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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Electronic Journal of Graph Theory and Applications (EJGTA) JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Cancer

I W. Sudarsa

Department Of Surgery, Division Of Oncologic Surgery, Faculty Of Medicine Udayana University/Sanglah General Hospital Bali-Indonesia

Author-ID : 975675

Biochemistry, Genetics & Molecular Biology Electrical & Electronics Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 24 Documents Claim Missing Document

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MANAGEMENT OF BREAST CANCER WITH BRCA GENE MUTATION I Wayan Ari Sumardika; I Wayan Sudarsa
E-Jurnal Medika Udayana vol 2 no 9 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.594 KB)

The management of individual who has a genetic predisposition for breast cancer requires careful planning. It is estimated that 5-10% of breast cancer in Western countries is a hereditary breast cancer and 80-90% of them is the result of BRCA1 and BRCA2 genes mutations. The individual with BRCA1 and BRCA2 gene mutations have a high risk for experiencing breast cancer and other types of cancer, especially ovarian cancer. Although there are some differences, management of patients with hereditary breast cancer in principle is equal to management of non-hereditary breast cancer. Contra lateral mastectomy surgery and/or oophorectomy may be considered as initial therapy. The uses of breast conserving surgery in patients with BRCA-positive status are still controversial because of the risk of recurrence on ipsilateral breast, so did the use of ionization radiation modalities. Post surgery follow up is an important aspect in the management of patients with mutations of these genes in which follow up aims to find local recurrence, secondary breast cancer, contra lateral breast cancer as early as possible

KANKER PAYUDARA PADA WANITA USIA TUA DI RUMAH SAKIT UMUM PUSAT Putu Ayu Kartika Putri Saraswati; I Wayan Sudarsa
E-Jurnal Medika Udayana vol 3 no 6 (2014):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (44.442 KB)

Pendahuluan: Sebagian besar insiden dan kematian akibat kanker payudara terdapatpada wanita berusia diatas 65 tahun. Laju insiden kanker payudara adalah 82,2 kasusbaru dari 100.000 wanita berusia dibawah 65 tahun dibandingkan dengan 403,8 dari100.000 wanita berusia 65 tahun keatas. Permasalahan-permasalahan yang dihadapioleh pasien kanker wanita usia tua adalah terlambatnya diagnosis, penanganan yangkurang agresif, kondisi kesehatan umum pasien yang lemah, dimana akan membatasipilihan terapi. Tujuan dari studi deskriptif ini adalah untuk mengetahui frekuensi kankerpayudara pada wanita usia tua, serta mengetahui distribusinya berdasarkan stadium dandiagnosis histopatologi.Metode: Penelitian ini menggunakan rancangan penelitian deskriptif cross-sectional.Penelitian dilakukan dengan mengambil data sekunder dari pasien wanita berumur >65tahun dengan kanker payudara di RSUP Sanglah tahun 2002-2012.Hasil: Dari penelitian yang telah dilakukan, ditemukan bahwa jumlah pasien wanitadengan kanker payudara >65 tahun adalah sebanyak 51 orang

CLINICOPATHOLOGICAL FEATURES OF YOUNG AGE BREAST CANCER PATIENTS IN BALI I Wayan Sudarsa
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

