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Bayu Brahma
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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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Deciphering The Links Between Non-Alcoholic Fatty Liver and Hepatocellular Carcinoma Prognosis: A Weighted Gene Co-Expression Network Analysis Approach Abady, Mariam Mahmoud; Magdy, Amal
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1220

Abstract

Background: Metabolic Associated Fatty Liver Disease (MAFLD) is a common liver disease associated with an increased risk of developing hepatocellular carcinoma (HCC). Current treatments for MAFLD-related HCC are limited, highlighting the need for new biomarkers and therapeutic targets to improve patient outcomes. This study employed Weighted Gene Coexpression Network Analysis (WGCNA) to uncover novel gene associations and interactions in MAFLD and HCC, providing new insights into their molecular mechanisms.Method: A dataset comprising liver biopsy tissues was obtained from 106 HCC-naive MAFLD patients (164 biopsy tissues, including 1st biopsy for all patients and 2nd follow-up biopsy for 58 PLS (Prognostic Liver Signature)-MAFLD high-risk patients). Transcriptomic data from liver tissue samples were subjected to WGCNA, facilitating the identification of gene modules associated with risk stratification.Results: Analysis of 12544 genes from the GSE193066 dataset revealed 17 distinct gene coexpression modules. Notably, the black, blue, and cyan modules exhibited strong correlations with MAFLD-related HCC. Functional enrichment analysis provided significant insights into key biological processes and pathways, including epithelial-mesenchymal transition, inflammatory response, angiogenesis, and signaling pathways such as KRAS, wnt-β-catenin, and p53 pathway. Conclusion: This study utilizes WGCNA to identify crucial genes and pathways involved in MAFLDrelated HCC. The results provide a basis for future research and call for validation in larger patient cohorts. Overcoming these limitations and exploring the clinical significance of the identified genes and pathways can enhance diagnostics and enable targeted therapies for MAFLD-related HCC.
Presacral Schwannoma Resembling Lymph Node Metastasis in a Patient with Locally Advanced Prostate Cancer Hama, Yukihiro; Tate, Etsuko
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1096

Abstract

Introduction: SSchwannomas originating in the pelvic region are rare and present diagnostic challenges when they coexist with malignancies. Case Presentation: A 58-year-old man with urinary frequency and an elevated prostate-specific antigen level underwent preoperative imaging. T2-weighted magnetic resonance imaging (MRI) of the prostate identified an irregular hypointense lesion with extracapsular invasion, as well as a presacral nodule resembling lymph node metastasis. The presacral nodule exhibited an intermediate signal intensity on the apparent diffusion coefficient map that was derived from diffusion-weighted images. Dynamic contrast-enhanced MRI revealed persistent enhancement in the presacral node, while the prostate tumor exhibited strong early enhancement followed by washout. Pathological and laparoscopic findings confirmed the coexistence of locally advanced prostate cancer and pelvic schwannoma. Conclusions: MRI is useful not only in detecting prostate cancer but also in differentiating lymph node metastases from schwannoma.
Epidural Analgesia for Palliative Pain Management for A Patient with An Advanced Stage Prostate Cancer: A Case Report Susilo, Astrid Pratidina; Pryambodho, Pryambodho
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1187

Abstract

Introduction: Patients with advanced-stage cancer should be able to stay at home with their families without suffering from pain. This case report aims to discuss challenges in pain management of a patient with bone metastasis of prostate cancer who received epidural analgesia at home. Challenges were related to the patients, health professionals, and system. Understanding each factor will bring insights to develop a workable pain management program in the palliative setting. Case Presentation: A 66-year-old male was diagnosed with left sacroiliac joint pain due to metastatic prostate cancer. After a three-year history of prostate cancer and ineffective chemotherapy, the patient complained of pain in the left hip that did not improve with conventional medications (paracetamol, tramadol, and Morphine Sustained Release/MST). In response, the consideration of an epidural implant emerged as a potential solution, offering the prospect of home-based care and autonomous medication administration through an epidural continuous block with intermittent drug injection. Conclusions: This case highlights home-based interventional pain management for cancer, addressing challenges at the patient, health professional, and system level. Overcoming these challenges requires a multidisciplinary approach and robust institutional policies. The insights gained offer valuable lessons for hospitals aiming to enhance the competence of pain and palliative care teams and establish comprehensive support systems in hospital and home settings.
A Metastase Clear Cell Papillary Renal Cell Carcinoma (ccpRCC): A Case Report Octavian, Aditya Eka; Rahmadianto, Hajid; Nawangtantrini, Gita
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1217

