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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

Perioperative Management of a Giant Ovarian Tumour in an Adolescence with Severe Scoliosis and Unilateral Diaphragmatic Dysfunction: A Case Report Gezy Wita Giwangkancana; Andi Kurniadi; Yunita Susanto Putri; Euis Maryani
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2385

Though giant ovarian tumor are rare but due to the limitations in oncology surgery during the COVID-19 pandemic, many oncology patients are presented with a more severe stage and giant ovarian tumors may be more commonly seen during this period. The aim of this case report study was to describe the perioperative management of an adolescent patient with a giant ovarian tumor, severe scoliosis, and unilateral diaphragm dysfunction. An 18-years-old girl weighing 28 kgBW came with a giant abdominal mass that extended to her thoracic and back areas. The patient had a history of severe scoliosis since childhood. She had signs of respiratory distress and was not comfortable lying down. Preoperatively, the surgeon used ultrasonography to guide cyst puncture using a thoracic tube and 6,500 cc of mucinous fluid was drained. Inhalational induction with preservation of spontaneous breathing was performed. Two massive masses filled the entire abdominal area, adhering to the peritoneum while pushing and tenting the diaphragm cranially and laterally to the right and bilateral salpingo-oophorectomy was conducted. Serial radiological examinations showed unilateral diaphragmatic dysfunction and a progressing ventilator associated pneumonia. Improving post-operative outcome of patients with giant intraabdominal masses must include preoperative assessment of potential peri-operative respiratory complications, preparation of intraoperative hemodynamic, and ventilatory disturbances with gentle weaning and multidisciplinary approach during the post-operative care to assess readiness of ventilator weaning. Manajemen Perioperatif Pasien dengan Tumor Ovarium Permagna pada Remaja dengan Skoliosis Berat dan Gangguan Diafragma UnilateralTumor ovarium berukuran masif pada anak jarang ditemukan di masa moderen karena perbaikan sistem pelayanan kesehatan namun di masa COVID-19, kasus dapat ditemukan karena hambatan pelayanan pembedahan onkologi. Laporan kasus ini bertujuan melaporkan manajemen perioperatif pada pasien remaja dengan tumor ovarium massif, skoliosis berat dan disfungsi diafragma. Remaja berusia 18 tahun dengan berat 35 kilogran datang dengan massa abdomen sangat besar disertai riwayat skoliosis. Pasien memiliki tanda ancaman gagal napas dan tidak nyaman pada posisi berbaring dan hanya dapat beristirahat dalam posisi duduk. Sebelum induksi, dokter bedah melakukan punksi massa dan didapatkan 6.500 cc cairan musin. Pasien diinduksi dengan napas spontan menggunakan gas anestesi. Bilateral salfingoofarektomi dilakukan dan pascaoperasi pasien dirawat di ruang intensif. Selama masa pemulihan pasien sulit disapih dari ventilator dan hasil pemeriksaan radiologis berulang menunjukkan tanda disfungsi diafragma dan pneumonia. Simpulan, meningkatkan hasil keluaran pada pasien dengan massa intraabdomen massif harus meliputi pemeriksaan preoperatif yang cermat mengenai komplikasi pernafasan perioperative, persiapan permasalahan hemodinamik intraoperative dan strategi penyapihan dari ventilator yang efektif dengan melibatkan pendekatan multidisiplin.

Penggunaan Magnesium Sulfat untuk Menurunkan Angka Kejadian Cerebral Palsy pada Bayi Prematur Herry Aktyar Matondang; Jusuf Sulaeman Effendi; Budi Handono; Andi Kurniadi
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

