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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 23 Documents
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Search results for , issue "Vol 19, No 4 (2025): December" : 23 Documents clear
Malignant Spindle Cell Tumor of the Breast: Differentiating between Metaplastic Carcinoma and Malignant Phyllodes Tumor Rosdiana, Yusfita Efi; Rahmadiani, Nayla
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1383

Abstract

Background: Spindle cell lesions of the breast include both benign and malignant tumors, with metaplastic carcinoma (MBC) and malignant phyllodes tumor (MPT) being the key malignant entities requiring differentiation due to distinct treatment strategies and prognoses. MBCs are rare, aggressive triple-negative breast cancers with significant histological and molecular heterogeneity. They often harbor TP53, PIK3CA, and EGFR mutations and are believed to arise from epithelial precursors. MBCs require wide surgical margins (radical mastectomy), and standard chemotherapy is often ineffective due to tumor heterogeneity. In contrast, MPTs are fibroepithelial tumors with a characteristic leaf-like growth pattern and originate from stromal–epithelial interactions. They are primarily treated with wide surgical excision (simple mastectomy), with limited evidence supporting adjuvant therapy. Malignant progression in MPTs is linked to TP53, MED12, and EGFR mutations, along with chromosomal abnormalities such as 1q gain. Differentiating MBC from MPT is challenging due to overlapping histological and immunohistochemical features. MBCs typically express epithelial markers like cytokeratin and p63, while MPTs show stromal overgrowth with minimal epithelial marker expression. Although advanced imaging techniques like MRI can assist in diagnosis, histopathological and immunohistochemical evaluation remain crucial. This article is a structured narrative literature review, synthesizing current evidence from peer-reviewed studies retrieved through a targeted search of PubMed, Scopus, and Web of Science without year restriction, prioritizing recent publications. The findings are organized into clinical, histopathological, immunohistochemical, and molecular aspects to facilitate accurate differentiation between MBC and MPT. In conclusion, integrating clinicopathological, immunohistochemical, and molecular data is essential for distinguishing these rare tumors, as they differ in pathogenesis, treatment approaches, and prognosis, thereby guiding optimal patient management.
The Analysis Study of The Relationship of Microbiome Dysbiosis and Risk of Colorectal Cancer: A Comprehensive Systematic Review from a Laboratory Perspective Dwana, Laksmita; Sinsanta, Sinsanta; Lesmana, Bimantara
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1348

Abstract

Background: Colorectal cancer (CRC) is a significant global health concern, with rising incidence rates linked to lifestyle and environmental factors. Recent research highlights the potential role of microbiome dysbiosis in CRC development, suggesting that alterations in gut microbiota may influence disease risk and progression. This systematic review aims to evaluate and synthesize laboratory-based research on the relationship between microbiome dysbiosis and risk factors for CRC, along with the risk for its progression. The review assesses methodologies, identifies key microbial markers correlated with risk factors, and explores potential implications for early detection and treatment.Methods: Adhering to PRISMA 2020 guidelines, the review focused on studies from 2014 to 2024, examining microbiome dysbiosis and CRC risk. Databases searched included PubMed, ScienceDirect, and SagePub. Inclusion criteria comprised English-language studies on laboratory-based microbiome analysis related to CRC. The review process involved a three-level screening to select relevant studies, followed by a detailed quality assessment.Results: Out of numerous publications, eight key studies were included. This review emphasizes the evolving role of microbiome-based biomarkers in CRC detection and management. Key studies highlight the potential for integrating microbial markers and metabolomics into clinical practice to improve early diagnosis and therapeutic strategies. The findings suggest that microbiome dysbiosis can significantly impact CRC risk and progression, providing a foundation for future research and clinical applications.Conclusions: This systematic review explores the role of microbiome dysbiosis in colorectal cancer (CRC) development and progression, with a focus on microbiome-based biomarkers for early detection. It evaluates laboratory-based research on how microbiome alterations contribute to CRC risk, highlights methodological approaches for microbiome analysis, and identifies strengths and limitations in current research. The findings suggest that microbiome-based biomarkers hold promise for early CRC diagnosis and treatment. Nevertheless, there is a need for future research to refine these biomarkers, integrate them into existing diagnostic methods, and better understand the mechanisms of microbiome-related CRC progression to enhance prevention, diagnosis, and management strategies.
Intrapulmonary Mature Teratoma Presenting with Trichoptysis: A Rare Case Report Nidzarsyah, Muhammad Mirsa; Hidayat, Moulid; Lestari, Rina; Widiasari, Komang Sri Rahayu; Fathana, Prima Belia; Santosa, Hilda; Kumaladewi, Baiq Ratna; Restuningdyah, Novia Andansari Putri; Arsatt, Maz Isa Ansyori
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1390

