penelitian analitik komparatif retrospektif berdasarkan data rekam medis Rumah Sakit Cipto Mangunkusumo. Pemilihan sesuai kelengkapan data: stadium kanker serviks, profil status sosiodemografi yang terdiri atas tingkat pendidikan, paritas, usia, penduduk pulau Jawa atau non-Jawa, dan status pekerjaan. Hubungan antar variabel dianalisis multivariat untuk mencari hubungan berbagai faktor sosiodemografi terhadap stadium kanker serviks. Analisis data menggunakan program SPSS versi 22.0 dan Microsoft Excel. Hasil : Terdapat 4.584 pasien kanker serviks yang memenuhi kriteria inklusi. Sebanyak 19,3% pasien dengan stadium awal. Selanjutnya 82,8% pasien memiliki pendidikan formal sekolah dasar atau kurang, 63,3% pasien memiliki jumlah paritas kurang dari tiga, 80,9% pasien berusia antara 18-65 tahun, 88,3% pasien berdomisili di pulau Jawa, dan 80,5% tidak bekerja. Didapatkan asosiasi bermakna (p<0,05) antara stadium kanker serviks dan tingkat pendidikan (aOR = 0,86; 95% CI= 0,78-0,94) dan usia (aOR= 1,46; 95% CI= 1,18-1,40). Tidak ditemukan asosiasi bermakna (p>0,05) antara stadium kanker serviks dengan paritas, domisili kependudukan, dan status pekerjaan. Simpulan: Tingkat pendidikan rendah dan usia lanjut (>65 tahun) berasosiasi dengan stadium lanjut kanker serviks saat diagnosis.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN TINGKAT KEHAMILAN PASIEN HIPERPLASIA DAN KANKER ENDOMETRIUM: TINJAUAN SISTEMATIS DAN META-ANALISIS Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Wulandari, Anisa Saphira; Binathara, Geraldus Sigap Gung; Soloan, Garry; Sini, Kieran Pasha Ivan; Purwoto, Gatot; Utami, Tofan Widya; Anggaraeni, Tricia Dewi; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Winarto, Hariyono
Jurnal Ilmiah Kesehatan Vol 23 No 03 (2024): Jurnal Ilmiah Kesehatan terbitan Desember Volume 23 Nomor 03 Tahun 2024
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikes.v23i03.3405

Abstract

Hiperplasia endometrium dan kanker endometrium adalah kondisi yang memengaruhi kesuburan wanita. Tujuan dari tinjauan sistematis dan meta-analisis ini adalah untuk mengevaluasi faktor-faktor yang berhubungan dengan tingkat kehamilan pada pasien dengan kondisi tersebut. Pencarian dilakukan di lima database utama: PubMed, Science Direct, Scopus, Embase, dan Cochrane Library. Dari 2.742 studi yang awalnya ditemukan, 7 studi memenuhi kriteria inklusi dan dianalisis lebih lanjut. Meta-analisis dilakukan untuk mengevaluasi efek terapi kombinasi Levonorgestrel-Releasing Intrauterine System (LNG-IUS) dengan progestin dan pengaruh indeks massa tubuh (BMI) terhadap tingkat kehamilan. Analisis gabungan dari dua studi yang membandingkan kombinasi LNG-IUS dengan progestin terhadap LNG-IUS saja menghasilkan Odds Ratio (OR) sebesar 1,54 [95% CI: 0,74–3,24], tanpa signifikansi statistik (p = 0,25). Untuk BMI, gabungan dua studi memberikan Risk Ratio (RR) sebesar 1,40 [95% CI: 0,93–2,10], juga tidak signifikan (p = 0,11). Heterogenitas yang rendah (I² = 0%) pada analisis terapi dan sedang (I² = 53%) pada analisis BMI menunjukkan konsistensi antarstudi. Meskipun ada tren peningkatan angka kehamilan dengan terapi kombinasi LNG-IUS dan progestin serta BMI ≥ 25, hasil meta-analisis ini belum menunjukkan signifikansi statistik. Penelitian lebih lanjut diperlukan untuk memperjelas faktor-faktor yang berhubungan dengan kehamilan pada pasien dengan hiperplasia dan kanker endometrium.
Comparison of USG and CT Scan Findings in Late Stage Ovarian Cancer in Dr. Cipto Mangunkusomo National Referral Hospital Sugianto, Sugianto; Purwoto, Gatot; Nuranna, Laila; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Shelly, Vannesa
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1369