AbstractBreast cancer is, in general, a heterogeneous disease with diverse biological characteristics, histopathological types, subtypes and clinical behavior. Breast cancer in young age, although rare, is usually a unique and more aggressive cancer associated with poorer prognosis. The combination of young age and advanced stages of breast cancer would make this particular breast cancer more difficult to manage. Therefore, individually tailored therapies have been the subject of many studies for these patients. The purpose of this study was to determine clinicopathological features of young age breast cancer patients in Bali from 2014-2016. This was a descriptive study of young age (≤40 years) breast cancer patients in Bali from January 2014 until June 2016. The samples were taken from the Perhimpunan Ahli Bedah Onkologi Indonesia Cancer registry in Sanglah General Hospital Bali. There were 90 samples gathered from the cancer registry and 56 samples (62,2%) had complete clinicopathological records. Clinicopathological features included in this study were age group, histopathological type, primary tumor size, regional lymph node involvement, presence of distant metastasis, stage regrouping, tumor grade, hormonal receptor status, Her2 overexpression status, and breast cancer subtype. There were 56 young age breast cancer patients, with a mean age of 33,86±4,193 years old, the youngest patient was 22 years old, and the majority of the samples were in the 31-35 years age group (26 samples, 46,4%). Only 2 samples (3,6%) had special type carcinoma, both of them were invasive lobular carcinoma, the rest of the samples were invasive carcinoma of no special type. The 2 samples with invasive lobular carcinoma were in 31-35 years age group, had stage II (T2N0M0) and III (T4N1M0) breast cancer, both with grade II tumor and Luminal A subtype. The majority of primary tumor size was T4 (30 samples, 53,6%), nodal status was N1 (29 samples, 51,8%), and only 10 samples (17,9%) had distant metastasis. The majority of the stage regrouping was in stage III (35 samples, 62,5%) and had grade III tumor (33 samples, 58,9%). There were 10 samples (17,9%) with Luminal A subtype, 19 samples (33,9%) with Luminal B subtype, 16 samples (28,6%) with Her2 type subtype, and 11 samples (19,6%) with triple negative breast cancer subtype. We concluded that the majority of young age breast cancer patients in Bali were invasive carcinoma of no special type in advanced stage, with high grade tumor, and within Luminal B subtype.

C-X-C RECEPTOR 4 {CXCR4} METASTASIS KANKER PAYUDARA I Wayan Sudarsa; I Wayan Putu Sutirta Yasa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i2.1068

The chemokine receptors CXCR4 (chemokine C-X-C motif receptor 4) and its ligand (stromal derived factor-1/SDF-1 or chemokinemotif ligand 12/CXCL12) play an important role in cancer invasion and metastasis. The spread of breast cancer follows a nonrandommetastatic pattern typically involving spread of tumor to regional lymph nodes, lung, liver, and/or bone marrow. The ligand for CXCR4,SDF-1/CXCL12, is highly expressed by stromal fibroblasts within these tissues. The chemokine receptors CXCR4 is structurally related tochemokine receptor belonging to the superfamily of the seven transmembrane G-protein coupled receptors. In contrast to normal breasttissue, breast cancer cells typically express high levels of functional CXCR4 receptors that can direct chemotaxis and invasive responses.Expression of SDF-1/CXCL-12 in turn, promotes the progression of breast cancer by directly enhancing tumor-cell growth and by recruitingendothelial progenitor cells that are required for tumor angiogenesis. High-level expression of CXCR4 on neoplastic cells is associated withrelatively poor overall survival and bad prognosis in patients with breast cancer. The promising results in the preclinical tumor modelsindicate that CXCR4 antagonists may have to reduce the spread of cancer that is called anti tumor activity in patients with breast cancer.The chemokine receptors CXCR4 antagonists, although initially developed for treatment of acquired immunodeficiency diseases syndrome(AIDS), actually may become effective agents as a molecular targeted therapy for breast cancer.

Hubungan Antara Ekspresi Cyclooxygenase-2 dan Gambaran Klinikopatologikal dari Kanker Kolorektal di RSUP Sanglah Gede Budhi Setiawan; Wayan Sudarsa; I.B. Tjakra Wibawa Manuaba
JBN (Jurnal Bedah Nasional) Vol 1 No 2 (2017): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: untuk menyelidiki hubungan dari ekspresi cyclooxygenase-2 (COX-2) dengan gambaran klinikopatologikal pasien dengan kanker kolorektal (CRC). Metode: ekspresi COX-2 diperiksa mengunakan imunohistokimia pada 46 pasien dengan kanker kolorektal, di Rumah Sakit Sanglah Denpasar, antara bulan September 2004 dan November 2005. Dilakukan analisis hubungan ekspresi COX-2 dengan gambaran klinikopatologikal. Hasil: pewarnaan COX-2 terekspresi pada 91,3% sampel. Ekspresi COX-2 sebesar 94,6%, dan 100% pada stadium III dan IV CRC, dan berkorelasi positif dengan tahap TNM dari CRC (Spearman’s rho 0,846, p<0,05). Ekspresi COX-2 100% pada CRC yang berdiferensiasi buruk dan berkorelasi positif (Spearman’s rho 0,456, p<0,05). Tidak ada korelasi antara ekspresi COX-2 dan usia pasien, jenis kelamin, lokasi tumor, dan jenis histopatologi CRC (p>0,05). Simpulan: ekspresi COX-2 diregulasi pada CRC, dan berhubungan dengan TNM, dan diferensiasi. Hasil ini lebih mendukung bukti bahwa COX-2 mungkin terlibat dalam karsinogenesis dari CRC.

