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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 611 Documents
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The Effect of Hyperbaric Oxygen Therapy on Neutrophil to Lymphocyte Ratio (NLR) in Wistar Strain Female White Rats (Rattus norvegicus) Induced by 7,12-dimethylbenz[a]anthracene (DMBA) Mangkuluhur, Ande; Sudiarta, Ketut Edy; Nefertiti, Eva Pravitasari
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1406

Abstract

Background: Tumors are caused by uncontrolled cell growth, and the immune system plays a crucial role in this process. Neutrophils and lymphocytes are key immune cells involved in tumor behavior. Adenosine and its A2 receptor can activate neutrophils to promote inflammation that may lead to tumor growth. In contrast, lymphocyte especially cytotoxic T cells, can attack and kill tumor cells, helping to reduce tumor growth and inflammation. This study explores how hyperbaric oxygen therapy (HBOT) can influence the neutrophil-to-lymphocyte ratio (NLR) in female Wistar rats exposed to a known carcinogen, 7,12- dimethylbenz[a]anthracene (DMBA).Method: The research followed a post-test-only control group design. Two control groups were established: one that received a normal diet and the other that was treated with DMBA at a dosage of 20 mg/kgBW for four weeks. The treatment group received both the carcinogen and HBOT at 1.7 Atmospheric Absolute for 30 minutes, three times daily for five days. Blood samples were taken, and the NLR was measured using IBM SPSS software version 26. Result: Results showed significant differences in NLR among the groups. The negative control group had a mean NLR of 1.3444, the positive control group had 3.7889, and the treatment group had 1.6889. A statistically significant difference in these mean NLR values (p = 0.000) was observed among Female Wistar Rats subjected to the effects of the carcinogen DMBA combined with HBOT. Conclusion: The study concluded that HBOT significantly reduced NLR values in these rats exposed to the carcinogen. These findings highlight the potential of HBOT as a supportive therapeutic intervention in modulating the tumor-associated immune environment.
Global Research Trends on Ablation for Hepatocellular Carcinoma: Insights from A Comprehensive Bibliometric Analysis and Visualization Athoillah, Nabil; Hibatullah, Muhammad Naufal; Buaji, Brilliantara; Rayyan, Muhammad Isra; Febriakhano, Aji
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1443

Abstract

Background: Ablation has been intensively studied as an effective and minimally invasive management for hepatocellular carcinoma (HCC). Plenty of publications have been written in the last century about ablation in HCC, but no bibliometric analysis has comprehensively analyzed the topic of ablation in HCC. This study aimed to explore the recent development of HCC ablation using bibliometric analysis. Methods: Publication data were comprehensively retrieved from the Scopus database using total sampling technique from the first publication to August 3, 2024. Then, the data were analyzed and visualized using VOSviewer and RStudio software to reveal publications per year, most frequently occurring keywords, most productive authors and countries, article citations, and international collaborations.Results: Thirteen thousand, nine hundred fifty-five publications were extracted from the Scopus database between 1950 and 2024. The research trend on ablation and HCC has increased massively, especially since 1999. China and the World Journal of Hepatology were identified as the most productive countries and journals in this field. In addition, Kudo Masatoshi has 187 articles and is the most influential researcher in this field. The bibliometric data illustrated that the most frequently reviewed ablation modality was radiofrequency ablation, followed by microwave ablation, percutaneous ethanol injection, and high-intensity focused ultrasound. In addition, the bibliometric analysis showed that recent ablation research trends favored microwave ablation and high-intensity focused ultrasound as ablation techniques, using efficacy and safety parameters as primary outcomes. Meta-analysis is a research method related to ablation that has primarily been conducted recently. Ablation modalities are also frequently studied simultaneously with immunotherapy, systemic, and locoregional modalities.Conclusions: Current research on HCC ablation continues to increase, with study trends shifting from percutaneous ethanol injection and radiofrequency ablation to microwave ablation and high-intensity focused ultrasound. Meta-analysis and efficacy-safety are essential research methods and outcomes to review.
Transarterial Embolization as a First-Line Treatment for Ruptured Renal Angiomyolipoma: A Case Report Wicaksono, Krishna Pandu
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1534