AbstrakLatar belakang: Magnesium Sulfat merupakan senyawa kimia yang sudah banyak terbukti manfaatnya pada kehamilan. Selain digunakan sebagai obat anti kejang, dan obat tokolitik pada kontraksi prematur, magnesium sulfat berperan banyak pada proses intraseluler, diantaranya sebagai agen vasodilator pembuluh darah otak, menurunkan reaksi inflamasi, seperti sitokin dan zat radikal bebas, serta mencegah masuknya ion kalsium kedalam sel. Prematuritas merupakan masalah serius karena hampir sebagian besar dari neonatus yang berhasil hidup akan mengalami kecacatan neurologis kongenital termasuk cerebral palsy (CP).Metode: Analitik korelatif dengan desain cross sectional. Subjek penelitian adalah pasien dengan diagnosa cerebral palsy yang melakukan pemeriksaan ke Rumah Sakit Dr. Hasan Sadikin Bandung, dengan riwayat lahir prematur. Pengambilan sampel menggunakan teknik accidental sampling dengan jumlah total sampel 30 pasien. Analisis data secara statistik menggunakan uji Chi-square. Hasil: Penelitian menunjukkan 7 (23,3%) pasien anak dengan diagnosa cerebral palsy memiliki riwayat ibu hamil dengan pemberian magnesium sulfat (MgSO4), dan 23 (76,6%) pasien dengan diagnosa cerebral palsy memiliki riwayat ibu hamil tanpa pemberian magnesium sulfat (MgSO4). Hasil analisa data dengan menggunakan uji Chi-square didapatkan ρ-value 0,001< α = 0,05.Kesimpulan: Terdapat hubungan yang signifikan dari pemberian magnesium sulfat pada ibu hamil terhadap angka kejadian cerebral palsy pada bayi prematur di Rumah Sakit Hasan Sadikin Bandung. The Used of Sulfate Magnesium to Reduce Incidence of Cerebral Palsy on Preterm BirthAbstractObjective: Magnesium Sulfate is a chemical compound that has been widely used in pregnant women and has proven benefits to the condition of pregnancy. Prematurity is a serious problem because most of the successful neonates will experience congenital neurological disability including cerebral palsy (CP).Method: This research is a kind of analytic correlative research with cross sectional design. The research subjects were pediatric patients with a diagnosis of cerebral palsy who performed the examination at Hasan Sadikin Hospital Bandung, with a history of premature birth. Samples were taken by purposive sampling technique with a total number of samples 30 patients. Statistical analysis using Chi-square statistical test.Result: The result of this research showed 7(23,3%) pediatric patients with a diagnosis of cerebral palsy had a history of pregnant women with administration of magnesium sulfate (MgSO4), and 23(76,6%) patients with a diagnosis of cerebral palsy has a history of pregnant women without administration of magnesium sulphate (MgSO4). The data were analyzed using Chi-square test and obtained ρ-value 0,001 <α = 0,05.Conclusion: There is a significant relationship between administration of magnesium sulfate in pregnant women and the incidence of cerebral palsy in premature infants at Hasan Sadikin Hospital Bandung.Key words: magnesium sulfate, preterm birth, premature infants, cerebral palsy

Akurasi Spesivisitas dan Sensitivitas Angka RMI 2 Skor pada Penderita Tumor Ganas Ovarium di RSUP Dr. Hasan Sadikin Bandung Periode 2017−2018 Arieff Kustiandi; Yudi Mulyana Hidayat; R.M Sonny Sasotya; Andi Kurniadi
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/v3n2.207