Abstract

Background: Ovarian cancer remains a leading cause of gynecological cancer mortality due to its typically late-stage diagnosis. Current diagnostic methods include ultrasonography (USG) and computed tomography (CT), with CT generally favored for its higher sensitivity and specificity. However, CT's limited availability in resource-poor settings raises the need to assess USG’s diagnostic viability in detecting advanced ovarian malignancies. This study aims to compare the diagnostic accuracy of USG and CT in detecting adnexal masses, ascites, lymph node involvement, omental cake, and distant metastasis in advanced-stage ovarian cancer.Method: A cross-sectional comparative study was conducted at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from January 2021 to December 2023. The study included 70 patients with histologically confirmed advanced ovarian cancer (FIGO stages III and IV) who underwent both USG and CT before surgical intervention. Diagnostic performance measures, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated for each modality, using surgical findings as the gold standard. Statistical analysis was performed using SPSS software, with significance set at p 0.05.Results: Both imaging methods demonstrated high specificity (100%) and PPV for adnexal mass detection, indicating reliability in confirming positive cases. However, CT showed superior sensitivity and accuracy across most parameters, particularly for ascites (sensitivity: 93.94%), lymph node involvement (56%), and distant metastases (36.67%). In comparison, USG had lower sensitivity, especially for distant metastases (6.67%), but maintained high specificity. These findings suggest that while USG is effective for initial assessment, CT is preferred for detailed staging.Conclusion: This study confirms CT’s superiority over USG in comprehensive ovarian cancer staging, particularly for detecting metastatic indicators. However, USG’s accessibility and affordability support its role as an initial diagnostic tool, especially in resource-limited settings. A multimodal approach, integrating USG for preliminary screening with CT for confirmation, may optimize diagnostic outcomes. Further research should focus on enhancing USG’s sensitivity to bridge the diagnostic gap in underserved regions.
Clinicopathological Profile and Disease-Free Survival in Stage I-II Endometrial Cancer at Cipto Mangunkusumo Hospital Muhammad Rizkinov Jumsa; Nuryanto, Kartiwa Hadi; Tricia Dewi Anggraeni; Tantri Hellyanti
Nusantara Medical Science Journal Vol. 10 No. 2 (2025): Volume 10 Issue 2, July - December 2025
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v10i2.48383

Abstract

Introduction: This study aimed to describe the clinicopathological profile and evaluate the disease-free survival (DFS) of patients with FIGO 2009 stage I–II endometrioid endometrial cancer, and to determine the prognostic value of key factors, emphasizing lymphovascular space invasion (LVSI) and tumor grade. Methods: A retrospective cohort of 111 patients treated between January 2017 and December 2022 was analyzed. Variables included age, menopausal status, BMI, depth of myometrial invasion, LVSI, and tumor grade. Survival was estimated using the Kaplan–Meier method; associations were assessed with Fisher’s exact test, and independent prognostic factors were identified using multivariate Cox regression analysis Results: The median follow-up for the 111 patients was 32 months. Most were stage IB (42.4%), aged 45–60 years (46.8%), postmenopausal (73%), and obese (63%). Stage-specific DFS rates were: Stage IA – 94.6% (1-year), 87.8% (2-year), 87.8% (3-year); Stage IB – 93.6% (1-year), 91.0% (2-year), 91.0% (3-year); Stage II – 92.6% (1-year), 88.9% (2-year), 88.9% (3-year). LVSI positivity (15.3%) and high tumor grade emerged as the strongest prognostic factors. Multivariate analysis confirmed LVSI as an independent predictor across all stages, with hazard ratios ranging from 3.85 in stage IA to 4.25 in stage IB and 12.5 in stage II (p<0.05). In stage II, LVSI-positive patients showed a 57.1% 3-year DFS versus 100% in LVSI-negative patients. Conclusions: LVSI and tumor grade are independent, interrelated prognostic markers in early-stage endometrial carcinoma. Their integration into risk stratification refines adjuvant therapy guidance. Implementation requires standardized pathological reporting and efficient referral systems to improve long-term surveillance adherence.
Co-Authors Achmad Kemal Harzif Ampri, Irfan Arieqal Hatta Andi Darma Putra Anggaraeni, Tricia Dewi Argy, Gabriella Binathara, Geraldus Sigap Gung Eka Rusdianto Gunardi Fitriyadi Kusuma Gatot Purwoto Gita Pratama Hariyono Winarto Hariyono Winarto Hellyanti, Tantri JM Seno Adjie Kanadi Sumapradja Kemal Akbar Suryoadji Laila Nuranna Lestari, Silvia Werdhy Marcel Elian Suwito Michael Adrian Mila Maidarti Muhammad Haekal Muhammad Haekal Muhammad Rizkinov Jumsa Shelly, Vannesa Sini, Kieran Pasha Ivan Soloan, Garry Sugianto Sugianto Suryoadji, Kemal Akbar Talya, Natasha Tantri Hellyanti Tofan Widya Utami Tofan Widya Utami Tofan Widya Utami Tricia Dewi Anggraeni Tyagitha, Galuh Anindya Utami, Tofan Widya Wulandari, Anisa Saphira Yanfaunas, Atika Mahira Yo, Edward Christopher