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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 21 Documents
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Search results for , issue "Vol 19, No 3 (2025): September" : 21 Documents clear
Role of Liquid Biopsy as a Future Approach to Early Diagnosis and Management of Colorectal Cancer Danardono, Edwin; Soediono, Mochammad Ridhwan; Amiruddin, Muhammad Tidar Abiyu
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1319

Abstract

Colorectal cancer (CRC) is a major global health challenge, ranking as the third most prevalent cancer worldwide. Traditional tumor biopsies are invasive and limited by issues such as tumor heterogeneity and the inability to perform repeated sampling. Liquid biopsy, a non-invasive diagnostic approach that analyzes biomarkers in bodily fluids like blood, offers an innovative solution to these challenges. By detecting circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes, and tumor-educated platelets (TEPs), liquid biopsy allows for real-time tumor monitoring, early cancer detection, and personalized treatment strategies. This review explores the clinical applications of liquid biopsy in CRC, highlighting its potential for early detection, monitoring treatment response, and guiding customized therapies. Key biomarkers such as CEA, ctDNA, CTCs, and exosomal miRNAs offer insights into tumor dynamics and prognosis. While liquid biopsy shows promise for broad clinical use, challenges remain in standardizing methodologies and validating its efficacy through large-scale trials. Advances in technology and improved biomarker discovery are expected to enhance the accuracy and utility of liquid biopsy, making it a pivotal tool in CRC management and beyond.
Diagnostic Accuracy of Modalities for Diagnosis of Thoracic Cancer: Retrospective Analysis Ariawan, Wily Pandu; Hanafi, Arif Riswahyudi; Pradipta, Jaka; Jayusman, Mulawarman; Hanif, Muhammad Alfin; Hutabarat, Jubillete Windy; Amira, Salsabila Nur
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1307

Abstract

Background: Thoracic cancer becomes a huge consideration, especially for lung cancer, because it quietly increases over time and needs highly sensitive diagnostic modalities. Thus, we aim to investigate the diagnostic accuracy of several cytology-based modalities to diagnose thoracic cancer. It would serve as a reference for other cancer centers in estimating diagnostic approaches for thoracic cancer.Method: Retrospective analysis with a cross-sectional study comprised of 2358 diagnostic procedures at Dharmais Cancer Hospital, Jakarta, Indonesia, from 2020 to 2023. Data were extracted from e-medical records. We compared seven cytology-based procedures to the gold standard, which is histopathology examination. Results: Study subjects (n=2358; mean age 60 ± 12.0; 62.6% male) predominantly used the mode of diagnostic Bronchial Brushing Cytology (BBC) about 676 (28.7%). Endobronchial Ultrasound (EBUS) was the highest sensitivity (88.1%) of the diagnostic approach for thoracic cancer (p 0.05).Conclusion: EBUS had the highest sensitivity in diagnosing thoracic cancer. However, multimodality diagnostic procedures should be considered for patients who have symptoms suggestive of thoracic cancer to get highly positive results and lower complications, both cytologically and histologically. As a national cancer center, providing data on diagnostic modalities is necessary, and an analysis of cancer services is required for informed policy recommendations.
Evaluating the Implementation of an Early Palliative Care Screening Tool for Inpatients at Persahabatan Hospital: Impact on Quality of Care, Length of Stay, and Clinical Outcomes Khonsa, Oni; Meliala, Andreasta; Darwito, Darwito
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1263

Abstract

Background: Palliative care is integrated medical care that is active and comprehensive, with a multidisciplinary approach to reduce the pain of terminally ill patients at the end of their lives. Persahabatan Hospital, as a national referral Type A hospital, receives many patients in severe and complex conditions, some of whom require palliative care. Early identification of Palliative Care Screening Tool (PCST) screening can result in more effective interventions and more optimal care in improving quality of life, reducing length of stay, and intensive care unit (ICU) admission rates. This study aims to assess the early implementation outcomes of the PCST in inpatients at Persahabatan Hospital. Method: This research is a sequential explanatory mixed methods design that examines how the implementation evaluation of PCST in palliative care at Persahabatan General Hospital is conducted, utilizing both retrospective quantitative and qualitative approaches. The quantitative approach involves utilizing secondary data from medical records and the PCST at Persahabatan General Hospital in Jakarta from January to December 2023. A random sampling technique was applied to select patients diagnosed with palliative care conditions, including severe liver disease,end-stage kidney disease, chronic obstructive pulmonary disease (COPD), advanced heart failure,and other chronic illnesses. At the same time, the qualitative approach employs the focus group discussion analysis method.Results: Out of 82 patients who underwent PCST screening, 56 patients underwent early screening, and 26 patients underwent late screening. The median length of stay for patients with early screening was 4 days, whereas for those with late screening, it was 18 days (p 0.001). Early screening had a relative risk of 4.34 (1.72–26.2) for successful palliative screening compared to late screening. Based on the analysis of the focus group discussion results, the main issues in implementing early screening were a lack of understanding of the screening process and difficulties in its implementation
Correlation of Age, Tumor Size, and Histopathological Type with Indicator Tumor Progression of Penile Squamous Cell Carcinoma in Bali Astuti, Ni Luh Putu Vina Juni; Lestari, Desak Putu Oki; Sari, Ni Luh Putu Eka Kartika; Armerinayanti, Ni Wayan; Evayanti, Luh Gde; Perdana, I Gede Sukma Okta
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1340