Abstract

Introduction: Intrapulmonary teratomas (IPT) are exceptionally rare, with only a handful of cases reported worldwide. The disease may lead to severe outcomes, such as massive hemoptysis, airway compression, and malignant transformation. Several international case reports on IPT focus on the diagnosis and surgical treatment approach. In Indonesia, only one case of intrapulmonary teratoma has been documented and analyzed for its radiological characteristics and anatomical pathology. Here, we present a case of mature IPT treated with surgery and adjuvant chemotherapy. To the best of our knowledge, this case is the second to be reported in Indonesia.Case Presentation: A 28-year-old man presented with a complaint of hemoptysis accompanied by clumps of hair (trichoptysis). Physical examination revealed no abnormalities. Chest X-ray and computed tomography (CT) thorax with contrast showed a right lung mass. The patient underwent lobectomy excision with the postoperative CT scan showing a residual mass. Furthermore, pathological findings confirmed a mature teratoma. Patients were then treated with adjuvant chemotherapy and showed clinical improvement.Conclusions: This case emphasizes the importance of including IPT in the differential diagnosis of hemoptysis, especially when trichoptysis–a rare but distinct symptom–is present. Although imaging tests like contrast-enhanced CT scans are crucial for identifying intrapulmonary masses, histological analysis is necessary for a conclusive diagnosis. The mainstay of treatment persists in surgical removal, and adjuvant chemotherapy may help control any remaining illness. This case emphasizes the importance of early detection and a multidisciplinary approach to enhance patient outcomes because it is one of the few documented IPT cases in Indonesia.
Clinicopathologic Profile of Lung Cancer Patients at Murni Teguh Memorial Hospital in 2023 Putri, Rosni Amanda; Lumongga, Fitriani; Permatasari, Amira; Laksmi, Lidya Imelda
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1371

Abstract

Background: Lung cancer is the most prevalent type of cancer worldwide, with a mortality rate of 1,817,469. This study aims to determine the clinicopathology of lung cancer patients in Murni Teguh Memorial Hospital.Methods: This is a descriptive study with a cross-sectional design. Clinical data were obtained from the medical records of lung cancer patients at Murni Teguh Memorial Hospital in 2023. The inclusion criteria were lung cancer patients who had been diagnosed histopathologically, while patients with incomplete medical records were excluded from the study. The data were processed using the Statistical Package for the Social Sciences (SPSS) software version 27.Results:  A total of 63 lung cancer patients were mostly (41.3%) aged 51-60 years. 48 subjects (76.2%) have been identified as male. Clinical symptoms of shortness of breath were found in 22 (34.9%) subjects, and the majority (47.6%) had a tumour size of T4. Based on histopathological classification according to WHO, 35 (55.5%) lung cancer patients mostly have adenocarcinoma.Conclusions: Lung cancer patients at Murni Teguh Memorial Hospital in 2023 presented with advanced disease, as reflected by the high proportion of large tumor size (T4) and respiratory symptoms such as shortness of breath. These findings highlight the tendency for late-stage presentation of lung cancer and underscore the need for improved early detection strategies and timely diagnostic interventions in this population. 
Exploring Cancer Patient Navigation Programs Across the Globe: A Scoping Review Nuzulullail, Agung Subakti; Agustin, Agustin; Dudini, Amalia Khasanah Ima; Fakhriyah, Anya Bunga; Annurahman, Arif; Sarifudin, Asri Wati; Hartini, Sri
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1394

Abstract

Background: The lack of quality cancer care is still experienced by cancer patients around the world. Cancer patient navigation was introduced to address this problem by eliminating the barriers encountered by patients. However, currently, the implementation of this program in each country varies according to the country's conditions. This study aims to explore the implementation of cancer patient navigation in several countries.Methods: A Scoping review used scientific articles from four databases, including SpringerLink, ProQuest, EBSCOhost, and Wiley. The selected articles were original research articles with publication years from 2020 to 2024. Determination of research questions and keywords used the P (Problem): practice and existence of cancer patient navigators; C (Concept): cancer patient navigators; and C (Context): various countries in the world. A total of 12 selected articles were related to the implementation of cancer patient navigation in 12 different countries. The research question was "How is the Implementation of Cancer Patient Navigators in Various Countries?"Results: A total of 12 articles were identified and providing an overview of three main themes related to cancer patient navigation. The themes were factors that influence services, the role of cancer patient navigators, and the benefits of cancer patient navigation. Implementation of cancer patient navigator (CPN) in various countries has demonstrated its effectiveness in overcoming cultural, logistical, financial, and healthcare access barriers through a personalized, multidisciplinary, and community-based approach to improve the quality of cancer diagnosis, treatment, and continuity of care.Conclusions: All studies explained that the services provided by CPN programs tended to be similar, although the locations and facilities differed in each country. Future researchers are advised to explore CPN implementation models in improving access, adherence, and clinical outcomes of cancer patients.
A Rare Case of Lower Limb Poroid Hidradenoma Anggreana, Farisa; Shelly, Wan Gifanni Efmadian; Fitriani, Katia; Andayani, Raden Roro Rini; Wirohadidjojo, Yohanes Widodo
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1354

