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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 562 Documents
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Primary Pulmonary Sarcoma Coinfected with Pulmonary Tuberculosis: A Case Report Dea Putri Audina; Sita Laksmi Andarini; Hana Khairina Putri Faisal; Prasenohadi Prasenohadi; Jamal Zaini; Herawati Hidajat
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.991

Abstract

Introduction: Pulmonary tuberculosis (TB) and malignancy are conditions with similar respiratory diseases and they are even known to coexist simultaneously. Therefore, accurate diagnosis of each disease is crucial to ensure precise treatment. This case study showed the coexistence of pulmonary TB and primary pulmonary sarcoma.Case Presentation: A 62-year-old male presented with a 3-month history of dyspnea, which worsened within 3 days. Before hospitalization, there were complaints of left chest pain, fatigue, loss of appetite, weight loss within 5 months, and night sweats. The patient who was a heavy smoker had experienced hemoptysis in the past 5 months. Upon physical examination, an increased respiratory rate and decreased oxygen saturation level. Furthermore, there were asymmetrical thorax movements, dull percussion on the left side, and decreased vesicular breathing sound on the left hemithorax, with no rhonchi or wheezing. A chest x-ray showed a destroyed left lung, while scanning confirmed left lung atelectasis and indicated a suspected mass within or around the left bronchus causing total obstruction in the main left bronchus. The bronchoscopy procedure identified a mass blocking the left main bronchus. However, a biopsy yielded inconclusive results. A rapid molecular test of TB detected Mycobacterium tuberculosis, which was discovered to be Rifampicin sensitive. As a result, the patient was treated daily with 4 fixed drug combinations for anti-TB. Despite the treatment, the complaint was not resolved within the next 3 months, as there was still a disease of cough in the form of mass-like phlegm, which uncovered a malignancy focus cell with differential diagnosis of pleomorphic sarcoma and sarcomatoid carcinoma.Conclusions: Lung malignancy not only overlapped with but also occurred simultaneously alongside lung TB. Therefore, it was crucial to establish a clear diagnosis in patients with chronic respiratory disease.
The Relationship Between Poly-ADP-Ribose Polymerase-1 (PARP-1) Expression with Clinicopathological Characteristics of Nasopharyngeal Carcinoma in Bali, Indonesia Putu Erika Paskarani; Ni Made Mahastuti; Silvia Khosasi; Made Dalika Nareswari
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.979

Abstract

Background: According to epidemiological research conducted in Bali, nasopharyngeal carcinoma (NPC) is the most common cancer among males, accounting for 4.9% of total cases reported between 2017 and 2019. NPC is typically detected at stage IV, indicating the presence of distant metastasis by malignant cells. However, research on the role of Poly-ADP-Ribose Polymerase-1 (PARP-1) in this type of cancer is still limited. Therefore, this research aims to investigate the relationship between PARP-1 and the clinicopathological aspects of NPC.Methods: This research employed an analytical observational design with a cross-sectional approach. From January 2018 to July 2022, biopsy tissue samples were collected from NPC patients, strictly following predefined inclusion and exclusion criteria. The clinical data of these patients were extracted from electronic medical records. Subsequently, the collected samples were subjected to immunohistochemical staining for PARP-1. The interpretation of PARP-1 results was conducted using the H-Score method. Data were analyzed using statistical software, specifically SPSS version 25.Results: The results showed that high PARP-1 expression was detected in 18 samples (62.1%), while the low aspect was observed in 11 samples (37.9%). Independent T-test analysis was conducted for sex, age, and clinical stage. No significant difference was found in the mean PARP-1 H-score among groups based on gender, age, and lymph node enlargement, with p-values of 0.68, 0.71, and 0.74, respectively. However, a statistically significant association was found between PARP-1 expression and clinical stage (p=0.02, 95% CI 1.45 – 63.50). Multivariate analysis showed that sex, age, lymph node enlargement, and clinical stage accounted for 22.1% of the variation in PARP-1 expression, with the clinical stage demonstrating a significant correlation (p=0.02). Conclusions: The clinicopathological data of NPC indicate a male-to-female ratio of 3:1. It was discovered that clinical stages IVA and IVB were the most commonly observed stages. Statistically significant differences were found in the mean and proportion of PARP-1 H-scores across different clinical stages. Future reviews need to include other histological subtypes and employ a prospective research design to evaluate the relationship between PARP-1 and NPC.
Clinical Efficacy and Safety of Microwave Ablation Compared to Radiofrequency Ablation in Hepatocellular Carcinoma Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Rifaldy Nabiel Erisadana; Yehuda Tri Nugroho Supranoto; Heni Fatmawati; Irawan Fajar Kusuma; Adrian Wibisono; Putu Ayu Laksmi Lestari
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.988