Abstract

Introduction: Angiomyolipoma (AML) is a benign renal tumor that can be accompanied by potentially life-threatening spontaneous retroperitoneal hemorrhage when it becomes large. Prompt management is crucial. Treatment options for ruptured renal AML include surgical intervention and embolization, with transarterial embolization (TAE) increasingly recognized for its renal-sparing advantage and reduced invasiveness. We describe a case effectively managed with emergency TAE, highlighting its safety and efficacy.Case Presentation: A 57-year-old male was admitted for evaluation of hematuria, right flank pain, abdominal distension, and dyspnea. His condition was complicated by severe anemia and declining renal function, with eGFR of 28.1 mL/min/1.73 m². CT-scan angiography demonstrated a large retroperitoneal hematoma and a pseudoaneurysm, 3.5 × 4.0 × 6.0 cm, at the upper pole of the right kidney, arising from an interlobar artery. Multiple bilateral angiomyolipomas were also shown. An emergency transarterial embolization was performed using polyvinyl alcohol (PVA) particles to devascularize hypervascular lesions and detachable coils to occlude the pseudoaneurysm. Further embolization was also performed in the mid-segment, resulting in the complete resolution of lesions while maintaining the functional renal parenchyma. Clinical improvement was evident during a two-day follow-up, as indicated by an increase in hemoglobin levels, resolution of hematuria, and relief of abdominal symptoms.Conclusion: This case supports the role of TAE as an effective and organ-preserving treatment for ruptured renal AML.
Correlation of Overexpression of PDL-1 With Lymph Node Metastasis in Penile Carcinoma Witari, Ni Putu Diah; Analysa, Analysa; Lestari, Putu Oki
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1360

Abstract

Background: Penile cancer cases are rarely found, but in the Bali area, the case is higher than in other regions in Indonesia. The death rate of penile cancer is still high, and 80% of cancer deaths are related to metastasis. As immunotherapy in cancer develops, PDL-1 is becoming one of the targets for immune therapies that promise to replace conventional therapies or serve as adjunct therapies. This study aims to see the correlation between the overexpression of PDL-1 and lymph node metastasis, which is one indicator of the poor prognosis of a cancer.Methods: This study used a case-control study design with a retrospective approach. The sample was 70 primary squamous type penile cancer formalin-fixed paraffin-embedded (FFPE) specimens with complete clinical data from several Anatomic Pathology laboratories in Bali, 2015-2023. FFPE sections that were damaged and did not have complete data were excluded. The case is 35 with lymph node metastasis, and 35 without lymph node metastasis as a control. In this study, the correlation between PDL-1 overexpression and tumor grading and lymph node metastasis in penile carcinoma will be explored. Data analysis with Chi-square using SPSS. The p-value for the significance test was less than 0.05. The accuracy of the data is determined by a 95% confidence interval (CI). The research was conducted from February 2024 to August 2024 Results: This study showed a significant correlation between PDL-1 overexpression and lymph node metastasis, p 0.05. There was a significant correlation of PDL-1 overexpression with lymph node metastasis (p = 0.001). There was a correlation between overexpression of PDL-1 and tumor size (p = 0.035), tumor grading (p = 0.027), and lymphatic invasion (p = 0.038). There was no correlation between PDL-1 overexpression with age (P = 0.424)Conclusions: This study demonstrates a significant correlation between PDL-1 overexpression and lymph node metastasis in penile carcinoma patients. Furthermore, PDL-1 overexpression is significantly associated with larger tumor size, higher tumor grade, and lymphatic invasion. These results suggest that PDL-1 serves as a critical prognostic biomarker for predicting disease aggressiveness and metastatic potential.
The Potential of Lasofoxifene as a New Hormone Therapy Targeting ESR1 Mutations in ER+ Breast Cancer Patients: A Narrative Review Abidin Shahab, Ali Zainal; Darmayanti, Salma
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1423