Abstract

Background: Penile cancer is a rare malignancy globally, but Bali accounts for approximately 40% of Indonesia’s cases. Age, tumor size, and histopathological type are recognized factors influencing penile cancer progression, with grade, depth of invasion, lymph node metastasis, and distant metastasis serving as key indicators. However, the prognostic value of these factors, particularly depth of invasion, remains debated. This study aimed to evaluate the correlation between age, tumor size, and histopathological type with indicators of tumor progression in penile squamous cell carcinoma (SCC) in Bali.Method: A cross-sectional analytical study was conducted on 160 cases of penile SCC. Dependent variables included tumor grade, depth of invasion, and lymph node metastasis, while independent variables were age, tumor size, and HPV status (inferred from histopathology). Age was categorized as 60 or ≥60 years, tumor size as 4 cm or ≥4 cm, and depth of invasion as T1–T4. Multivariate analysis using the chi-square test was performed to assess associations.Results:  Most patients were aged ≥ 60 years, had HPV-independent SCC, tumor size ≥ 4 cm, grade 2 tumors, and T1 depth of invasion, with lymph node metastasis observed in a minority. Multivariate analysis revealed significant correlations between age, tumor size, and histopathological type with grade (p = 0.026, R² = 0.056), depth of invasion (p 0.001, R² = 0.445), and lymph node metastasis (p = 0.004, R² = 0.075). Tumor size demonstrated the strongest association with depth of invasion (OR = 9.618, p 0.001) and lymph node metastasis (OR = 6.846, p 0.001).Conclusion: Tumor size is a significant predictor of both depth of invasion and lymph node metastasis in penile SCC. Clinical assessment of tumor size should be emphasized as a key prognostic factor to guide early intervention strategies in patients with penile SCC in Bali.
Determinants of Quality of Life of Cancer Patients Undergoing Chemotherapy at Dharmais Cancer Hospital Jakarta in 2024 -, Saman -; Ulfa, Laila; Sulistyowati, Yeny; Buwana, Cahya
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1298

Abstract

Background: Cancer is one of the non-communicable diseases that is a serious problem in health and one of the leading causes of death in the world. GLOBOCAN data shows new cases of cancer in Indonesia as many as 408,661 cases, with deaths amounting to 242,988 people. Cancer treatment, which is chemotherapy and its impact on it, can affect the patient’s quality of life. This study aims to investigate the factors that influence the quality of life of cancer patients undergoing chemotherapy at Dharmais Cancer Hospital in Jakarta. Method: Analytic observational research method with a cross-sectional design. The research was conducted in May 2024 in the inpatient room. The research sample consisted of 90 respondents using an accidental sampling technique. Data was collected on the quality of life in cancer patients undergoing chemotherapy using the European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire C30 (EORTC QLQ-C30) questionnaire instrument, which contains 30 questions about the global health scale, functional scale, and symptom scale. Data analysis in this research included univariate analysis, bivariate analysis with the Chi-square test, and multivariate analysis with multiple logistic regression test, and data processing using SPSS 25.Results: The results showed that global health status was 50% good, the functional scale was 63.3% good, the symptom scale was 55.6% good, and the patient’s quality of life was 55.6% good. Variables associated with the quality of life of cancer patients undergoing chemotherapy are nutritional status (p = 0.035) and chemotherapy education (p = 0.037). The variables of age (p = 0.178), cancer stage (p = 1.000), length of chemotherapy (p = 0.395), and family support (p = 1.000) were not significantly associated.Conclusion: Nutritional status is the most associated variable with the quality of life of cancer patients undergoing chemotherapy. It is recommended that this research be carried out, including all factors that can affect the quality of life of cancer patients undergoing chemotherapy, and evaluate changes in quality of life in each chemotherapy cycle.
Use of 177Lutetium-PSMA in the Treatment of Metastatic Castrate-Resistant Prostate Cancer: A Case Report Nerli, R B; Ghagane, Shridhar C; Bokare, Ashwin; Shetty, Rakesh; Ramesh, Sudha; Rai, Shreyas
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1324