Pembedahan Kanker di Masa Pandemi COVID-19 I Wayan Sudarsa
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): Special Issue COVID-19 - JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Secara ringkas, perawatan penderita kanker di masa COVID-19 ini, telah mengubah paradigma antara penderita dan tenaga medis terutama ahli bedah onkologi, untuk bersama-sama melawan COVID-19, maka dari itu diperlukan komunikasi yang baik antara dokter dengan penderita, edukasi penyakit dan tindakan prosedur yang dapat ditunda atau segera dikerjakan berdasarkan guideline terkini, dan persiapan ketersediaan sumber daya yang ada merupakan pertimbangan yang penting, untuk menekan penyebaran COVID-19 bagi tenaga medis terutama ahli bedah onkologi di Indonesia.

Skoring Prognostik Survival Pasien Triple Negative Breast Cancer Berbasis Immunoscore Putu Anda Tusta Adiputra; I Wayan Sudarsa
JBN (Jurnal Bedah Nasional) Vol 5 No 2 (2021): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2021.v05.i02.p05

Kanker payudara adalah salah satu masalah kesehatan utama di dunia. Data Globocan tahun 2018, terdapat lebih dari 2 juta kasus kanker payudara baru dengan angka mortalitas lebih dari 600.000 jiwa. Salah satu subtipe kanker payudara yang memiliki prognosis yang buruk adalah Triple Negative Breast Cancer (TNBC) yang terjadi sekitar 15% hingga 20% dari seluruh kanker payudara invasif yang telah terdiagnosis. Subtipe ini memiliki sifat yang lebih agresif yang ditandai dengan nilai disease-free and overall survival yang rendah. Hingga saat ini prediktor dan prognosis pasien kanker payudara secara umum dan TNBC pada khususnya dilakukan berdasarkan evaluasi demografi, klinis, dan histopatologi. Namun, berbagai penelitian menunjukkan bahwa sistem skoring yang didasarkan pada parameter tersebut tidak terlalu efektif dan hanya memberikan informasi yang terbatas dalam prediksi survival dan mortalitas TNBC. Salah satu potensi sistem prediktor dan prognosis pasien TNBC adalah berbasis sistem imun yaitu immunoscore. Dalam review ini akan dibahas lebih lanjut mengenai skoring prognostik survival pasien TNBC berbasis immunoscore.

Penanganan Pasien Kanker dan Risiko Infeksi selama Wabah COVID-19 Hendry Irawan; I Wayan Sudarsa
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): Special Issue COVID-19 - JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Pada kondisi wabah COVID-19, maka perlu adanya perhatian khusus pada pasien kanker. Pasien dengan kanker memiliki risiko tinggi apabila terinfeksi COVID-19, memiliki prognosis buruk, dan lebih cepat memburuk dibandingkan pasien tidak kanker. Tindakan preventif untuk menurunkan risiko infeksi COVID-19 di rumah sakit dan penggunaan terapi anti-kanker menjadi hal yang penting diperhatikan untuk membantu pasien kanker selama wabah.