Abstract

Introduction: Clear cell papillary renal cell carcinoma (ccpRCC) was recently identified, which acts like a benign tumor entity introduced by WHO in 2016. It shares morphologic features in both clear cells and papillary cells. It is characterized by its unique immunohistochemical, morphologic, and genetic features and indolent behavior with no reported recurrence or metastasis before. This paper presents a case of ccpRCC in adulthood with spinal metastasis.Case Presentation: A 16-year-old female patient presented to the urology polyclinic of Prof. Dr. Margono Soekarjo Hospital with an abdominal lump and hematuria. Subsequently, the patient underwent radical nephrectomy. Histopathological examination confirmed ccpRCC. After six months, the patient exhibited weakness in the lower extremities, sensory disturbances, and urinary retention. She was referred to the Neurology department, where physical examinations revealed paraplegia inferior and segmental hypoesthesia at the vertebrae T12 level. MRI examination showed signs of vertebral metastases. After receiving immediate treatment from the neurology department, the neurosurgery department scheduled the patient for a surgical procedure. The case was followed for eight months. Conclusions: ccpRCC is a benign kidney tumor exhibiting a combination of clear cell and papillary cell carcinoma characteristics. While patients with ccpRCC are typically asymptomatic, cases are presenting with symptoms such as hematuria. This case demonstrates the occurrence of hematogenic metastases in ccpRCC, highlighting the need for surgical intervention to preserve existing functionality
The Good Quality of Life of Breast Carcinoma with Aggressive Metastasis to Multilevel Vertebrae: A Case Report Mannagalli, Yusuf; Kirana, Ignatia Rosalia; Niatazya, Arindita; Utami, Lusyhandri Wiga; Pratiwi, Dwirani Rosmala
Indonesian Journal of Cancer Vol 18, No 2 (2024): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i2.1148

Abstract

Introduction: Bone is one of the most common metastase sites in breast cancer after lung and liver. Spinal involvement is regarded as an aggressive form of bone metastases due to the risk of neurological dysfunction and paralysis resulting in pain and disability. Therefore, the presence of spinal metastases in breast cancer usually worsens the quality of life (QoL) of patients. This is a persisting challenge in palliative care which aims to improve QoL and provide pain relief. In this case, we reported a 56-year-old female with end-stage breast cancer and extensive spinal involvement who had good QoL based on subjective and objective assessment. Case Presentation: A 56-year-old patient complained of pain in the left breast and back. Physical, imaging, and histopathology examination concluded that the patient suffered from stage IV breast cancer spreading to cervical and lumbal vertebrae, however, the patient reported minimal disturbances in daily activity despite the pain. Objective assessment of quality of life was done using EORTC QLQ-C30, QLQ-BM22, and QLQ-BR23, which revealed a high level of global health status exceeding average breast cancer patients. The high QoL observed in our patient could be attributed to effective symptom management, strong social support, and resilience in coping with the challenges of breast cancer. Conclusions: Continuous psychosocial support, effective symptom management, and strengthening individual resilience have the potential to improve the quality of life in breast cancer patients with spinal metastases.
Headache Characteristic in Brain Tumor Patients Sembiring, Saulina; Sofyan, Henry Riyanto; Madjid, Irma Savitri; Alvonsius Silalahi, Raymond Aris Nimrod; Albertin, Elizabeth; Aninditha, Tiara
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1197

