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INDONESIA
Indonesian Journal of Cancer
Published by National Cancer Center-Dharmais Cancer Hospital
ISSN : 19783744     EISSN : 23556811     DOI : https://www.doi.org/ 10.33371
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health
Indonesian Journal of Cancer is a peer-reviewed and open-access journal. This journal is published quarterly (in March, June, September, and December) by Dharmais Cancer Hospital - National Cancer Center. Submissions are reviewed under a broad scope of topics relevant to experimental and clinical cancer research. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted acceptance for publication. The journal publishes original research articles, case reports, and review articles under the following categories: cancer management, cancer prevention, cancer etiology, epidemiology, molecular oncology, cancer diagnosis and therapy, tumor pathology, surgical oncology, medical oncology, radiation oncology, interventional radiology, as well as early detection.
Arjuna Subject : Kedokteran - Onkologi
Articles 10 Documents
 1 
Search results for , issue "Vol 17, No 4 (2023): December" : 10 Documents clear
A Case Report of Pediatric Colorectal Carcinoma in an 11-year-old Indonesian Pahlevi Adeputra Nasution, Iqbal; Fikri, Erjan; Dutra Pratama, Raka
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1016

Abstract

Introduction: Colorectal carcinoma (CRC) is a rare condition among pediatric patients and is often considered the last possible diagnosis in individuals with defecating issues. Therefore, this case report aims to present and elaborate on the identification of pediatric CRC in a center in Indonesia.Case Presentation: An 11-year-old female adolescent presented with obstipation for a week after a series of defecating difficulty episodes spanning the last three months. Furthermore, these difficulties had been progressively worsening over the past two weeks. The patient also reported recurrent colic pain in the abdominal region, but the exact location was unspecified. Positive results of goat-like stool were found for three months, without any observed diarrhea episodes and blood or mucous layer on the stool. A significant weight loss of ±10 kg was reported during the illness period. On physical examination, symmetrical abdominal distention was observed, and colon-in-loop and CT assessment results supported this. These diagnostic measures showed a malignant-suggestive mass ascending to the transverse colon. A right extended hemicolectomy procedure was then carried out as the definitive treatment, accompanied by stoma ileocolostomy to divert defecation. The histopathological analysis on the 4.0 x 4.0 cm intraluminal mass confirmed the presence of poorly differentiated adenocarcinoma. Conclusion: The identification of chronic constipation among pediatric patients must raise awareness regarding the potential for mechanical bowel obstruction due to a malignant mass, specifically in inpatients.
Major Microbiota Profile of Breast Cancer From Faecal Specimen and Cancerous Breast Tissue: A Comprehensive Systematic Review Annisa, Annisa; Perdana Putri, Rachma Greta; Solikhah, Solikhah
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1030

Abstract

Background: The microbiota population in breast cancer tissue is known to have a crucial role in the tumor microenvironment supporting developmental ability. Despite a heterogeneous profile, the relationship between microbiota and breast cancer is still not fully understood. Therefore, this study aimed to explain the major microbiota profile associated with breast cancer and explore potential biological connections Methods: Following the PRISMA guidelines, the literature review investigated the diverse composition of microbiota profiles in breast cancer patients compared to those in normal conditions. Utilizing the PICO framework, a comprehensive search was conducted on the Pubmed and Google Scholar databases. The searches were restricted to open-access articles from the last 5 years. Additionally, critical appraisals are conducted for quality assessment. Results: A total of 145 articles were identified using the relevant keywords, out of which 17 successfully passed filtering and screening for inclusion in the review. Major microbiota observed in breast cancer patients included firmicutes, proteobacteria, actinobacteria, and bacteroidetes. The microbiota profile was influenced by factors such as cancer subtype, menopausal history, and tumor severity. These microorganisms play a role in the inflammatory response to their metabolite products and modulate hormonal changes, potentially enhancing tumor survival. Conclusions: Generalizing the expression of microbiota profile both in the gut or its tissue might be challenging due to its multifactorial nature, dependent on patient characteristics such as age, menopausal status, BMI, tumor grade, and subtype. The study suggests that the major microbiota that shows increased prevalence in breast cancer include firmicutes, proteobacteria, actinobacteria, bacteroidetes, and blautia, each playing a distinct role in the developmental process. 
Impact of Artificial Intelligence on Mammography Interpretation by Breast Radiologists, Non-Breast Radiologists, and Senior Residents Darmiati, Sawitri; Afifi, Rahmi; Billy, Christy Amanda; Panigoro, Sonar Soni; Kartini, Diani; Prihartono, Joedo
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1100

