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Suryana, Kresna Dharma
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Characteristics and Survival of Patients with WHO Grade 4 Diffuse Glioma in Dharmais National Referral Cancer Hospital Tadjoedin, Hilman; Suryana, Kresna Dharma; Rosalina, Rosalina; Hartono, Bryan Arista; Widarta, Oskar Ady; Dewin, Nikrial; Andriani, Rini
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1261

Abstract

Background: The WHO grade 4 diffuse glioma are extremely aggressive and account for over 60% of adult Central Nervous System (CNS) tumors. The diagnosis and management pose significant challenges due to the need for comprehensive evaluation and holistic treatment approaches. This study aims to determine the clinical characteristics of WHO grade 4 diffuse glioma in Indonesia and the overall survival as a secondary goal. Methods: This is a retrospective cohort study of all WHO grade 4 glioma patients from 2017 to 2022 at Dharmais National Cancer Hospital, Jakarta, Indonesia. Demographic characteristics were presented descriptively. Kaplan-Meier plot was used to evaluate the median survival. Results: Twenty-eight patients were eligible for this study. The median age group is 45 years old, with equal male and female prevalence. Headache was the most prevalent primary symptom. The therapy following surgery was radiotherapy (RT) with chemosensitizer (82.1%) and RT alone (14.3%) with both followed by adjuvant chemotherapy. There was one patient (3.6%) underwent palliative therapy. The median survival of all patients was 10 months, whereas 10 months in RT with the chemo-sensitizer group and 1 month in RT only group. There was no statistically significant difference between RT with and without chemotherapy sensitizer in terms of survival rates. Conclusions: Our study reports a younger median age of WHO Grade 4 diffuse glioma. Male subjects were equivalent to females. Median OS was 10 months and were longer in RT with the chemosensitizer group. Further multicentered and at the genetic level investigation was needed, to achieve optimal outcomes.
Epidemiology Profile of Stage IV Ovarian Cancer in Dharmais National Cancer Hospital: An Observational Study Tadjoedin, Hilman; Suryana, Kresna Dharma; Hanafi, Widyorini Lestari Hutami; Kunigara, Manika Putri; Shiba, Alyssa Fairudz
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1308

Abstract

Background: Stage IV ovarian cancer showed a low 5-year survival rate, around 31%. Regrettably, the unclear symptoms and the ineffectiveness of early detection result in many patients being diagnosed with stage IV. Moreover, establishing a stage IV diagnosis is challenging and tricky. This study aims to provide a comprehensive overview of the clinical, laboratory, histopathological, and survival characteristics of stage IV ovarian cancer patients.Method: A cross-sectional study with a descriptive observational design, 100 of 1520 subjects gathered from the Cancer Registry of Dharmais National Cancer Hospital between January 2018 and December 2022, conducted on stage IV ovarian cancer patients who were not accompanied by primary cancer at other sites.Results: Among the 100 study subjects, 76.0% were aged 40–60 years, with a median age of 49.5 years. Most had a normal nutritional status (39.0%) or were underweight (34.0%). Comorbidities were present in 40.0% of the subjects, with hypertension being the most common (57.5%). The initial symptoms were abdominal enlargement in 74.0% of subjects, with 43.0% reporting shortness of breath. Laboratory examinations revealed that the majority had hemoglobin levels 10 mg/dL (90.0%), serum creatinine levels 1.2 mg/dL (90.0%), and D-Dimer levels 2000 ng/ mL (69.0%). Histopathological analysis identified high-grade serous carcinoma (HGSC) in 24.0% and clear cell carcinoma in 19.0% of subjects. The most common metastatic sites were the pleura (44.0%), liver (41.0%), and lungs (25.0%). Around 48.0% and 41.0% had surgery only and surgery with adjuvant chemotherapy, respectively. The majority of the outcomes (91.0%) indicated that patients with stage IV ovarian cancer did not survive and the median survival among the subjects was 4 months.Conclusion: The majority of stage IV ovarian cancer patients were aged 40–60 years, with abdominal enlargement as the initial symptoms, elevated D-Dimer levels, HGSC as the predominant histopathological type, and a high mortality rate as the outcome. Further research is recommended to explore additional variables and analyze factors contributing to mortali
Factor Associated with Mortality of Hospitalized Cancer Patients with COVID-19 Infection in Indonesia National Cancer Center Kurniawati, Sri Agustini; Sutandyo, Noorwati; Tadjoedin, Hilman; Pradipta, Jaka; Ismuha, Ratu Ralna; Ummah, Citra Dovina Khaira; Suryana, Kresna Dharma; Budi, Erwin
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.v18i2.1077

Abstract

Background: Cancer patients with COVID-19 are at risk of developing severe complications and outcomes due to immunosuppressive and inflammatory states. This study aims to provide insight into risk factors associated with mortality in this population. Methods: A retrospective cohort study was conducted at Dharmais National Cancer Center, Jakarta, Indonesia, from May 2020 to July 2021. Data were collected through electronic medical records using the consecutive sampling technique. The numerical and categorical data were then tested statistically. Results: The results showed 180 cancer patients with COVID-19 were hospitalized at Dharmais National Cancer Center. Among the patients, 114 patients survived, and 66 patients deceased. Across all risk factors analyzed to mortality, patients with Diabetes Mellitus (OR 0.41;0.22-0.77, p-value 0.05) and high level of D-dimer (OR 2.00;1.06-3.79, P-value 0.05) have a higher risk in mortality. The Results showed that survived patients have lower D-dimer levels (2010 ng/L) and deceased patients have higher D-dimer levels (3264 ng/L) with P-value 0.05. Conclusion: High D-dimer levels and diabetes are risk factors significantly associated with mortality in hospitalized cancer patients with COVID-19 Infection.
The Difference between Chronic Myeloid Leukemia before and during the COVID-19 Pandemic: A Retrospective Study from Dharmais Cancer Center Tadjoedin, Hilman; Suryana, Kresna Dharma; Hadisantoso, Dwi Wahyunianto; Siregar, Nia Novianti; Djamal, Rizky Syawaluddin; Setiawan, Lyana; Hartono, Bryan Arista; Kunigara, Manika Putri
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.v19i4.1365