Abstract

Background: Headache is an alarm for structural abnormalities, and it frequently manifests as an initial symptom of brain tumors, with an occurrence rate ranging between 36-80%, depending on the type and location of the tumorMethods: We conducted a retrospective cross-sectional study to observe hospitalized brain tumor patients at Dr. Cipto Mangunkusumo Hospital from January 2022 to March 2023. This study described the prevalence and the percentages of baseline characteristics.Results: Our study revealed that out of 101 brain tumor patients, predominated by females (60.4%) with a mean age of 46.2 years. Secondary brain tumors originating from breast cancer were more prevalent (13.9%). Frontal lobe location was frequent (32.3%), displaying rapid growth (66.3%), focal deficits (82.2%), and headaches (79.2%). Atypical headache was the most common phenotype (40%), often occurring either before the onset of neurological deficits (prechronous) or concurrently with them (synchronous). Discussion: The study revealed that high-grade, rapidly growing brain tumors tend to induce focal neurological deficits and headaches due to the tumor’s progressivity and mass effect. Brain tumor lesions were primarily found in the frontal lobe of the supratentorial region, displaying a mainly atypical headache phenotype. The absence of pain receptors in the parenchyma suggested that pain resulted from mechanical stimulation of other pain-sensitive structures.Conclusion: Atypical headaches occurring within 30 days before neurological deficits could indicate potential malignancy.
The Correlation of Neutrophil-Lymphocyte Ratio (NLR) and the Response Evaluation Criteria in Solid Tumors (RECIST) in Non-small Cell Lung Cancer (NSCLC) Patient Andayani, Novita; Arliny, Yunita
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1178

Abstract

Background: The biological marker Neutrophil-Lymphocyte Ratio (NLR) is still being studied for its effectiveness as a predictor of prognosis and treatment response to cancer. This study aims to assess the effectiveness of the NLR as a prognostic biomarker in Non-small Cell Lung Cancer (NSCLC) patients. Methods: This observational study with a cross-sectional design intends to determine the effect of NLR on the response to the treatment of the patients as measured by Response Evaluation Criteria in Solid Tumors (RECIST). The samples collected were advanced-stage NSCLC patients who underwent chemotherapy from January 2021 to December 2022 to assess the prognosis and its relationship with NLR. The area Under the Curve Receiver Operating Characteristic (AUC ROC) curve was used to see the sensitivity, specificity, and cut-off point. Results: Sixty-seven samples met the criteria of the samples’ study. The best NLR cut-off point was 4.335 with a sensitivity of 86.7% and a specificity of 55.5%. The AUC value was 0.701 with a significance of 0.019. NLR values above the cut-off point were more frequently found in patients with progressive disease (29 samples; 43.3%). Conclusions: This study showed that there was a relationship between NLR and RECIST in NSCLC patients. NLR was quite effective as a prognostic biomarker of NSCLC patients who underwent chemotherapy.
Diagnostic Accuracy of CA-125 Levels for Ovarian Tumor Patients with Suspected Malignancy Pangaribuan, Machyuddin Tumpak Marojahan; Razali, Renardy Reza; Darmawi, Darmawi
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1159

Abstract

Background: Ovarian cancer is a deadly gynecological cancer that appears in ovarian tissue. To detect earlier stages of ovarian cancer and prevent unnecessary surgery, an examination and screening strategy with higher sensitivity and specificity levels are needed. The CA-125 examination is available at Arifin Achmad Hospital and has often been performed on ovarian tumor patients with suspected malignancy. Currently, the accuracy of the CA-125 examination still raises debate in diagnosing malignant ovarian tumors. This study aims to determine the diagnostic accuracy of CA-125 levels in diagnosing ovarian cancer in ovarian tumor patients with suspected malignancy at Arifin Achmad Hospital. Method: This research is an analytical diagnostic test study with a cross-sectional approach, using secondary data recorded from medical records from 2019 to 2022 on ovarian tumor patients with suspected malignancy at Arifin Achmad Regional Hospital.Results: The diagnostic accuracy of CA-125 levels in ovarian cancer is 94.5%, the optimal cut-off value is 36.5 IU/ml, the sensitivity is 86.1%, the specificity is 90.1%, the positive predictive value is 89.4%, the negative predictive value 86.9%. The results of the study showed that there was a significant age difference between benign ovarian tumors and ovarian cancer. The most common histopathological feature of benign ovarian tumors is serous cystadenoma. The most common histopathological feature of malignant ovarian tumors is serous adenocarcinoma. There is a significant relationship between CA-125 levels and ovarian tumors.Conclusion: The identification of CA-125 levels in diagnosing ovarian cancer in ovarian tumor patients with suspected malignancy was a promising test with high diagnostic accuracy level
Sinonasal Schwannoma and Progressive Nasal Obstruction Fakhriani, Rizka; Herdini, Camelia; Yudistira, Danu
Indonesian Journal of Cancer Vol 18, No 2 (2024): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i2.1092