Abstract

Breast cancer remains the most prevalent malignancy among women and a leading cause of cancer-related mortality worldwide. Estrogen receptor-positive (ER+) breast cancer accounts for the majority of breast cancer cases, with hormonal therapy being the primary treatment approach. However, resistance to conventional endocrine therapy, particularly due to mutations in the estrogen receptor 1 (ESR1) gene, poses a significant challenge. ESR1 mutations, especially in the ligand-binding domain, lead to ligand-independent activation of the receptor, rendering standard therapies ineffective. Lasofoxifene, a selective estrogen receptor modulator (SERM), has emerged as a promising alternative for ER+ breast cancer patients with ESR1 mutations. Preclinical studies have demonstrated its ability to inhibit tumor growth and metastasis more effectively than current endocrine therapies. Moreover, clinical trials, such as ELAINE 1 and ELAINE 2, have shown promising outcomes, particularly in combination with CDK4/6 inhibitors, suggesting improved progression-free survival and clinical benefit rates. Lasofoxifene's unique pharmacological profile allows it to stabilize both wild-type and mutant ESR1 receptors, making it a potential targeted therapy for hormone-resistant breast cancer. Despite its potential, several challenges remain, including the risk of drug resistance and the need for further clinical validation. Future research should focus on optimizing combination therapies, understanding resistance mechanisms, and identifying predictive biomarkers to personalize treatment strategies. Lasofoxifene represents a novel therapeutic avenue in the management of ER+ breast cancer, offering hope for patients with limited treatment options due to endocrine therapy resistance.
Artificial Intelligence (AI)-Powered Chest X-Ray Enables Early-Stage Lung Cancer Diagnosis in a Patient Presenting with Acute Coronary Syndrome: Role for AI in Incidental Screening Wulandari, Laksmi; Hayati, Fierly; Shivabasappa, Santhosh
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1502

Abstract

Introduction: Lung cancer is the most common cause of cancer-related death worldwide. Screening with low-dose computed tomography (LDCT) of the thorax is recommended for high-risk individuals. However, its utilization is limited in many developing countries because of cost and accessibility. Chest X-ray is a commonly used imaging test for the initial evaluation of patients with chest pain. But nodules are frequently missed, and recent advances in artificial intelligence software have shown potential in identifying subtle nodules. There are limited reports on the real-world impact of AI chest X-ray on lung cancer detection.Case Presentation: A 53-year-old male who presented with chest pain and shortness of breath to the cardiology clinic. The patient was diagnosed with non-ST elevation acute coronary syndrome (NSTEACS) and managed appropriately. Artificial intelligence (AI)-enabled chest X-ray identified a high-risk nodule in the right lower zone that was suspicious for malignancy. Subsequent contrast chest computerized tomography scan revealed an enhancing solid lesion with a spiculated margin in the right lower lobe, and the biopsy result confirmed lung adenocarcinoma (stage IB). The patient underwent right inferior lobectomy and is doing well.Conclusions: This case report highlights the potential of AI chest X-ray for the incidental detection of suspicious nodules in patients presenting with non-pulmonary symptoms. In settings with no established lung cancer screening programs, integration of AI in the routine chest X-ray workflow can help detect high-risk pulmonary nodules and facilitate early diagnosis of lung cancer.
Phenotypic Plasticity and Functional Shift in Cisplatin-Resistant Cervical Cancer Cell Line Kristiani, Lidya; Ivana, Kathy; Gabriela, Vania; Rattu, Shereen Angelina; Tanoto, Joselyn Phoebe Wylma; Dearyza, Sonya; Angelica, Rosemarie; Wirabuana, Shareena; Dreesa, Amelia; Tehubijuluw, Marcella Diviani; Crystalia, Audrey Amira
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1415