Tujuan: Penelitian ini bertujuan untuk mengetahui spesifitas dan sensitivitas skor RMI 2 dalam menentukan keganasan ovarium. Kadar CA 125 dan skor RMI 2 diukur dari hasil pemeriksaan histopatologi digunakan sebagai pemeriksaan gold standard. Penelitian ini dilakukan pada periode Januari 2017−Desember 2018.Metode: Penelitian ini menggunakan metode observasional analitik dengan rancangan cross sectional. Data kategorik diuji dengan uji chi-square atau uji Exact Fisher. Data numerik digunakan uji-t tidak berpasangan atau uji Mann Whitney. Sumber data diperoleh dari rekam medis pasien di Poli Ginekologi Onkologi RSUP Dr. Hasan Sadikin Bandung berdasarkan angka skor RMI 2 pada penderita suspek tumor ganas ovarium.Hasil: Sampel berjumlah 172 dengan 31 berkategori jinak dan 141 berkategori ganas berdasarkan hasil histopatologi. Hasil penelitian menunjukkan nilai median CA 125 kelompok ganas dibanding kelompok jinak (437, 05 vs 212,14) bermakna secara statistik p = 0,001 (nilai p<0,05). Cut of point skor RMI 2 adalah >200 dengan sensitivitas 95,74% dan spesifisitas 16,12%.Kesimpulan: Skor RMI 2 adalah metode yang digunakan untuk memprediksi tumor ganas ovarium. Hal ini sangat berguna digunakan dengan kombinasi CA 125 dengan hasil pemeriksaan ultrasonografi (USG) dan status menopause atau dikenal dengan Risk Malignancy Index (RMI skor 2 cut off point >200 ) dengan sensitivitas 95,74%, spesifisitas 16,12%dan akurasi 81,39 %. Skor RMI 2 mempunyai sensitivitas yang tinggi, tetapi mempunyai spesivisitas yang rendah, sehingga membutuhkan penelitian lebih lanjut.Accuracy of Specificity and Sensitivity of RMI 2 Score Numbers in Ovarium Fanner Tumors in RSUP Dr. Hasan Sadikin Bandung Period 2017-2018AbstractObjective: This study aims to determine the specificity and sensitivity of RMI 2 score in ovarian malignancy. The CA 125 level and the RMI 2 score were measured and adjusted by histopathology examination as gold standard. This research was conducted in period January 2017−December 2018.Methods: This research used observational analitic research method with cross sectional design. Categorical data were tested by chi-square test or Fisher's Exact test. Numerical data are used unpaired t-test or Mann Whitney test. The source of data from medical records of patients in Gynecology Oncology Clinic Dr. Hasan Sadikin Bandung based on the RMI 2 score with suspected ovarian malignant tumors.Result: Samples were 172 with 31 benign categories and 141 malignant categories based on the results of histopathology. The results showed a median value of CA 125 of the malignant group compared to the benign group (437, 05 vs. 212.14) statistically significant p = 0.001 (p value <0.05). The RMI 2 score cut off point > 200 with a sensitivity of 95.74% and specificity of 16.12%. Conclusion: This study is an RMI 2 score is a useful way as a predictor of ovarian malignancy. This is very useful to use with a combination of CA 125 with the results of ultrasonography (USG) and menopausal status or known as the Risk Malignancy Index (RMI score 2 cut off point> 200) with a sensitivity of 95.74%, specificity 16.12% and accuracy 81 , 39%. RMI 2 score has high sensitivity, but has low specificity, so it needs further research.Key words: CA 125, RMI 2 score, ovarian malignancy

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

Profil Klinikopatologi Pasien Tumor Trofoblas Gestasional yang Dilakukan Operasi di RSUP DR. Hasan Sadikin Bandung Tahun 2017-2020 Aviscena Fahmi Ali; Dodi Suardi; Hermin Aminah Usman; Gatot Nyarumenteng Adhipurnawan Winarno; Andi Kurniadi
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.381

Tujuan: Mengetahui proporsi klinis dan histopatologi pasien tumor trofoblas gestasional yang dilakukan operasiMetode: Penelitian ini menggunakan desain studi deskriptif, dengan pengambilan data menggunakan total sampling. Kriteria inklusi adalah Pasien tumor trofoblas gestasional yang dilakukan operasi dengan data lengkap.Hasil: Total 27 kasus, didapatkan bahwa pasien tumor trofoblas gestasional yang dilakukan operasi sebagian besar memiliki kategori usia ≥40 tahun (59,26%), paritas multipara (66,67%), kehamilan sebelumnya mola (66,67%), interval dengan kehamilan sebelumnya >12 bulan (55,56%), kadar β-hCG sebelum operasi 103 -<104 mIU/ml (40,74%), ukuran tumor terbesar ≥5 cm (88,89%), lokasi metastasis tidak ada (74,07%), jumlah metastasis 0 (74,07%), kegagalan kemoterapi agen multipel (74,07%), jenis operasi histerektomi (96,30%), kadar β-hCG setelah operasi <103 mIU/ml (77,78%), dan gambaran histopatologi koriokarsinoma (88,89%). Diskusi: Penelitian ini didapatkan bahwa seluruh pasien tumor trofoblas gestasional yang dilakukan operasi memiliki skor FIGO/WHO ≥7 yang berarti berisiko tinggi.Kesimpulan: Kasus-kasus tumor trofoblas gestasional yang dilakukan operasi pada penelitian ini sebagian besar memberikan profil klinis berupa multipara, jenis kehamilan sebelumnya mola, dan kegagalan kemoterapi agen multipel dengan jenis histopatologi koriokarsinoma.Profile Clicopathological of Gestational Trophoblastic Neoplasia Patients Who Underwent Surgery at Dr. Hasan Sadikin General Hospital Bandung in 2017–2020AbstractObjective: Knowing the clinical and histopathological proportion of gestational trophoblastic neoplasia patients who underwent surgery.Methods: This study uses a descriptive study design and the data collection using total sampling. The inclusion criteria gestational trophoblastic neoplasia patients who underwent surgery with complete data.Result: : A total of 27 cases, it was found that the most GTN patients who underwent surgery had an age category of 40 years (59.26%), multiparity (66.67%), previous molar pregnancies (66.67%), intervals with previous pregnancies >12 months (55.56%), β-hCG levels before surgery 103 -<104 mIU/ml (40.74%), the largest tumour size 5 cm (88.89%), no metastatic site (74.07 %), failure of multiple agent chemotherapy (74,07%), hysterectomy surgery (96.30%), β-hCG level after surgery <103 mIU/ml (77.78% ), and histopathological features of choriocarcinoma (88.89%).Discussion: In this study, it was found that all gestational trophoblastic neoplasia patients who underwent surgery had a FIGO/WHO score ≥7 which means high risk.Conclusion: The gestational trophoblastic neoplasia cases that underwent surgery in this study presented a clinical profile of multiparity, previous molar pregnancy, and failure of multiple agent chemotherapy with histopathological type of choriocarcinoma.Key words: Profile, gestational trophoblastic neoplasia, operation