Abstract

Background: Artificial intelligence (AI) is recognized to have tremendous potential to revolutionize breast cancer management through mammography. However, the extent of its impact on radiologists with different levels of experience remains largely unexplored. Therefore, this study aimed to comprehensively show how AI could assist radiologists of varying expertise including breast and non-breast radiologists, as well as senior residents, in performing mammogram interpretation.Methods: This retrospective study analyzed eligible mammograms from Cipto Mangunkusumo Hospital between January 2017 and March 2021. Mammographic readings were conducted independently by two breast radiologists, two from other subspecialties, and three senior residents, all blinded to clinical information. AI standalone performance, as well as radiologists with and without AI assistance, was measured. Results: The results showed that a total of 886 eligible mammograms were analyzed. AI standalone performance, assessed using ROC curve analysis, yielded an AUC of 0.946 (95% CI, 0.925–0.967) with sensitivity and specificity of 90.1% and 93.6%, respectively. AI assistance significantly improved the sensitivity and specificity of all radiologists, regardless of experience level, with a median increase of 19.4% (IQR, 10.4–33.5%) and 12.1% (IQR, 5.2–16.2%), respectively. Moreover, there was a trend toward a higher increase with AI assistance in dense compared to fatty breasts.Conclusions: AI proved to be a highly effective diagnostic supplement for radiologists across varying experience levels, specifically in non-breast radiologists, offering the potential to add even greater value in cases of dense breast tissue. The results were derived from a national referral tertiary hospital that generally received many breast cancer cases referred from other hospitals for further treatment. Therefore, further studies incorporating different levels of hospitals were needed.
Survival of Lung Adenocarcinoma Patients with Tyrosine Kinase Inhibitor Therapy Based on EGFR Mutation Status in Tumor and Plasma Samples Haryati, Haryati; Arganita, Fidya Rahmadhany; Oktaviyanti, Ika Kustiyah
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.995

Abstract

Background:The prognosis for epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) is greatly improved when treated with tyrosine kinase inhibitor (TKI). In this context, EGFR mutation status should be determined at the diagnosis stage but circulating tumor DNA (ctDNA) has been increasingly used for molecular profiling. Therefore, this study aimed to establish the correlation between the presence of ctDNA before TKI therapy and subsequent clinical outcomes Methods: A total of 18 patients with NSCLC who received EGFR-TKI therapy were enrolled. EGFR mutations were simultaneously identified in tumor samples and plasma ctDNA, as well as information regarding overall survival (OS) and progression-free survival (PFS). Result: These case studies showed that 14 of 18 patients (77.8%) with concordance results detected EGFR-positive mutations on ctDNA examination and histopathology from plasma and tumor samples, respectively. The median PFS was similar at 7.5 months in both groups, while the median OS was shorter in patients with EGFR-detected in ctDNA (17 vs. 25.5 months) after TKI-targeted therapy. Conclusion: The identification of EGFR mutations in plasma ctDNA was a promising, effective, and minimally invasive alternative to tumor biopsy. The existence potentially reflected the disease burden and showed a poor prognosis.
Factors Influencing Distress and Coping Strategies Among Patients with Metastatic Spinal Tumor at Cipto Mangunkusumo General Hospital Agiananda, Feranindhya; Nugraeni, Tiara; Diatri, Hervita; Aninditha, Tiara; Kusumaningrum, Profitasari
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.994

Abstract

Background: Patients with metastatic spinal tumor are experiencing various symptoms, including neurological deficits that cause distress and affects their quality of life. The vulnerability to distress is influenced by coping strategies. Therefore, this study aimed to investigate factors associated with distress and coping strategies in patients with metastatic spinal tumors at Cipto Mangunkusumo General Hospital. Methods: In a cross-sectional study conducted at Cipto Mangunkusumo General Hospital from September 2021 to May 2022, factors associated with distress and coping strategies in patients with metastatic spinal tumors were investigated. The analysis included a total of 104 subjects from both outpatient and inpatient settings. Distress levels and areas of concern were assessed using the Distress Thermometer (DT) questionnaire while coping strategies were evaluated through the Coping Orientation to the Problem Experienced (COPE) instrument. Bivariate and multivariable analyses were carried out to assess the relationship between sociodemographic factors, spinal tumor characteristics, specific areas of concern, coping strategies, and distress.Results: The results showed that 57.7% of metastatic spinal tumor patients experienced distress. In the 18-59 age group, motor disorders, sensory disturbances, autonomic disorders, treatment status, problem-focused coping (PFC), emotion-focused coping (EFC), and avoidance coping had significant associations with distress. However, the multivariable analysis showed that EFC (OR = 1.156, 95% CI: 1.024–1.304, p=0.019), avoidance coping (OR = 1.154, 95% CI: 1.005–1.326, p=0.042), and sensory disturbance (OR = 16.001, 95% CI: 1.472–173.960, p=0.023) were identified as risk factors for distress.Conclusions: Patients with metastatic spinal tumors who used emotion-focused coping, avoidance coping, and sensory disturbance faced significant risk factors for distress
Characteristics of Kidney Cancer Patients At Hasan Sadikin Hospital, Bandung Ardiansyah, Novan; Safriadi, Ferry
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1125