Abstract

Introduction: Poroid hidradenoma (PH) is a benign tumor of the eccrine gland, which is the rarest variant of poroid tumor. The case reports that have been published since 1990 are around 75 cases. The presentation of PH lesions is nonspecific and varied, which often leads to misdiagnosis and requires histopathological examination to confirm the diagnosis. Case Presentation: A 53-year-old woman came with complaints of a prominent wound on her right lower leg for 4 years. Physical examination showed a partially bluish erythematous nodule accompanied by blackish brown crusted erosion in the central area, 1 cm in diameter, and solitary. Dermoscopic examination shows a central blue-grey pigmented area, a whitish halo, and erosion. The differential diagnosis of this case is keratoacanthoma, eccrine poroma, dermal duct tumor, and PH. Histopathological findings showed solid and cystic components, as well as poroid and cuticular cells in the dermis area. The final diagnosis in this case is PH.Conclusion: This report shows the challenge of PH diagnosis that requires an in-depth understanding of the clinical manifestation, dermoscopic, and histopathologic features.
Factors Associated with Mortality of B-cell Non-Hodgkin Lymphoma Patients at Tertiary Care Hospital in Bali, Indonesia Agustini, Made Priska Arya; Pratiwi, Made Sindy Astri; Yani, Made Violin Weda; Rena, Made Renny Anggreni
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1359

Abstract

Background: Non-Hodgkin Lymphoma (NHL) incidence has increased rapidly in recent decades. Although new treatment methods have been found, the mortality rate of NHL, especially in developing countries, is still high. Several factors can affect the mortality rate of NHL. However, data on factors related to the mortality rate of NHL patients in Bali are still not available. Therefore, this study aims to determine the survival rate and prognostic factors of mortality in NHL patients, especially those with the B-cell type, in Bali.Method: This study is a retrospective cohort study at Prof. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia. The data was collected from electronic medical records from January 2020 to December 2023. The inclusion criteria for this study were all adult patients (aged ≥ 18 years) with a first-time diagnosis of B-cell NHL. Exclusion criteria included patients with other types of cancer, not undergoing chemotherapy, and incomplete medical records. Survival analysis and factors associated with mortality were analyzed using Kaplan-Meier curves, log-rank test, and Cox proportional hazards regression.Results: There were 143 B-cell NHL patients who met the inclusion criteria. The 1-year overall survival rate in this study was 59.4%, with a median survival time of 9 months. The majority of the causes of patient mortality were disease progression (76.7%). An ECOG Performance Status ≥2 (HR = 3.362; 95% CI 1.949 – 5.799; p = 0.000) and high-grade histopathological features (HR = 3.002; 95% CI 1.193 – 7.556; p = 0.020) were significantly associated with poor survival in B-cell NHL patients.Conclusion: The 1-year survival rate of B-cell NHL patients in Bali remains relatively low compared to previous studies. An ECOG performance status ≥ 2 and high-grade histopathological features are prognostic factors for mortality in B-cell NHL patients in Bali.
Paraaortic Lymph Node Involvement among Indonesian Women with Cervical Cancer Pradana, Wisniardhy Suarnata; Aslam, Achmad Bayhaqi Nasir; Nugroho, Rafiq Sulistyo; Setijowati, Nanik; Siswidiyati, Siswidiyati
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1350

Abstract

Background: Incorporating para-aortic irradiation alongside standard pelvic irradiation has shown potential benefits for treating cervical cancer. However, its efficacy remains debatable due to insufficient information about paraaortic lymph node (PALN) involvement among Indonesian women. This study aims to determine the incidence of PALN and assess potential influencing factors, such as age, characteristics of the cervical mass (size and surrounding tissue involvement), and histopathology.Method: This study was a retrospective analytic observational study with a cross-sectional design, examining PALN involvement and localization in patients’ computed tomography (CT) scans before radiotherapy in 2023. The inclusion criteria are cervical cancer patients who were confirmed through a histopathological examination and underwent an abdominal CT scan before radiotherapy from January to December 2023. The exclusion criteria are cervical cancer patients accompanied by other primary tumors and patients who have undergone hysterectomy. The CT scans were conducted using a 16-slice Canon Aquilion from T12 to the proximal third with a 3 mm slice thickness. Factors influencing the risk of PALN involvement were analyzed using chi-square tests.Results: Eighty-seven eligible patients were analyzed. The median age was 52.26 years, with 72.4% at stage IIIB, 77% diagnosed with squamous cell carcinoma, and 89.7% with a mass size of over 4 cm. Almost all patients exhibited surrounding tissue involvement. 32.2% of patients had paraaortic lymph node involvement, with the majority (70.7%) located in the left para-aortic region and ≤ 5 mm from the aorta. There was no significant relationship between PALN involvement and age, characteristics of the cervical mass, or histopathology type.Conclusion: In a population of locally advanced cervical cancer, almost one-third of patients showed PALN involvement. Implementing PALN radiation in this population could potentially enhance outcomes, irrespective of the patient’s age, characteristics of the cervical mass, or histopathology results.
The Role of Neutrophil-to-Lymphocyte Ratio (NLR) as a Predictor of Lymph Node Metastasis in Papillary Thyroid Carcinoma Patients in Cipto Mangunkusumo Hospital Yulian, Erwin Danil; Andrian, Christopher Rico
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1398

