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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.
Comprehensive Management of Pediatric Epidural and Subdural Hematomas Following Traumatic Brain Injury: A Case Report Sari, Francisca Wuri Anzaz; Widarta, Oskar Ady
Jurnal Ners Vol. 8 No. 2 (2024): OKTOBER 2024
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v8i2.25299

Abstract

This case report details the management and implications of a 13-year-old male patient who presented with Epidural Hematoma (EDH) and Subdural Hematoma (SDH) following a traumatic brain injury sustained from a fall. The patient's treatment involved decompressive craniotomy to relieve intracranial pressure and reduce the risk of further brain damage, followed by cranioplasty to reconstruct the cranial vault. The case highlights the complexities involved in pediatric neurosurgery, especially in managing EDH and SDH, which are common yet critical conditions in traumatic brain injury cases. These hematomas, while distinct in their location and nature, share a common etiology in trauma and require prompt and effective surgical intervention. The importance of decompressive craniotomy in such cases is emphasized, particularly for alleviating increased intracranial pressure and minimizing additional cerebral injury. However, the potential postoperative complications, including cerebrospinal fluid leaks, infections, and seizures, necessitate vigilant postoperative care and monitoring. The epidemiology of EDH and SDH in the context of traumatic brain injury underscores their prevalence and the significant impact they have on the pediatric population. The successful management of this case, with both immediate surgical intervention and comprehensive postoperative care, illustrates the effectiveness of current treatment protocols. This case also sheds light on the critical need for a multidisciplinary approach in the long-term rehabilitation of pediatric patients, ensuring optimal recovery and development post-injury. In conclusion, this report contributes to the understanding of the management of traumatic brain injuries in children, emphasizing the significance of timely surgical intervention, careful monitoring for complications, and the importance of a holistic approach to patient care for favorable outcomes.
Gambaran Epidemiologi Kasus Tumor Meningioma Intrakranial WHO Derajat II dan III di Rumah Sakit Kanker Dharmais Singh, Arwinder; Firdaus, Muhammad; Widarta, Oskar Ady; Sugiarto, Yosafat Kurniawan; Halim, Danny; Faried, Ahmad
MAHESA : Malahayati Health Student Journal Vol 3, No 11 (2023): Volume 3 Nomor 11 (2023)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v3i11.11573

Abstract

ABSTRACT Meningioma is the most common primary intracranial tumors in adults. Although most meningioma cases are regarded as benign, certain types have been suggested of having higher proliferative capacities compared to the majority. Knowing the epidemiology of the more aggressive types of meningioma are important to anticipate the disease burden and improve their management.  This study aims to describe the epidemiology of WHO grade II and III intracranial meningiomas at Dharmais National Cancer Center Hospital. All patients diagnosed with WHO grade II or III intracranial meningiomas between 2011 and 2022 were included in this study. Information on patient’s characteristics, tumor location, and histopathological analyses. As many as thirty-three patients diagnosed with WHO grade II and III intracranial meningiomas between 2011 and 2022. Most patients were female (72.72%), aged between 40- to 60-year-old (57.57%), classified as WHO grade II (60.6%), and had their tumors located at convexity regions (48.48%). The most common grade II intracranial meningioma is atypical (95%), while the majority of grade III intracranial meningiomas is anaplastic (76.92%). In both WHO grade II and III intracranial meningiomas, the highest number of patients aged between 40- to 60-year-old, 60% and 53.85%, respectively. Interestingly, most WHO grade II intracranial meningiomas were in skullbase regions (50%); meanwhile, majority of WHO grade III intracranial meningiomas were in convexity regions (69.23%). Although it only represents a minor fraction from the total meningioma cases, patients who are diagnosed with WHO grade II and III intracranial meningiomas are faced with higher risks of morbidity and mortality compared to WHO grade I intracranial meningiomas. The results of this study describe the current epidemiology of this challenging tumor. Keywords : Intracranial, Meningioma, Benign, WHO Grading ABSTRAK Meningioma adalah tumor intrakranial yang paling sering terjadi pada pasien dewasa. Meskipun kebanyakan kasus meningioma intrakranial tergolong jinak, namun beberapa tipe meningioma tertentu terbukti memiliki kapasitas proliferatif yang lebih tinggi dibandingkan dengan mayoritas tipe meningioma. Pengetahuan mengenai epidemiologi dari tipe meningioma yang bersifat agresif sangatlah penting untung mengetahui beban penyakit dan melakukan upaya peningkatan manajemen penyakit ini. Penelitian ini bertujuan untuk mengetahui data epidemiologi meningioma intrakranial derajat 2 dan 3 berdasarkan klasifikasi histopatologis yang ditetapkan oleh badan kesehatan dunia / World Health Organization (WHO). Seluruh pasien yang didiagnosis dengan meningioma intrakranial derajat 2 dan 3 di RS Kanker Dharmais selama periode tahun 2011 s.d. 2022 dimasukkan ke dalam studi ini. Data mengenai karakteristik pasien, lokasi tumor, dan hasil analisis histopatologis diambil dan diolah sebagai data penelitian. Sebanyak 33 pasien didiagnosis dengan meningioma intrakranial derajat 2 dan 3 selama periode tahun 2011 s.d. 2022. Mayoritas pasien adalah perempuan (72.72%), berusia antara 40 s.d. 60 tahun (57.57%), didiagnosis dengan meningioma intrakranial derajat 2 (60.6%), dengan lokasi tumor di daerah konveksitas (48.48%). Jenis meningioma derajat 2 tersering adalah atipikal (95%), sedangkan jenis meningioma derajat 3 tersering adalah anaplastik (76.92%). Rentang usia terbanyak dari pasien penderita meningioma intrakranial derajat 2 (60%) dan 3 (53.85%) adalah 40 s.d. 60 tahun. Dalam hal lokasi tumor, lokasi tumor tersering dari meningioma derajat 2 adalah dasar tengkorak (50%), sedangkan lokasi tumor tersering dari meningioma derajat 3 adalah konveksitas (69.23%). Meskipun mayoritas pasien yang didiagnosis dengan meningioma intrakranial tergolong sebagai derajat 1, namun pasien meningioma intrakranial derajat 2 dan 3 memiliki resiko morbiditas dan mortalitas yang lebih tinggi. Hasil dari penelitian ini memaparkan data epidemiologi terkini dari jenis meningioma intrakranial yang terbilang lebih agresif. Kata Kunci: Meningioma, Intrakranial, Jinak, Derajat WHO