Abstract

Background: Cervical cancer remains the deadliest cancer among women. Furthermore, the development of resistance toward cisplatin, the golden standard treatment, has posed a significant challenge, threatening therapeutic efficacy and contributing to tumor recurrence. While enhanced DNA repair and drug inactivation have been implicated in resistance, their impact on cervical cancer remains poorly understood. This study aims to generate cisplatin-resistant cervical cancer cell lines to explore potential phenotypic and functional changes.Methods: We generated cisplatin-resistant cells through repeated exposure to increasing cisplatin concentrations up to 8 µM. Morphological changes were analysed using ImageJ software. Using manual hemocytometer counting, we generated a growth curve to assess cell growth, while a migration assay measured wound closure over time. Mitochondrial activity was evaluated using the MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay, and gene expression of p53, Bax, and β-actin was quantified via qPCR. Statistical analysis, including two-tailed Student’s t-tests, was performed to compare wild-type and treated groups, with significance at p 0.005. Graphs and data visualization were performed using Microsoft Excel and GraphPad Prism 10.2.3.Results: Cisplatin-resistant (CPR) HeLa cells exhibited concentration-dependent morphological changes, including multinucleated "giant cells" and neuron-like "transition cells" with extended arms, suggesting adaptive responses to cisplatin-induced stress. Cell size increased with higher cisplatin concentrations, potentially enhancing survival, while proliferation decreased, indicating an energy trade-off for resistance mechanisms. Mitochondrial activity declined in CPR cells, likely due to mitochondrial DNA damage, leading to reduced ATP production and oxidative stress. Gene expression analysis revealed decreased Bax levels, associated with reduced apoptosis. Despite these changes, migration capacity remained unchanged.Conclusions: The results reveal that cisplatin-resistant (CPR) HeLa cells develop distinct changes in characteristics, including morphologies and functional capacity, particularly decreased mitochondrial activity and proliferation in exchange for increased ability to avoid apoptosis. These findings deepen our understanding of cisplatin resistance and emphasize the need for innovative therapeutic strategies, such as targeting the altered characteristics and non-proliferative survival mechanisms of CPR cells.
Exploring the Psychological and Spiritual Aspects of Palliative Care Nurses for Cancer Patients in Dharmais Cancer Hospital Ridlo, Muhamad; Dwi Rahmawati, Agustini Liviana
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1557

Abstract

Background: Cancer was a major non-communicable disease that threatened patients’ lives. Nurses had significant responsibilities and roles in palliative care, which created psychological pressures and challenges in service delivery. This study aimed to explore the psychological and spiritual aspects of palliative care nurses for cancer patients in Dharmais Cancer Hospital.Method: The research design used is descriptive qualitative. The sampling technique used was purposive sampling. Study subjects included 15 nurses who performed palliative care for cancer patients and met the inclusion and exclusion criteria that had been made by researchers. Data was collected through semi-structured interviews with face-to-face interviews. There were 13 open-ended questions with an open nature, and an audio recording was done with an average of 40 to 50 minutes. The recordings that have been obtained are verbatim, and interview transcripts are made for analysis. The analysis used the Miles and Huberman method with a thematic analysis approach.Results: The results of the study obtained three themes, among others: a) response to feelings of providing positive care; b) caring for cancer patients; c) sincerity and always getting closer to God.Conclusion: The psychological studies' findings will be a source of information to provide early detection or psychological interventions for nurses in improving mental health while providing palliative care to cancer patients.
Evaluation of Vimentin-Positive Circulating Tumor Cells in Breast Cancer and Their Association with Pre and Post-chemotherapy Yulian, Erwin Danil; Utami, Sri Anidyo; Wulandari, Dewi; Kekalih, Aria; Idhil, Andi Nurul Isri Indriany
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1479