Abstract

Background: Ablation modalities for the treatment of hepatocellular carcinoma (HCC) including microwave ablation (MWA) and radiofrequency ablation (RFA) are clinically important due to their numerous advantages. Several trials showed inconsistent results regarding safety and efficacy, making the comparison between MWA and RFA challenging. Therefore, this study aimed to enhance the evidence on treatment modalities regarding the clinical efficacy and safety of MWA compared to RFA in HCC patients. Methods: A systematic review and meta-analysis was conducted following the PRISMA guidelines. Subsequently, a literature search was carried out by PubMed, ScienceDirect, and Google Scholar for randomized controlled trials (RCTs) in HCC patients who passed through MWA compared to RFA. Quantitative analysis of pooled risk ratio with a 95% confidence interval was performed using Review Manager 5.4 software in a random-effects model or fixed-effects model forest plot.Results: Based on 9 RCTs included in the analysis, there were insignificant different results in terms of complete ablation rates (CA) [RR=1.01, 95%CI (0.99 to 1.03), p=0.47] and adverse events (AE) [RR=1.15, 95%CI (0.88 to 1.50), p=0.31]. However, lower incidence of local tumor progression (LTP) [RR=0.73, 95%CI (0.54 to 0.99), p=0.04], intrahepatic de novo lesions (IDL) [RR=0.90, 95%CI (0.81 to 1.00), p=0.05], and extrahepatic metastases (EHM) [RR=0.65, 95%CI (0.44 to 0.95), p=0.03] exhibited significant differences in MWA group.Conclusions: This meta-analysis provided evidence that MWA and RFA had equivalent CA rates and AE in HCC patients. However, MWA was considered superior to RFA due to a lower incidence of LTP, IDL, and EHM.
Factors Related to Physical Activity Behavior Among Breast Cancer Patients in Dr. Sardjito General Hospital Yogyakarta Cicirosnita Jayadi Idu; Haryani Haryani; Uki Noviana
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.989

Abstract

Background: Breast cancer patients are likely to have reduced physical activity behavior after being diagnosed. Factors associated such as sociodemographic and clinical health status have been investigated in some countries, but few studies have been conducted in Indonesia. Therefore, this study aimed to determine the sociodemographic factors and clinical health status associated with changes in physical activity behavior among breast cancer patients.Methods: A cross-sectional design was used and the samples included a total of 250 breast cancer patients at the Integrated Nuclear Medicine and Cancer Installation, Dr. Sardjito Hospital Yogyakarta. The samples were selected using the consecutive sampling method from June to July 2021, while the instruments employed had been previously tested for their validity and reliability. These included a questionnaire on the characteristics of sociodemographic and clinical health status, the Visual Analogue Scale (VAS), the Brief Fatigue Inventory (BFI), and the International Physical Activity Questionnaire Form (IPAQ-SF). This study obtained ethical clearance, while data were analyzed using chi-square and logistic regression multinominal tests with p<0.05.Results: The results showed that cancer stage (stage III: OR=2.71, 95%CI:1.14-6.45), fatigue (severe fatigue: OR=0.49, 95% CI:0.25-0.96), and pain (mild pain: OR= 27.44, 95%CI:3.20-235.18), were significantly associated with physical activity behavior in breast cancer patients. Pain as the most dominant factor (mild pain: OR=20.388, p=0.001) caused 5 times increased risk of reduced physical activity compared to others. Conclusions: Based on the results, cancer stage, fatigue, and pain were significantly related to the physical activity behavior of breast cancer patients, with pain being the most dominant factor.
Osimertinib as First-Line Therapy of Patients with Lung Adenocarcinoma EGFR TKI Mutation from Pleural Fluid Samples: A Case Report Harry Akza Putrawan; Arif Santoso; Nur Zam Zam; Irma Fitriani; Zainul Muttaqin
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.993