Abstract

Introduction: Schwannomas, are non-malignant tumors with well-defined encapsulation and gradual growth patterns. These tumors consist of Schwann cells, which originate from the neural crest. The prevalence of schwannoma cases in the head and neck region ranges from approximately 25% to 45%. However, in the sinus cavity, the occurrence is only 4%. Case Presentation: In this study, we provide a clinical case with a 25-year-old female patient with rhinorrhoea symptoms, recurrent epistaxis, and a decreased sense of smell. The patient had a progressive obstruction in the right nasal cavity over one year. A biopsy and computed tomography (CT) scan identified a schwannoma and soft tissue density lesions in the right maxillary ethmoid sinuses and left septal deviation. The confirmation of schwannoma diagnosis is also achieved through histopathological examination. The tumor was surgically excised from the patient's body utilizing lateral rhinotomy and an extirpation technique under general anesthesia. The patient had positive outcomes during the follow-up; the patient revealed the absence of symptoms and no evidence of disease recurrence. Conclusions: Lateral rhinotomy with extirpation methods represents an effective option for managing sinonasal schwannoma due to its ability to access challenging anatomical regions and facilitate the sensitive excision of tumors. 
Resilience in Healthcare: A Hospital-based Investigation of Breast Cancer Diagnostics Amid the Pandemic in Indonesia Choridah, Lina; Anwar, Sumadi Lukman; Heriyanto, Didik Setyo; Handoko, Alberta Vania; Sumoro, William; Icanervilia, Ajeng Viska; Rengganis, Anggraeni Ayu
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1166

Abstract

Background: Widespread disruptions in healthcare services have occurred due to ongoing challenges during the pandemic. The tremendous impacts have struck countries with limited resources, greater distances of geographical access to healthcare services, and a shortage of healthcare personnel. Long delay of diagnosis and disruption in patient care affects the long-term prognosis of breast cancer. This study was conducted to investigate the effects of the COVID-19 pandemic and government-mandated social restrictions on the provision of diagnostic services for breast cancer patients in a tertiary referral hospital. The study aimed to explore how travel restrictions and patients' apprehension about COVID-19 exposure have contributed to notable declines in diagnostic and treatment procedures for breast cancer within this healthcare setting. Methods: This study was retrospective design and used a hospital registry to collect information on demographics, imaging, and pathology from January 2018 to September 2021.  Breast ultrasound  (US) and mammography data were collected from the Picture Archiving and Communication System (PACS), while pathology data were collected from e-medical records. The descriptive statistics of the annual total volume of imaging and pathological examinations were interpreted and statistics were only calculated for diagnostics mammography. Results: Between 2018 and 2021, the volume of monthly breast sonograms drastically decreased by 65% in 2020 and 2021 during the pandemic, while mammography significantly reduced by more than 40% from the 2019 levels. Breast US and mammography procedures were significantly lower during the first and second waves of the pandemic in March until May 2020 and June until September 2021, respectively. Although the proportion of breast ultrasound-guided fine-needle aspiration biopsy (FNAB) increased year by year, the number of FNAB for primary breast lesions significantly decreased by 84% in 2020 and 2021. Conclusions: We observed significant decreases in diagnostic procedures for breast cancer. Reconfiguration of breast cancer care scheduling is required to accommodate the potential for increased hospital visits after the travel restrictions.

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