Abstract

Background: Breast cancer is the most common cancer among women worldwide, leading to 670,000 deaths globally in 2022. Epithelial-mesenchymal transition (EMT) plays a role in the metastasis of breast cancer. The EMT process begins with the invasion of cancer cells into surrounding tissues, intravasation into blood vessels, circulating tumor cells (CTCs), evasion of the immune process, and extravasation to a new location. Epithelial cells undergoing EMT are characterized by an increase in mesenchymal markers such as vimentin, which indicates migration of breast cancer cells. Previous studies have shown that EMT contributes to resistance to chemotherapy. This study aims to evaluate pre and post-chemotherapy of vimentin-positive CTCs in breast cancer patients and the association with chemotherapy. Methods: A prospective cohort study at Dr. Cipto Mangunkusumo General Hospital and Koja Hospital, Jakarta, from March to June 2024. This study obtained vimentin-positive CTCs pre- and post-chemotherapy and clinicopathological factors in 24 breast cancer patients. The inclusion criteria were patients diagnosed with breast cancer with histological subtype invasive carcinoma of no special type, and patients were eligible for chemotherapy and continued to receive first-line chemotherapy. Vimentin-positive CTCs were evaluated by using the FITC immunofluorescence technique with a BD FACSLyric flow cytometer. The association between the vimentin-positive CTCs pre- and post-chemotherapy was analysed by using the Wilcoxon test. The Mann-Whitney test was used to analyse the association between the delta number of vimentin CTCs and clinicopathological factorsResults: Total vimentin CTCs pre- and post-chemotherapy were measured in 24 patients. The delta vimentin-positive CTCs were calculated as the difference between total vimentin-positive CTCs pre-chemotherapy minus total CTCs post-chemotherapy. A significant association was observed between the vimentin-positive CTC levels pre- and post-chemotherapy (p = 0.009). Clinicopathological factor analysis showed no significant association between delta CTCs. Conclusions: The vimentin-positive CTC level in breast cancer patients was significantly reduced post received chemotherapy. Due to the small sample size, this study may have limited statistical power. This study suggests further research on vimentin-positive CTCs as predictor factors for chemotherapy response in breast cancer patients.
Comparison of Outcomes between Laparoscopy and Laparotomy in Colorectal Cancer at Dr. Cipto Mangunkusumo Hospital Jeo, Wifanto Saditya; Noorsukma, Hutomo Rezky
Indonesian Journal of Cancer Vol 20, No 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1516

Abstract

Background: Colorectal cancer (CRC) is one of the most common types of cancer in the world and a leading cause of cancer-related deaths. Laparotomy is the standard curative treatment for localized disease. Laparoscopy offers several advantages, including less postoperative pain, shorter hospital stays, faster recovery, and lower risk of infection. Therefore, we conducted this study to evaluate the outcomes of laparoscopy versus laparotomy in CRC, particularly at Dr. Cipto Mangunkusumo Hospital, Jakarta. Methods: This retrospective study included CRC patients who underwent laparoscopy (56 subjects) and laparotomy (79 subjects) from 2022 to 2024 in Dr. Cipto Mangunkusumo Hospital. Inclusion criteria were: patients aged over 18 years, diagnosed with stage I–III colorectal cancer, and treated with either laparoscopic or open surgical resection. The outcomes were hospital stay, intraoperative blood loss, complications, surgical duration, and surgical fee. Chi-square test was used for categorical variables, and the independent T-test was used for continuous variables.Results: A total of 135 CRC patients (54.8% female) with a mean age of 54.74±12.90 years old were recruited in this study. Nearly half of the patients (49.6%) had tumors located in the rectum. We found that laparoscopy was associated with a lower risk of postoperative complications (OR = 0.091; 95%CI 0.011–0.777; p = 0.008) and a lower risk of 2-year mortality (OR = 0.395; 95% CI 0.178–0.878; p = 0.054). We found no significant difference between hospital stay, intraoperative blood loss, surgical duration, and surgical cost in bivariate analysis. Multivariate analysis revealed significant differences in surgery duration (B -0.196; p = 0.025) and surgical fee (B 0.263; p = 0.028), with no significant differences in blood loss, postoperative complications, treatment duration, and 2-year mortality rate.Conclusions: Laparoscopic surgery offers significant lower risk of postoperative complications. Although it was not statistically significant, we also found that laparoscopy had a lower trend of 2-year mortality. These findings support the use of laparoscopy as a safe approach for appropriately selected patients, though further studies are warranted in complex and advanced cases.

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