Abstract

Introduction: Lung cancer is still a major contributor to cancer mortality worldwide. More than 80–85% of cases are constituted by Non-Small Cell Lung Cancer (NSCLC), consisting of approximately 40% adenocarcinomas. The prevalence of T790M mutation also accounts for 30%–50% of resistance to first- and second-generation tyrosine kinase inhibitors (TKI) after 9-12 months of therapy. To overcome this health condition, osimertinib has emerged as a first-line target therapy for lung adenocarcinoma with Epidermal Growth Factor Receptor (EGFR) mutation. Therefore, this study aimed to determine the effectiveness of osimertinib administration as first-line therapy in adenocarcinoma patients with EGFR TKI mutation. Case Presentation: This study presented a case of 60-year-old woman with shortness of breath and cough accompanied by weight loss ± 10 kg in 3 months. Contrast chest MSCT (multislice computed tomography) scan showed a mass in the right lung accompanied by pleural and pericardial effusion. The results of the cytological examination of pleural fluid found a picture of adenocarcinoma. Furthermore, the diagnosis was continued by molecular examination of pleural fluid, and the results of the EGFR Exon 19 mutation were obtained. Based on the results of physical examination and several laboratory tests, a diagnosis of right pleural effusion and EGFR mutation lung adenocarcinoma was established.Conclusions: In this case, there was a clinical improvement after 8 months of osimertinib administration, along with enhancement in the control CT-SCAN. Osimertinib also showed the potential to extend progression-free survival by approximately 18.9 months compared to other generations of tyrosine kinase inhibitor therapy. This result was supported by the improvement of the clinical and performance status of patients in this case during osimertinib administration.
HGF/C-Met Expression in Epithelial Ovarian Carcinogenesis and Its Potential as Molecular Targeted Therapy Angeline Maranata; Tantri Hellyanti; Ria Kodariah
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.1047

Abstract

Background: The Mesenchymal-Epithelial Transition factor (C-Met) is a tyrosine kinase receptor (TKR) that binds to a ligand called Hepatocyte Growth Factor (HGF). Recent studies conducted on patients with epithelial ovarian cancer (EOC) reported that high expression of C-Met was associated with poorer clinicopathological grading and outcomes. Therefore, this study aimed to further explore the downstream pathway specifically activated when the HGF/C-Met complex was formed, the interplay between C-Met and other molecules, as well as the impact on EOC when these interactions were inhibited through designated molecular targeted therapy.Methods: The search strategy using the PubMed search engine (https://pubmed.ncbi.nlm.nih.gov/) was conducted on September 21, 2022, with the keywords: “HGF/C-Met and ovarian cancer”. The search resulted in 261 articles, and they were filtered by “published in the last five years,” which yielded 67 articles. These articles then underwent further screening, resulting in 40 articles for analysis. A systematic literature review was conducted to improve the quality of this study. Approximately 150 articles were thoroughly examined and organized using a reference manager, then 15 with the greatest impact and clinical relevance to this study were selected. Results: The HGF/C-Met complex was found to stimulate signaling pathways linked to the growth of epithelial cells and also caused the phosphorylation of tyrosine residues on other tyrosine receptors. The activation of C-Met affected the downstream pathways involving molecules associated with cell proliferation and survival, such as epidermal growth factor receptor (EGFR), p53, and KRAS. C-Met can be combined with other tyrosine kinase inhibitors in chemotherapy to enhance the initiation of cell death (apoptosis) in cancer cells.Conclusions: The HGF/C-Met mediated a signaling cascade that played an essential role in the tumorigenesis of ovarian carcinoma and had the potential to be a targeted molecular therapy in EOC
Characteristics of Referral Patients with Gestational Trophoblastic Neoplasia in Dr. Hasan Sadikin General Hospital Bandung Kemala Isnainiasih Mantilidewi; Aditya Rifandi Zaenudin; Ali Budi Harsono; Anita Deborah Anwar; Jessica Kireina
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.990