Profil Penderita Kanker Endometrium di RSUP Dr. Hasan Sadikin Bandung Periode Tahun 2017-2020 Siti Salima; Andi Kurniadi; Gatot N.A. Winarno; Dodi Suardi; Hanifah Nurisa Putri
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.386

Tujuan: Mengetahui profil penderita kanker endometrium.Metode: Penelitian metode deskriptif dengan menggunakan data sekunder. Kriteria inklusi penelitian yaitu pasien dengan diagnosis kanker endometrium dilihat berdasarkan hasil histopatologi.Hasil: Distribusi pasien mayoritas berusia >50 tahun (62,0%), berasal dari Kota/Kabupaten Bandung (32,5%), memiliki indeks massa tubuh 18,5-22,9 kg/m2 (27,0%), multipara (36,5%), status postmenopause (59,0%), memiliki usia menarche ≥12 tahun (88,0%), tidak memiliki riwayat diabetes mellitus (66,0%) dan hipertensi (27,0%), terdiagnosis ketika stadium I (47,5%), dengan derajat diferensiasi baik/grade I (31,0%) dan tipe I endometrioid adenocarcinoma (82,5%). Terapi yang paling sering adalah tindakan operasi (50,0%) dengan tipe pembedahan histerektomi total dan salfingooforektomi bilateral (44,21%).Kesimpulan: Pasien kanker endometrium di RSUP Dr. Hasan Sadikin Bandung periode tahun 2017-2020 ditemukan paling banyak berusia >50 tahun, dari Kota/Kabupaten Bandung, indeks massa tubuh normal, multipara, postmenopause, usia menarche ≥12 tahun, tidak ada riwayat DM dan hipertensi, terdiagnosis pada stadium I dengan tipe I endometrioid adenocarcinoma dan derajat diferensiasi baik (grade I), serta dilakukan tindakan operasi dengan tipe pembedahan histerektomi total dan salfingooforektomi bilateral.Profile of Endometrial Cancer Patients in Dr. Hasan Sadikin Central General Hospital Bandung in 2017–2020AbstractObjective: Identifying the profile of endometrial cancer patientsMethods: This research used descriptive method by collecting secondary data. The inclusion criteria was patients with endometrial cancer diagnosis based on the histopathological results.Results: In this research, the majority of patients were aged >50 years (62,0%), came from Bandung City/Regency (32,5%), with body mass index of 18,5-22,9 kg/m2 (27,0%), multiparous (36,5%), postmenopause (59,0%), menarcge age of ≥12 years (88,0%), no history of diabetes mellitus (66,0%) and hypertension (27,0%), diagnosed at stage I (47,5%), with histopathological results well differentiated/grade I (31,0%) and type I endometrioid adenocarcinoma (82,5%). Surgery (50,0%) with the type of total hysterectomy and bilateral salpingoophorectomy (44,21%) was the most common treatment.Conclusion: In 2017-2020, endometrial cancer patient in Dr. Hasan Sadikin Central General Hospital Bandung were mostly found in the aged of >50 years, came from Bandung City/Regency, normal body mass index, multiparous, postmenopause, menarche age of ≥12 years, no history of diabetes mellitus and hypertension, diagnosed at stage I with histopathological result type I endometrioid adenocarcinoma and well differentiated (grade I), and the treatment was surgery with the type of total hysterectomy and bilateral salpingoophorectomy.Key words: Endometrial cancer, profile, risk factor