Abstract

Introduction: Despite several recent advances and the introduction of newer anti-cancer agents, metastatic castrate-resistant prostate cancer (mCRPC) remains challenging to treat and remains fatal. Recent studies have raised the possibility of targeted radionuclide therapies such as 177Lutetium-PSMA (prostate-specific membrane antigen) as a viable therapeutic option in men with metastatic prostate cancer. Case Presentation: A 53-year-old male presenting with lower urinary tract symptoms was found to have cancer of the prostate on further evaluation. The patient underwent radical prostatectomy, and during follow-up, bony metastasis was noted at the end of two years. The patient received androgen deprivation therapy and, over the next ten years, underwent chemotherapy, enzalutamide therapy, and secondary chemotherapy. The patient continued to have painful bony metastasis and was treated with 177Lutetium-PSMA therapy. Conclusion: 177Lutetium-PSMA demonstrates a promising treatment response in men with metastatic castration-resistant prostate cancer (mCRPC).
Reliability and Construct Validity of the Short Form 36 Questionnaire for Conjunctival Tumor Patients in Indonesia Indrakila, Senyum; Soewoto, Widyanti; Purnomo, Joko; Malindha, Erma; Prastawa, Reza Pahlevi
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1320

Abstract

Background: The Short Form 36 (SF-36) questionnaire was used to measure quality of life (QoL) in Indonesia for patients with various conditions. However, its validity and reliability, specifically for patients with conjunctival tumors, remain understudied. Given the limited research on health-related quality of life (HR-QoL) in this patient population, our research aims to fill this gap by validating the SF-36 specifically for conjunctival tumor patients. Method: This observational, cross-sectional study recruited patients with conjunctival tumors receiving treatment at the Department of Ophthalmology, Dr Moewardi Hospital, between May and July 2024, using consecutive sampling. Participants completed the SF-36 questionnaire in the Indonesian context. Validity was assessed through bivariate correlation analysis, examining the Pearson correlation value for each item's questionnaire with the total QoL score. Reliability was determined using scale reliability analysis, focusing on Cronbach's alpha coefficient. The data was processed using IBM SPSS version 26.Results: The Pearson correlation coefficients for the 36-item scores range from 0.345 to 0.797, indicating a moderate to significant correlation. The scale-level Cronbach's alpha for the comprehensive tool is 0.942, suggesting excellent internal consistency. The SF-36 demonstrated robust reliability across its eight domains, confirming its suitability for measuring QoL in this demographic. These findings confirm that the SF-36 questionnaire in the Indonesian context is highly reliable and has construct validity in conjunctival tumor patients.Conclusion: The SF-36 questionnaire in the Indonesian context exhibits a satisfactory reliability scale and construct validity in assessing the QoL of conjunctival tumor patients. Further research with a larger participant pool is recommended.
Correlations of Protein 53 (p53) Expression with the Degree of Tumor Budding in Cervical Carcinoma Wardana, Ni Komang Sara Kusuma; Armerinayanti, Ni Wayan; Cahyawati, Putu Nita
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1270

Abstract

Background: Cervical carcinoma is a malignant tumor that is most often found in the female reproductive system. Persistent Human Papillomavirus (HPV) infection is the most important factor in the development of cervical carcinoma. The E6 and E7 oncoproteins in HPV inhibit the action of p53. As a result, p53 transcription and the apoptosis process are inhibited. Tumor budding has been extensively studied and established as a significant prognostic factor. This study aims to determine the relationship between p53 expression and the degree of tumor budding of cervical carcinoma.Method: This cross-sectional study used 50 paraffin blocks and secondary data from patients diagnosed with cervical carcinoma stored at BaliMed Denpasar Hospital. Paraffin blocks were then subjected to immunohistochemical examination to evaluate p53 expression and HE examination to evaluate the degree of tumor budding. Data analysis was performed using the Spearman test and linear regression test with the SPSS 25 software program. Results: The results showed that thirty-two subjects had low expression of p53, and 62,5% of them had high-grade tumor budding. The p53 expression is lower in cervical cancer with highgrade tumor budding compared with low-grade tumor budding (rs = -0.33). There are significant correlations between p53 expression and the degree of tumor budding in patients with cervical carcinoma (p = 0.018). A total of 50 samples that met the inclusion and exclusion criteria were analyzed. The majority of patients were aged ≤ 50 years (58%) and had squamous cell carcinoma (90%) in the early stage (92%). Low p53 expression was found in 64% of samples. A significant negative correlation was found between p53 expression and tumor budding grade (p = 0.018; r = -0.333), which remained significant in multivariate analysis (p = 0.024; r² = -0.328), indicating that low p53 expression is associated with high-grade tumor budding. Conclusion: The p53 expression was significantly downregulated in cervical carcinoma with highgrade tumor budding. These findings indicate that tumor budding can be considered as a prognostic marker, but further research that sorts HPV dependent and HPV independent cervical carcinomas is needed.
Sensitivity and Specificity of Ultrasonography for Assessing Axillary Lymph Nodes in Breast Cancer Patients in Surakarta, Indonesia Bellynda, Monica; Yarso, Kristanto Yuli; Rosati, Ari; Kamil, Muhammad Rizki; Muhammad, Faizal
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1339