Abstract

Background: Pre-treatment inflammatory parameters based on blood tests can serve as prognostic predictors in cancer, one of which is an elevated neutrophil-to-lymphocyte ratio (NLR). However, the role of NLR as a predictor of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) remains controversial. This study was conducted to evaluate the role of NLR as a predictor of LNM in patients with PTC.Method: This cross-sectional analytical study was conducted at RSUPN Dr. Cipto Mangunkusumo from March to September 2024. The research utilized secondary data from the medical records of PTC patients. The receiver operating characteristic (ROC) curve was employed to determine the NLR cut-off value. Bivariate analysis was performed using the Chi-Square test, and multivariate analysis was conducted using multiple logistic regression. A p-value of 0.05 was considered statistically significant.Results: A total of 75 subjects were included in the study. ROC analysis showed an area under the curve (AUC) of 0.656. An NLR cut-off value of 2.34 yielded significant results (p = 0.03; OR = 3.15; 95% CI: 1.22–8.14) with sensitivity and specificity of 64%. Tumor size (p = 0.019), extrathyroidal extension (p 0.001), and papillary thyroid carcinoma variants (p = 0.002) were significantly associated with LNM. Patients with tumor sizes 4 cm had a lower risk of LNM (OR 0.28; 95% CI: 0.11–0.75). After adjusting for confounding variables, multivariate analysis revealed that subjects with high NLR had a 6.17-fold increased risk of LNM (aOR = 6.17; 95% CI: 1.68–22.64). Conclusion: Preoperative NLR in PTC patients is significantly associated with LNM. Tumor size, extrathyroidal extension, and aggressive variants of papillary thyroid carcinoma are significantly associated with LNM and influence the relationship between NLR and LNM.
Dosimetry Audit of IMRT and VMAT External Radiotherapy Techniques: Multi-Institutional Study in East Java Province Maqsuroh, Fiki Hurum; Zahro, Ummu Mar’atu; Dzulfikar, Ahmad Zaki; Harfiyyah, Vivin Fashihatil; Hentihu, Fatimah Kunti; Pawiro, Supriyanto Ardjo
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1258

Abstract

Background: The Multi-Leaf Collimator (MLC) application is utilized in the Linear Accelerator (LINAC) with Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) methods, both of which include advanced methods of administering radiotherapy, which aim to improve dose distribution and increase local tumour control by adjusting the external beam into a shape-specific tumour. Dosimetry audit is a crucial quality assurance procedure in radiotherapy facilities, ensuring patient dosing quality. This study aimed to simulate the dosimetry audit method of IMRT techniques and VMAT with point dose and dose delivery distribution evaluation. Method: The phantom utilized in this study was constructed from acrylic material and featured a C-shaped insert. It comprised a main body and an insert, with the body measuring 15 × 15 × 15 cm and the insert measuring 6 × 6 × 6 cm. The main body was fabricated from polymethyl methacrylate (PMMA) with a density of 1.17 g/cm³, serving as a surrogate for human tissue. The insert, composed of a resin and carbon powder mixture with a density of 1.19 g/cm³, was designed to represent both the organ at risk (OAR) and the planning target volume (PTV) in the study. Phantom images were taken with the center of the CT simulator, then radiation planning was performed with a PTV dose of 4 Gy/2 fractions (D95% 95%, D2% 107%, and Dmax 110%) and a maximum OAR dose of 2.8 Gy. This study was conducted at four radiotherapy centres in East Java province by conducting dosimetry audits on point doses using TLD and dose distribution by evaluating gamma index analysis using EBT3 Film.Results: The results of point dose readings using TLD at all centres and radiation techniques were still within the tolerance limit, namely ± 5%. Apart from that, to evaluate the gamma index using film, at three centres with the 3%/3mm criteria, the gamma passing rate was 90%. Conclusion: This method can be used as a reference in conducting dosimetry audits in radiotherapy using TLD and film

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