Abstract

Background: : Gestational trophoblastic disease (GTD) is a heterogeneous group of lesions caused by abnormal trophoblast proliferation and the malignant form is called gestational trophoblastic neoplasia (GTN). Dr. Hasan Sadikin General Hospital, located in Bandung, West Java, is one of the main cancer referral hospitals in Indonesia. Consequently, the characteristics of GTN patients in this hospital can represent the general population in the province. This study aimed to elaborate on the characteristics of referral patients with GTN in Dr. Hasan Sadikin General Hospital.Methods: : Medical records of post-molar GTN patients in Dr. Hasan Sadikin General Hospital from between January 2019 to December 2020 were collected and analyzed. GTN was diagnosed according to the International Federation in Gynecology and Obstetrics (FIGO) criteria. Additionally, both the sociodemographic and clinical characteristics of patients were evaluated.Results:  The results showed that among the 160 participants in this study, the overall mean age was 33±8.7 years, with a mean βhCG level of 241,461.81±630,557.90 mIU/mL. Moreover, approximately 16.3% had gestosis and 5% were diagnosed with hyperthyroidism. The majority of post-molar observations at the hospital were not carried out according to standards, with only 8.1% of patients receiving optimal surveillance. About 56.8% visited the hospital due to vaginal bleeding, while most histopathological results showed complete hydatidiform moles (44.4%), and choriocarcinomas (16.3%). Most of the patients were diagnosed as stage I (81.9%), had lowrisk FIGO scores (80.6%), and were treated with methotrexate (80.6%).Conclusions:  GTN patients in Dr. Hasan Sadikin General Hospital showed clinical characteristics consistent with previous studies. The low percentage of patients receiving optimal post-molar surveillance could cause delayed referral. This suboptimal surveillance might be due to the high cost of βhCG testing, lack of facilities, and low patient compliance in West Java
Three-Year Overall Survival of Advanced Stage ALK-Positive NSCLC at a Single Clinical Setting in Indonesia Sita Andarini; Andintia Aisyah Santoso; Mochammad Aris Arfiansyah; Ginanjar Arum Desianti; Muflih Adil Hanif; Arif Riswahyudi Hanafi; Sutji Mariono
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.1051

Abstract

Background: ALK-positive Non-Small Cell Lung Cancer (NSCLC) is a rare condition predominantly observed in much younger non-smokers with adenocarcinoma histology, often accompanied by brain metastases. Despite its unique features, there is a lack of data concerning the treatment of ALK-positive NSCLC in Indonesia. Therefore, this study represented the first attempt to document the treatment landscape for ALK-positive NSCLC in the country. The available ALK inhibitors included crizotinib, alectinib, brigatinib, and lorlatinib, and none of these were listed under the Indonesian Universal Health Coverage as of September 2022. This study aimed to characterize survival outcomes of ALK-positive NSCLC patients treated within a specialized thoracic oncology practice in Indonesia.Methods: The retrospective observational cohort study drew secondary data from medical records of ALK-positive NSCLC patients treated at a private thoracic oncology clinic. Data were collected retrospectively, spanning from December 2019 to December 31, 2022. Exclusion criteria included incomplete data, untreated ALK-positive NSCLC, cases at stage I-III, or diagnoses made after August 2021. The observation period extended up to 36 months, although several patients exceeded 48 months, with one individual currently boasting a 96-month survival.Results: A total of 15 patients with ALK-positive NSCLC were selected as the respondents in this study. The median age stood at 50.8 years, predominantly female, and diagnosed with adenocarcinoma. Predominant sites of metastasis included pleural effusion and brain metastases, and preliminary 36-month survival rates reached 73.3%. The 1-year survival rate was recorded at 100%, while the 2-year overall survival (OS) stood at 80%, aligning closely with global ALK inhibitors clinical trial data.Conclusions: This study provided the first-ever dataset indicating an ALK-positive profile within a singular thoracic oncology clinic in Indonesia. Despite the accessibility constraints of treatments, ALK-positive patients showed comparable total survival to pivotal clinical trial data. This preliminary dataset shed light on the profile and treatment of ALK-positive NSCLC in the country.
A Randomized Trial of Total Drain Volume in Post-Modified Radical Mastectomy (MRM) Breast Cancer Patient Using Songket Incision Compare to Stewart Incision plus Axillary Anchor at Dr. Mohammad Hoesin Hospital Palembang Meigi Medika; Nur Qodir
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.981