Faktor-faktor yang mempengaruhi kualitas hidup pasien kanker tiroid berdiferensiasi baik (DTC) paska tiroidektomi total di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar I Gusti Ngurah Gde Dwi Aryanata; I Wayan Sudarsa; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Thyroid Cancer is the most common endocrine cancer. The majority of thyroid cancer (80-85%)Â is well differentiated. Surgery is the treatment of choice for Well-Differentiated Thyroid Cancer (DTC). This research aims to evaluate the quality of life of patients with thyroid cancer who have undergone total thyroidectomy compared to the general population and also assess the influencing factors.Methods: This research includes 50 patients suffering from DTC after total thyroidectomy and 50 participants were selected to represent the general population who are then asked to fill out a detailed questionnaire EORTC QLQ 30 Indonesia Version including demographic data and clinical data as the TSH levels, the type of histopathology and interval of time since diagnosis, taken from the patient's medical record. Data were analyzed using independent t-test and linear regression in STATA 14 for windows.Results: It is evident that the quality of life of patients with DTC after total thyroidectomy is significantly lower compared to the general population (P<0.05). In addition, several factors such as age, educational level and income of the family give a strong influence as for gender, marital status, employment status, and the time interval since diagnosis gives a mild influence to the quality of life (P<0.05). However, TSH levels and type of histopathology was not proven to affect the quality of life (P>0.05)Conclusion: There are several factors related to quality of life among patients with DTC such as age, educational level and income of the family, gender, marital status, employment status, and the time interval since diagnosis

Relationship between Monocarboxylate Transporter 4 (MCT-4) Expression and Breast Cancer Clinicopathology and Subtype in Sanglah General Hospital, Denpasar, Indonesia Gede Andry Nicolas Andry Nicolas; I Wayan Sudarsa; Putu Anda Tusta Adiputra; Desak Made Wihandani; I Gede Putu Supadmanaba
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Breast cancer is the second leading cause of death in women in developing countries. The activity of Warburg and Reverse-Warburg effects on breast cancer is reflected by the expression patterns of two molecules, namely caveolin-1 and Monocarboxylate Transporter-4 (MCT-4). MCT-4 is a transmembrane transport protein that transports lactate from the cytoplasm to the intercellular fluid.Method: This is a cross-sectional analytical study to determine the relationship between MCT-4 expression and breast cancer clinicopathology and subtypes. The study was conducted between April and May of 2020 with 62 breast cancer patients as samples in Sanglah General Hospital, Denpasar. Analysis was done with SPSS 25.Results: A logistic regression analysis was performed to analyze the relationship between the dependent variable (MCT-4) and the covariates (stage, grade, and subtype). Of the three variables significantly associated with MCT-4 expression, only clinical-stage and subtype (luminal and non-luminal) remained independently associated with MCT-4 expression. Analysis on the clinical stage and subtype variables showed an adjusted OR of 4.727 (p = 0.047; 95% CI: 1.109 - 21.922) and 17.850 (p = 0.009; 95% CI: 2.069 - 154.003) , respectively. This suggests that MCT-4 has a significant association with subtype and clinical-stage, increasing the risk of cancer stage progression and developing a more malignant (non-luminal) subtype.Conclusion: High MCT-4 expression was significantly associated with malignant subtypes, high histological-grade cancer and advanced breast cancer.

Co-Authors A. Winata, A. Arif Winata Bharata, Made Dwi Yoga Budi Heryanto Desak Made Wihandani Faisal Susanto Gede Andry Nicolas Andry Nicolas Hendry Irawan I B. T Wibawa-Manuaba I G. N. Pustaka I G. P. Supadmanaba I Gusti Ayu Sri Mahendra Dewi I Gusti Ngurah Gde Dwi Aryanata I Ketut Wiargitha I Nyoman Semadi I Wayan Ari Sumardika I Wayan Putu Sutirta Yasa I. B. Tjakra Wibawa Manuaba Ida Bagus Made Suryawisesa K Tangking Widarsa K. Y. Yarso M.A. Keswara Maheswari, Luh Putu Dewanda Ni Gst Ayu Agung Manik Yuliawati Wetan Ni Luh Putu Harta Wedari Ni Made Dian Hartaningsih Ni Made Mahastuti Nyoman Golden Nyoman Putu Riasa O. Y. Ampur, O. Y. Paskarani, Putu Erika Patriawan, Putu Pattipeilohy, Allen Anderson Putu Anda Tusta Adiputra Putu Ayu Kartika Putri Saraswati Selvy Musdalifah Setiawan, I Gede Budhi Sri Maliawan Suryawisesa, Ida Bagus Made Theodore Dharma Tedjamartono Tjokorda Gde Bagus Mahadewa Yasa, I Nyoman Wawan Tirtha

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