Abstract

Background: Breast cancer is the most common malignancy in women worldwide. Early detection is effective in reducing breast cancer mortality by 25–30%. Staging assessment with sentinel lymph node biopsy (SLNB) is the gold standard for patients with clinically negative axillae. Ultrasound examination of the axillae is often performed as a preoperative treatment for breast cancer patients to determine the stage of the cancer, where regional axillary lymph node assessment can be related to the prognostic factors of breast cancer, as well as assessing the prognosis for distant metastases. This study aims to evaluate the sensitivity of ultrasound examination of the axillary lymph nodes in breast cancer.Method: This study employs a descriptive research method with a retrospective approach, utilizing secondary data and comprising 283 samples. Inclusion criteria included patients diagnosed with cervical carcinoma confirmed by histopathological evaluation and complete medical records documenting age, primary complaints, histopathological classification, and TNM staging. Data were processed and presented using descriptive statistics. The study was conducted at the Surakarta Hospital between 2020 and 2022. Inclusion criteria were breast cancer patients with stage T1-2 N0 M0 confirmed by histopathological examination who underwent axillary lymph node ultrasound examination in Surakarta. Data was taken from the medical records. Patient's initial, age, date of examination, clinical diagnosis, expertise of the ultrasound, and histopathology of the axillary lymph node were recorded. The gold standard is SLNB. The calculation of diagnostic validity was carried out using a 2x2 table, and then the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ultrasound were calculated.Results: 176 cases met the inclusion criteria, with 59.10% patients aged over 50 years old. Seventeen cases had positive ultrasound but negative histopathology examinations. Meanwhile, the remaining 15 cases had negative ultrasound but positive histopathology examinations. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy results are as follows: 82%, 83%, 80%, 83%, 4.89, 0.21, and 82%, respectively.Conclusion: Ultrasound examination for assessing axillary lymph nodes is easy, inexpensive, effective, and safe. The results can be increased with better radiological methods and experience from higher-level operators.
Factors Related to the Quality of Life of Patients with Breast Cancer Undergoing Chemotherapy at Dharmais Cancer Hospital Mutiara, Septy; Yulianto, Sherly Putri; Shinta, Shinta; Marta, Shinta; Susilowati, Shinta; Masfufah, Dian Siti; Idu, Cicirosnita Jayadi; Ngasu, Kristina Everentia
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1331

Abstract

Background: Breast cancer is one of the most common cancers in the world, and patients commonly undergo chemotherapy. Chemotherapy adherence and other factors are associated with reduced quality of life (QoL) in patients with breast cancer. This study aimed to determine factors that influence the decreased QoL of breast cancer patients and the probability of reducing the QoL of patients with breast cancer.Method: A cross-sectional research design was employed with 159 respondents, using a purposive sampling technique. The criteria were patients with breast cancer undergoing chemotherapy, without experiencing decreased activity due to disability or respiratory disorders. The questionnaires were the Adolescent Scale Activity Questionnaire (ASAQ), chemotherapy compliance questionnaire, International Physical Activity Questionnaire (IPAQ), body image scale questionnaire, Malnutrition Screening Tool (MST), spiritual well-being scale (SWBS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast 23 (EORTC QLQ-BR23). Analysis was conducted using a chi-square test and a multivariate logistic regression. The research has been tested ethically by Dharmais Cancer Hospital.Results: Most patients with breast cancer undergoing chemotherapy at Dharmais Cancer Hospital were in the age category of ≤ 45 years (38.5%), secondary education or less (76.1%), unemployed (64.8%), and stage III (56.6%). The overall research results were sedentary behavior (OR=0.05, 95%CI:0.01-0.38), chemotherapy adherence (OR=9.94, 95%CI:2.12-46.57), daily physical activity (OR=5.65, 95%CI:1.21-26.40), body image (OR=20.44, 95%CI:2.59-161.61), and spiritual well-being (OR=10.78, 95%CI:2.86-40.57), identified as factors associated with QoL in patients with breast cancer. Meanwhile, the strength of the most significant relationship was high sedentary behavior (OR=9.10, SE: 1.16), and the smallest was low spiritual well-being (OR=0.07, SE: 1.03).Conclusion: We found that high sedentary behavior, non-compliant chemotherapy adherence, low daily physical activity, negative body image, and low spiritual well-being were related to decreased QoL in patients with breast cancer.

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