Profil dan Karakteristik Penderita Tumor Trofoblas Gestasional di RSUP Dr. Hasan Sadikin Periode 2021 Muhamad Bagja Ramadhan; Siti Salima; Andi Kurniadi; Gatot Nyarumenteng Adhipurnawan Winarno; Ali Budi Harsono
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.380

Tujuan: Tumor trofoblas gestasional (TTG) adalah suatu bentuk keganasan ginekologi pada hidatidosa yang diakibatkan oleh adanya abnormalitas proliferasi sel trofoblas. Insidensi TTG di negara Asia Tenggara ialah 9,2:40000 kehamilan. Beberapa faktor yang mempengaruhi perkembangan TTG diantaranya ialah riwayat kehamilan, usia dan kadar b-hcg. Namun hingga saat ini profil pasien TTG masih terbatas, oleh karenanya penelitian ini bertujuan menganalisis profil dan karakteristik pasien TTG di RSUP Dr. Hasan Sadikin Bandung.Metode: Metode penelitian ini ialah deskriptif kuantitatif, dengan menggunakan data sekunder yang berasal dari rekam medis pasien. Seluruh pasien yang didiagnosis TTG pada periode 2021 menjadi sampel pada penelitian ini. Variabel penelitian ini ialah status sosiodemografi, faktor risiko, gambaran klinis, dan gambaran terapi.Hasil: Jumlah sampel pada penelitian ini ialah 66 pasien. Sebanyak 53,03% pasien berusia 20-35 tahun. Sebanyak 55 pasien datang dalam kondisi stadium I (83,33%) sedangkan berdasarkan skoring FIGO sebanyak 42 pasien (63,63%) merupakan pasien dengan risiko rendah. Metastasis paru terjadi pada 7 pasien (20,61%). Kesimpulan: Mayoritas pasien TTG berusia 20-35 tahun dan tidak bekerja. Secara gambaran klinis; stadium I dan risiko rendah sering ditemukan. Kemoterapi dominan dipilih, serta multi-agent lebih sering digunakan.Profile and Characteristics GTN cases in Hasan Sadikin General Hospital in 2021 Gestational Trophoblastic NeoplasmaAbstractObjective: Gestational trophoblastic tumor (TTG) is a form of hydatidiform gynecologic malignancy caused by abnormal trophoblast cell proliferation. The incidence of TTG in Southeast Asian countries is 9.2:40000 pregnancies. Several factors that influence the development of TTG include a history of pregnancy, age and levels of b-hCG. However, until now the profile of TTG patients is still limited, therefore this study aims to analyze the profiles of TTG patients at Dr. Hasan Sadikin Bandung.Methods: This research method is descriptive quantitative, using secondary data derived from the patient's medical record. All patients diagnosed with TTG in the period 2021 were sampled in this study. The variables of this study were sociodemographic status, risk factors, clinical features, and therapeutic features.Results: The number of samples in this study was 66 patients. A total of 53.03% of patients aged 20-35 years. A total of 55 patients came in stage I condition (83.33%) while based on FIGO scoring 42 patients (63.63%) were low risk patients. Pulmonary metastases occurred in 7 patients (20.61%). Conclusion: The majority of TTG patients are aged 20-35 years and do not work. In the clinical picture; stage I and low risk are common. Predominant chemotherapy is chosen, and multi-agent is used more often.Key words: Gestational Trophoblastic Neoplasia, Patient Profile, Hydatidiform mole, Gynecological Malignancy

Karakteristik Karsinoma Ovarium Pra-Menopause dengan Kadar CA 125 ≤200 U/mL di RSUP Dr. Hasan Sadikin Bandung dari Tahun 2019–2021 Yudi Mulyana Hidayat; Eunike Febe Febriani; Ali Budi Harsono; Gatot N. A. Winarno; Andi Kurniadi
Indonesian Journal of Obstetrics & Gynecology Science Volume 6 Nomor 2 Juli 2023
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v6.n2.491