Abstract

Background:  Kidney cancer accounts for 5% and 3% of all malignancies in men and women, respectively, representing the 7th most common cancer in men and the 10th most common cancer in women. In Asia, especially in Indonesia, the incidence of kidney cancer has not been widely reported. Therefore, researchers intend to investigate the characteristics of Kidney Cancer at Hasan Sadikin Hospital, Bandung, during the period 2015–2019. Methods: This research is a descriptive retrospective study taken from the medical records of patients with kidney cancer in the Department of Urology, Universitas Padjadjaran, Hasan Sadikin Hospital. The study was conducted from June 2019 until all the medical record data for the sample were fulfilled. The data included age, gender, and histopathological findings. Results: From the data collection, it was found that there were a total of 126 patients with kidney cancer, occurring in 83 male patients (65.8%) and 43 female patients (34.2%). The age group 0–10 years dominated the occurrence of kidney cancer, with 32 out of 126 patients (25.4%), followed by the 41–50 age group with 30 patients (23.8%), and the 21–30 age group had the fewest diagnoses of kidney cancer. A total of 78 patients (61.9%) were diagnosed with Renal Cell Carcinoma (RCC). Clear cell RCC was more common, with 64 cases (50.7%), compared to papillary RCC with 13 cases (10.3%) and Chromophobe RCC with 1 case (0.8%). The most commonly found kidney cancer was Wilm’s tumor, with 33 patients (26.1%), occurring in individuals under 20 years of age. Conclusion: This study found that kidney cancer is more common in males than in females. RCC is the most frequently diagnosed type, with clear cell subtype being predominant, especially in patients over 40 years of age. Wilm’s tumor dominates kidney cancer cases in individuals under 20 years of age.
The Relationship between Degree of Differentiation with the Incidence of Lymphovascular Infiltration Triple Negative Breast Cancer in West Sumatera Hidayat, Nur Latifah Alfaina; Yenita, Yenita; Khambri, Daan
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1010

Abstract

Background: The degree of differentiation and the incidence of lymphovascular infiltration in Triple Negative Breast Cancer (TNBC) are several determinants of the prognosis and survival of sufferers. This disease has a more aggressive clinical course than other breast cancer phenotypes. Targeted therapy has not been able to improve survival in TNBC patients. This study aims to analyze the relationship between the degree of differentiation and lymphovascular infiltration in Triple Negative Breast Cancer in West Sumatra. Methods: This is an observational analytic study with a cross-sectional approach. The number of study samples was 44 TNBC patients at the Ropanasuri Special Surgery Hospital, Ibnu Sina Islamic Hospital, and RSUP Dr. M. Djamil, Padang, in 2016–2021. The data studied were the degree of differentiation and lymphovascular infiltration from the results of anatomical pathology examination which were analyzed using the Chi Square test. Results: The most histopathological types in TNBC were Invasive Carcinoma Mammae of No Special Type (79,5%) with the most age range of patients over 60 years (43,2%). The majority of the degrees of differentiation found were grade II (75%), lymphovascular infiltration negative category (65,9%), and there was a significant relationship (p 0,001) between the degree of differentiation and lymphovascular infiltration in TNBC Conclusions: There was a relationship between the degree of differentiation and lymphovascular infiltration in TNBC, namely the higher the histopathological grade of cancer cells, the higher the probability of experiencing lymphovascular infiltration.
Factors Influencing Quality of Life of Parents with Children Affected by Acute Lymphoblastic Leukemia: A Study at Childhood Cancer International Foundation, Jakarta Trisya, Michelle; Tjhay, Francisca; Hasan, Surilena; Widjaja, Nelly Tina
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1005