Abstract

Background: Chronic myeloid leukemia (CML) is a rare disease, with a global incidence rate ranging from 10 to 15 cases per 1,000,000 population annually, constituting approximately 15% of all adult leukemia. The achievement of complete response in CML patients has been affected by the COVID-19 pandemic. This study aimed to determine differences in characteristics, survival, and complete hematological response (CHR) in CML patients before and after the COVID-19 pandemic at Dharmais Cancer Hospital.Method: A cohort retrospective was conducted using medical records among CML patients diagnosed and treated in 2018 to 2022 in Dharmais Cancer Hospital. Demographic, characteristics, and survival were described. Overall survival was analyzed using Kaplan-Meier and log-rank test, and bivariate analysis was used with the Chi-square and Fisher's exact test. Patients aged 18 years with CML confirmed by bone marrow analysis, and detected fusion of BCR-ABL were included, and multiple malignancies were excluded.Results: The study was conducted on 108 subjects (56 vs. 52, before and during the pandemic, respectively). The demographic characteristics in both periods showed that the majority of subjects were male (59.8% vs. 40.2%), had normal BMI (58.1% vs 41.9%), and had no comorbidities. However, there was a difference in age distribution. The subjects before the pandemic were predominantly over 40 years, while those during the pandemic were 18-39 years. A total of 91/108 subjects survived (49.5% before vs. 50.5% during the pandemic). The median overall survival was 55 vs. 52 months, with a p-value of 0.173. No significant association was found between the study period or history of COVID-19 infection and CHR. However, a significant association was observed between the CML phase and outcomes.Conclusion: No significant differences were observed in demographic or clinical characteristics, overall survival, or CHR among CML patients before and during the COVID-19 pandemic.
Factors Influencing Chemotherapy Adherence in Patients with Triple-Negative Breast Cancer: A Cross-Sectional Study at the National Cancer Center, Dharmais Hospital, Indonesia Suryana, Kresna Dharma; Girsang, Ermi; Nasution, Sri Lestari Ramadhani; Tadjoedin, Hilman; Anjasari, Melati Salsabila
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.v19i4.1653

Abstract

Background: Triple‑negative breast cancer (TNBC) is an aggressive subtype of breast malignancy with limited targeted therapy options, making adherence to systemic therapy critical for improving survival outcomes. This study aimed to determine the sociodemographic, clinical, and psychosocial factors influencing adherence to systemic therapy among patients with TNBC, especially in resource-constrained settings.Method: A cross-sectional observational study was conducted among 105 female TNBC patients undergoing systemic therapy at the Dharmais Cancer Hospital. Adherence was defined as completion of ≥ 85% of planned systemic therapy cycles without unjustified delay or omission. Data were collected from medical records and structured questionnaires, covering sociodemographic, clinical, and psychosocial characteristics, including psychological distress measured using the Depression Anxiety Stress Scale-10 (DASS-10). Bivariate and multivariate logistic regression analyses were performed to identify factors associated with non-adherence.Results: Median patient age was 48 years (range 25–76), and the majority worked as housewives (58.1%). Most had completed high school education (51.5%), and nearly half earned less than IDR 3 million monthly (48.6%). Clinically, most patients were diagnosed at stage III (40.9%) or IV (38.1%), with comorbidities present in 41.9%, predominantly hypertension (19.1%). While overall adherence to systemic therapy was relatively high, logistic regression analysis identified significant predictors of non-adherence. Comorbid conditions (p 0.01; OR 5.7; 95% CI: 1.94–16.02) and severe levels of anxiety/depression based on DASS-10 scores (p = 0.015; OR 5.65; 95% CI: 1.08–29.42) remained independently associated with lower adherence (p 0.05), underscoring the importance of psychological and clinical support to improve treatment compliance.Conclusion: Comorbid conditions and psychological distress significantly contribute to non-adherence among TNBC patients. Integrating psycho-oncology support and comorbidity management into routine cancer care may enhance treatment adherence and outcomes.
Co-Authors Anjasari, Melati Salsabila Budi, Erwin Dewin, Nikrial Djamal, Rizky Syawaluddin Girsang, Ermi Hadisantoso, Dwi Wahyunianto Hanafi, Widyorini Lestari Hutami Hartono, Bryan Arista HILMAN TADJOEDIN, HILMAN Kunigara, Manika Putri Lyana Setiawan Nasution, Sri Lestari Ramadhani Nia Novianti Siregar, Nia Novianti Noorwati Sutandyo Pradipta, Jaka Ratu Ralna Ismuha Rini Andriani Rosalina Rosalina Shiba, Alyssa Fairudz Sri Agustini Kurniawati, Sri Agustini Ummah, Citra Dovina Khaira Widarta, Oskar Ady