Tujuan: Mendeskripsikan karakteristik karsinoma ovarium pra-menopause dengan kadar CA 125 ≤ 200 U/mL di RSUP Dr. Hasan Sadikin Bandung dari tahun 2019 sampai 2021.Metode: Penelitian deskriptif ini menggunakan metode total sampling dari data sekunder pasien kanker ovarium yang memenuhi kriteria inklusi dan memiliki variabel lengkap.Hasil: Penelitian yang melibatkan 32 sampel ini, menunjukkan nilai rata-rata CA 125 sebesar 82,63 U/mL dengan interval 3,3–194,8 U/mL. Mayoritas pasien berada pada rentang usia 40–49 tahun (40,6%), sudah menikah (87,5%), berprofesi sebagai ibu rumah tangga (81,3%), dan tinggal di Kawasan Pembangunan Bandung Raya (34,4%). Sebanyak 37,5% pasien adalah nullipara dan memiliki tipe histopatologis tumor epitel mucinous. Stadium tumor terbanyak adalah stadium I (56,3%). Kebanyakan pasien menjalani surgical staging komplit sebagai terapi penyakitnya (46,8%). Kesimpulan: Sebagian besar pasien karsinoma ovarium pra-menopause dengan kadar CA 125 ≤ 200 U/mL pada tahun 2019–2021 berada pada rentang usia 40–49 tahun, sudah menikah, bekerja sebagai ibu rumah tangga, dan berdomisili di Kawasan Pengembangan Bandung Raya. Kebanyakan pasien berstatus nullipara, memiliki tumor dengan tipe histopatologis epitel mucinous, dan terdiagnosis pada stadium I. Tipe pengobatan yang paling umum ditemui adalah surgical staging komplit.Characteristics of Pre-Menopausal Ovarian Carcinoma with CA 125 Level ≤ 200 U/mL in Dr. Hasan Sadikin General Hospital Bandung From 2019–2021Abstract Objective: To describe the characteristics of pre-menopausal ovarian carcinoma patients with CA 125 Level ≤ 200 U/mL in Dr. Hasan Sadikin General Hospital Bandung from 2019 until 2021.Method: This descriptive study used the total sampling method of secondary data on ovarian cancer patients that have met the inclusion criterias and have complete variables.Results: This study involving 32 samples showed the average level of CA 125 was 82,63 U/mL with the interval of 3,3 – 194,8 U/mL. Majority of the patients were in the age range of 40 – 49 years old (40,6%), has been married (87,5%), were housewifes (81,3%), and lived in Development Area of Bandung Raya (34,4%). About 37,5% patients were nullipara and had mucinous epithelial histopatology type of tumor. The most abundant tumor stage were stage I (56,3%). Most patients had undergoing complete surgical staging for their therapy (46,8%). Conclusion: Most of pre-menopausal ovarian carcinoma patients with CA 125 level ≤ 200 U/mL in 2019–2021 were in the age range of 40 – 49 years old, has been married, had profession as housewifes, and domiciled in Development Area of Bandung Raya. Majority of patients were nullipara, had tumor with mucinous epithelial histopatology type, and were diagnosed at the stage I. The most found therapy were complete surgical staging.Key words: ovarian cancer, CA 125, cancer antigen 125, characteristic

Performance of Pre-Operative IOTA Three-Step Algorithm in Detecting Ovarian Carcinoma in a Referral Center in Indonesia Kurniadi, Andi; Permadi, Wiryawan; Kusuma, Aria Yusti; Kireina, Jessica; Andarini, Mia Yasmina; Winarno, Gatot Nyarumenteng Adhipurnawan; Harsono, Ali Budi
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1044

Background: To assess the diagnostic performance of a three-step algorithm using the International Ovarian Tumor Analysis (IOTA) Group ‘simple rules’, ‘simple descriptors’, and Assessment of Different NEoplasias in the adneXa (ADNEX) model for discriminating benign and malignant adnexal masses. Methods: This was a retrospective observational study, performed at a tertiary-care university hospital, on women diagnosed with adnexal mass on ultrasonography from January 2021 and February 2022. The examiner first classified the mass using ‘simple descriptors’ (first step) and, if not possible, using ‘simple rules’ (second step). For inconclusive masses, an assessment using the ADNEX model was done as the third step. All masses were managed surgically. Histopathology results were used as the reference standard.Results: One hundred and forty-one women were included (median age of 48 years). Histopathology results showed 104 (73.76%) mass to be malignant, and 37 (26.24%) mass to be benign. Twelve (8.51%) of 141 masses could be classified using simple descriptors, 89 (63.12%) masses were classified using simple rules, and 40 (28.37%) masses were classified using the ADNEX model. Overall accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the three-step algorithm were 89.36%, 94.23%, 75.68%, 91.59%, 82.35%, 3.87, and 0.08 respectively.Conclusions: The IOTA three-step algorithm, based on the sequential use of simple descriptors, simple rules, and ADNEX model, performs well for classifying adnexal masses as benign or malignant

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