Abstract

Background: Breast cancer is the most common malignancy in women globally. In Indonesia, a total of 65,858 new cases with a 22,530 mortality rate were reported in 2020. To overcome this health condition, surgery serves as the primary treatment, with post-mastectomy complications frequently involving seroma formation, exacerbating post-operative problems. Therefore, this study aimed to assess the total drain volume in post-MRM breast cancer patients using Songket incision compared to Stewart incision plus axillary anchor. This experiment was conducted to determine the optimal surgical option for breast cancer patients.Methods: A two-arm randomized controlled trial was conducted in female patients with breast cancer treated at the Surgical Oncology Division of Mohammad Hoesin Hospital Palembang between April to May 2022. Patients were blindly assigned to one of the two arms, namely the Songket incision and Stewart incision plus an axillary anchor. The eligible sample consisted of patients diagnosed with breast cancer who were slated for Modified Radical Mastectomy (MRM) surgery, willing to participate, and signed informed consent. The primary outcome of this study was total drain volume, while the secondary objective encompassed the length of treatment selected.Results: A total of 26 patients participated in this study (n=13 in each arm). The total drain volume using the Stewart incision was 378.07 ± 219.57, compared to 174.23 ± 97.44 ml for the Songket design (p< 0.001). The mean length of treatment was 4.46 ± 0.77 days in the Stewart incision plus axillary anchor group and 3.23 ± 0.43 days in the Songket incision design (p < 0.001). Conclusions: Songket incision was the best surgical option for breast cancer patients.
The Administration of Probiotics to Prevent Diarrhea in Cervical Cancer Patients Undergoing Radiotherapy: A Literature Review Dewi Wulandari; Tarafainy Basalamah; Diyah Eka Andayani
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.983

Abstract

Background: Cervical cancer is the 4th most prevalent among women worldwide and ranks as the 4th leading cause of cancer-related death. During radiotherapy for this disease, about 80% of patients experience diarrhea or radiation-induced diarrhea (RID) which can significantly compromise quality of life and disrupt the continuity of the therapy when left untreated. Furthermore, it was reported that probiotics exhibit promising efficacy in preventing the incidence of RID, but the conclusive nature of this investigation remains uncertain. This study aimed to determine the effectiveness of probiotics in preventing the incidence of diarrhea in cervical cancer patients receiving radiotherapy.Methods: A comprehensive search was conducted on 4 large databases, namely Pubmed, PMC, Cochrane Library, and EMBASE, adhering to the eligibility criteria. Results: Following the application of the stipulated eligibility criteria, 2 articles were obtained, namely Systematic Reviews/Metaanalysis (SR/MA) and Randomized Control Trial (RCT). The risk ratio of diarrhea incidence in cervical cancer patients who were administered probiotics while receiving radiotherapy was 0.61 (CI 95% 0.46-0.81, p=0.0007). The therapeutic effect was most pronounced when Lactobacillus acidophilus and Bifidobacterial strains, were given 3 times daily. Conclusions: The administration of probiotics proved to be a valuable strategy in preventing the incidence of diarrhea in cervical cancer patients receiving radiotherapy

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