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All Journal Medicinus : Jurnal Kedokteran
Tarigan, Tiara Namora
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Medicine & Pharmacology Public Health

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COX-2 Expression and Its Prognostic Implications in Uterine Leiomyosarcoma: A Systematic Review and Meta-Analysis Suherman, Levita Dyah Kartika; Sungkarto, Kenny; Ellyamurti, Devanti Octavia; Tarigan, Tiara Namora; Negara, Puspa; Tjahyanto, Teddy; Wijaya, Jeremiah Hilkiah
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9547

Abstract

Background : Uterine leiomyosarcoma (ULMS) is a rare, aggressive malignancy with high recurrence and poor survival, necessitating prognostic biomarkers and therapeutic targets. Cyclooxygenase-2 (COX-2), implicated in tumorigenesis and angiogenesis, remains understudied in ULMS. This systematic review and meta-analysis assessed COX-2’s prognostic role in ULMS. Methods : Following PRISMA guidelines, six studies (n=185) were retrieved from PubMed, EMBASE, and Scopus (2001–2024). Inclusion criteria required ULMS cohorts with COX-2 expression data and survival outcomes. Risk of bias was assessed using QUADAS-2, and evidence certainty via GRADE. A random-effects meta-analysis calculated pooled effect estimates with 95% confidence intervals (CIs), while heterogeneity was evaluated using I² statistics. Result : COX-2 expression correlated moderately with epithelial components (pooled effect: 0.51, 95% CI: 0.26–0.77) and weakly with mesenchymal components (0.26, 95% CI: 0.06–0.45). High heterogeneity (I² = 89.5% and 82.2%) reflected differences in study design, tumor subtypes, and COX-2 measurement thresholds. QUADAS-2 indicated a low risk of bias, and GRADE confirmed high evidence certainty. Stronger epithelial correlations were observed in Asian cohorts, highlighting geographic variability. Conclusions: COX-2 plays a more significant role in epithelial-driven ULMS carcinogenesis. Despite heterogeneity, robust methodologies support these findings. Future studies should standardize COX-2 assessment, expand cohort sizes, and integrate multi-omics approaches to refine prognostic and therapeutic applications.
Recent Therapies for Endometriosis: A Systematic Review Putra, Ananda; Winata, Raymond Malvin; Berlianzsa, El-Varel Baby; Chandra, Angelica Isabella Monica; Manubulu, Charles Pauris; Tarigan, Tiara Namora; Ellyamurti, Devanti Octavia; Firdaus, Najmarani Devi; Risdiana, Dilla Alfinda
Medicinus Vol. 13 No. 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i1.10779

Abstract

Background: Endometriosis is a chronic gynecological disorder characterized by the growth of endometrial tissue outside the uterine cavity. It commonly affects women of reproductive age and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. The disease significantly impacts productivity, social functioning, and sexual health, making it one of the leading causes of disability and reduced quality of life among women. Methods: This review was conducted through a literature search using databases such as PubMed, ScienceDirect, Google Scholar, and ResearchGate. Articles published between 2016 and 2025 were selected using the keywords endometriosis, hormonal therapy, and non-hormonal therapy. Relevant studies were analyzed, cross-referenced, and evaluated to identify current therapeutic strategies for endometriosis management. Result: The management of endometriosis currently includes both hormonal and non-hormonal therapies. Hormonal treatments involve the use of aromatase inhibitors, gonadotropin-releasing hormone (GnRH) analogues, selective estrogen receptor modulators (SERMs), selective progesterone receptor modulators (SPRMs), and dienogest, all aimed at suppressing estrogen production and endometrial growth. Non-hormonal therapies, on the other hand, utilize anti-inflammatory, anti-angiogenic, and pro-apoptotic mechanisms to target the inflammatory cascade that contributes to the pathogenesis of endometriosis. These therapies aim to reduce chronic inflammation, cell proliferation, and pain without interfering with ovulation or fertility. Conclusions: Both hormonal and non-hormonal therapies play a crucial role in managing endometriosis. While hormonal therapy remains the mainstay of treatment, non-hormonal approaches show promising results with fewer side effects and greater patient tolerability. However, further clinical studies are required to evaluate their long-term efficacy and safety before they can be widely implemented in clinical settings.
Co-Authors Berlianzsa, El-Varel Baby Chandra, Angelica Isabella Monica Ellyamurti, Devanti Octavia Firdaus, Najmarani Devi Manubulu, Charles Pauris Negara, Puspa Putra, Ananda Risdiana, Dilla Alfinda Suherman, Levita Dyah Kartika Sungkarto, Kenny Tjahyanto, Teddy Wijaya, Jeremiah Hilkiah Winata, Raymond Malvin