Abstract

Background: The diagnosis and management of chronic diseases, such as Acute Lymphoblastic Leukemia (ALL), are significant for the quality of life of parents. In addition, several factors contribute to the quality of life of parents whose children battle ALL, including characteristics, duration of childcare, mental health, and family functioning. Therefore, this study aims to identify factors influencing the quality of life of parents whose children have ALL at the Childhood Cancer International Foundation in Jakarta. Methods: This cross-sectional study recruited 109 parents at the Childhood Cancer International Foundation as respondents. The assessment tools used included a Characteristics questionnaire, Self-Rating Questionnaire-20, APGAR Questionnaire, and WHOQOL-BREF questionnaire. Additionally, collected data were subjected to univariate, bivariate, and multivariate analysis. Results: Among the 109 respondents with an average age of 38 years and mean childcare duration of 28 months, 66.1% were females, 100% believed in God, 73.4% had partners, 47.7% possessed higher education, 83.5% earned below the regional minimum wage, 66.1% experienced mental health problems, and 11.9% had family dysfunction. Bivariate analysis showed a significant relationship between gender, mental health, and quality of life (p0.05). Multivariate analysis showed that marital status, education, economic status, and family functioning significantly correlated with quality of life. Conclusions: In conclusion, gender, marital status, education, economic status, mental health, and family functioning were found to exert a significant influence on the quality of life of parents raising children with ALL.
Extensive Vulvectomy and Reconstructive Flaps for Advanced Vulvar Cancer in Young Woman: Case Reports Malik, Nasdaldy; Soemanadi, M; Mukarramah, Dewi Aisiyah
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1062

Abstract

Introduction: : Vulvar cancer is a rare disease accounting for approximately 5% of female genital tract tumors worldwide. It is a squamous cell cancer that mostly affects older women over the age of 65. In the existing body of literature, no instances of vulvar cancer have been documented in the form of case reports. Therefore, this study aimed to report the challenges and outcomes of vulvectomy with reconstructive flap in vulvar cancer survivors in a 39-year-old woman. Case Presentation: A 39-year-old woman with a palpable lump around the vulva was present and being examined. The anatomic pathology report (APR) features suggested poorly differentiated malignant tumors. A neoadjuvant chemotherapy was then administered to the patient aimed at shrinking the size of the tumor. However, there was no effective response to the chemotherapy, which resulted in a progressive tumor. Extensive vulvectomy and reconstructive flap were carried out to support quality of life, and the outcomes were reported, including flap, survival, complications, and mortality. These outcomes were evaluated between November 2021 and March 2023. No total flap loss was observed, and neither was there any donor site morbidity or mortality during the process. Conclusions: This study showed that vulvar cancer was a rare condition at a young age. Advanced vulvar cancer was found in the patients and extensive vulvectomy surgery was carried out followed by a pedicled ALT flap. This option was currently the best for immediate reconstruction due to the preservation of sensibility and tissue availability in the donor areas. The result showed no wound dehiscence, marginal necrosis, or surgical site infection. After 15 months of follow-up, the flap was observed to have good vascularization. The association of the Gynecologist with the Plastic Surgeon offered palliative care to improve the quality of life of the patient and provide good postoperative results.  
Myocardial Infiltration in Primary Mediastinal B-Cell Lymphoma Detected by Cardiac Magnetic Resonance Imaging Sutedjo, Verawati; Soewondo, Widiastuti; Yuniarti, Mira; Tenggara, Jeffry Beta; Erawati, Dini Rachma
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.966

Abstract

Introduction: Cardiac involvement, particularly myocardial infiltration in primary mediastinal lymphoma, is a rare occurrence with an incidence of only 9% in known cases of primary malignancy. Neoplasm infiltration into the myocardium manifests through direct invasion, hematogenous spread, transvenous invasion through the great veins, or lymphangitic spreading in the mediastinal. Myocardial infiltration in lymphoma presents a grim prognosis and its treatment may be associated with specific risks, such as myocardial rupture. Various imaging modalities may detect cardiac involvement, with cardiac magnetic resonance (CMR) imaging considered the gold standard. CMR enables clear delineation of myocardial infiltration, making it valuable for local staging, pretreatment planning, and evaluating treatment response. Case Presentation: : A 37-year-old woman patient was diagnosed with primary mediastinal large B-cell lymphoma. Mild chest discomfort and shortness of breath were observed 3 months before hospital admission. A thorax CT scan showed a heterogeneous contrast-enhancing mass with a central necrotic area in the anterior mediastinum. Following thoracotomy and tumor debulking, the patient complained of severe crushing chest pain radiating to her back, accompanied by new T wave inversion on ECG and elevated cardiac troponin levels a week after surgery. Coronary angiogram results showed a normal coronary artery. Subsequent cardiac MRI showed tumor infiltration into the anterior pericardial space, as well as the myocardium of the left and right ventricles. Chemotherapy was promptly initiated, resulting in a gradual improvement of symptoms. Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like IMRT. However, with careful planning, we can still obtain optimum tumor dose, minimize OAR dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on reirradiation, especially in OAR dose tolerance guidelines. 

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