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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 635 Documents
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Diffuse Large B-Cell Lymphoma (DLBCL) of the Mesocolon in A Young Man with Intussusception: A Case Report Laksmi, Lidya Imelda; Muhar, Adi Muradi; Hasibuan, Winda Syahfitri
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.v20i1.1449

Abstract

Introduction: Diffuse Large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL), accounting for 25% to 30% of NHL cases. Diffuse large B-cell lymphoma (DLBCL) commonly happens in the seventh decade and often arises in the lymph nodes but can also present as an extra nodal disease. Nodal DLBCL involves the lymph nodes and does not involve the organ under the lymph nodes. In this case, we want to report a case of 25 men diagnosed with intussusception caused by nodal mesocolon enlargement, and histomorphology examinations revealed that the nodal enlargement is DLBCL. Here we reported a case of 25 years old man diagnosed with invagination caused by nodal mesocolon enlargement and, histomorphology examinations revealed the nodal enlargement is DLBCL.Case Presentation: We reported a case of 25 years old man complaints nausea, vomiting, abdominal pain, and was diagnosed with intussusception. Macroscopic examination showed nodal enlargement without colon mucosal involvement. Microscopic examination showed a relatively uniform and monotonous distribution of lymphoid cells with large cell sizes, enlarged nuclei with a round to oval shape, vesicular chromatin, amphophilic cytoplasm and some foci of tumour cells arranged in loose stroma. Macrophage and atypical mitoses were found. Immunohistochemical examination results were as follows: CD 117 (-), DOG 1 (-), CK (-), CD 45 (+), Myogenin (-), MyoD1 (-), CD20 (-), CD3 (-), Ki67 50%, CD 20 (+), CD3 (-), CD 10 (-), BCL6 (-), MUM1 (+).Conclusion: Diffuse large B-cell lymphoma (DLBCL) can occur in gastrointestinal as extra nodal lymphoma. The mesocolon contains many lymph nodes, but gastrointestinal lymphoma usually involves the gastrointestinal tissue. This case reports a case of 25 years old man who presents with intussusception caused by DLBCL in nodal mesocolon without colon involvement.
Mammary Paget’s Disease in a 46-year-old Woman with Ductal Carcinoma in Situ (DCIS): A Case Report Putu Erika Paskarani; Hendry Irawan; Ni Gusti Ayu Agung Manik Yuniawaty Wetan; Cheryl Nini; Sang Ayu Putu Yuliantini
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1342

Abstract

Background: Mammary Paget’s disease (MPD) accounts for 1—4% of all breast carcinomas. It can affect both men and women with a wide age range, 27 to 88 years old, and 20—30% affect premenopausal woman. Moreover, no specific risk factor has been identified for MPD, and the exact pathogenesis remains uncertain. For these reasons, the MPD clinicopathologically engages in case reports. Case Presentation: A 46-year-old woman with a palpable mass in the left breast for 6 months. The ultrasound examination showed hypervascularity accompanied by nipple abrasions, and the mammography results did not identify malignant calcification or mass formation. Routine histopathology revealed anaplastic cells with round cell morphology, and partially clear, extensive eosinophilic cytoplasm was seen. In addition, immunohistochemical examination showed estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) strongly positive with 60% Ki67 proliferation index. Conclusions: Based on clinical data, radiological, combined with histopathological and immunohistochemical examination, the case supports mammary Paget disease with ductal carcinoma in situ (DCIS). It has an excellent outcome, > 95% survival at 20 years
Implementation of Cancer Patient Navigation in Various Countries: A Scoping Review Muhamad Abi Zakaria; Nandia Andririanti; Muhammad Ariandi Maulana; Nurfitria Anisa Hutami; Mukaromah Mukaromah; Petrus Paris Rumsori; Uki Noviana
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1397

Abstract

Background: The increasing incidence of cancer has led to growing challenges in the provision of cancer patient care. To address these challenges, cancer patient navigation (CPN) has been developed and implemented in various countries with different models and approaches. This scoping review aims to explore the implementation of CPN across developed and developing countries.Methods: A scoping review was conducted using the six-stage framework. The Population Concept—Context (PCC) framework guided the review, with cancer patients or survivors as the population, CPN as the concept, and implementation or practice as the context. Literature searches were performed in seven databases: PubMed, EBSCO, ScienceDirect, Scopus, ProQuest, Sage Journals, and Wiley Online Library. Articles were screened, extracted, and analyzed collaboratively, then grouped into thematic categories.Results: Thirteen studies met the inclusion criteria. Four major themes of CPN implementation were identified: early detection, diagnosis, treatment, and survivorship. Early detection focused on screening and education; diagnostics aimed to reduce delays in cancer diagnosis; treatment addressed financial, psychosocial, and systemic barriers; and survivorship emphasized long-term support, including psychological rehabilitation, symptom management, and supportive care planning.Conclusions: Cancer patient navigation improves care coordination, reduces barriers, and enhances continuity across all stages of cancer care. Despite variations in implementation across countries, navigation consistently supports patient-centered care and addresses gaps within health systems. Standardized roles, integrating navigation into national cancer programs, and evaluating long-term outcomes are essential to optimizing its effectiveness and sustainability
Current Findings in the Resistance Mechanism of Anti-CD19 CAR T-Cell Therapy in B-Cell Malignancies: A Literature Review Michelle Trisya; Putu Radhya Kirana Karmanita
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1399

Abstract

Background: Chimeric Antigen Receptor T-cell (CAR T-cell) therapy targeting CD19 on B-cells has emerged as a promising treatment for B-cell malignancies such as B-Acute Lymphoblastic Leukemia (B-ALL) and Diffuse Large B-cell Lymphoma (DLBCL). Despite its success, resistance mechanisms, including immune checkpoint inhibitors, persistent antigen stimulation, T-cell exhaustion, antigen loss, lineage switch, tumor heterogeneity, impaired death receptor signalling, and the tumor microenvironment, pose significant challenges. Understanding these mechanisms is crucial to advancing CAR T-cell therapy and improving its efficacy.Methods: This literature review was conducted by analyzing peer-reviewed articles and clinical trials focusing on CAR T-cell therapy for B-ALL and DLBCL. Key mechanisms of resistance were identified, and their biological underpinnings were evaluated to highlight trends and potential strategies for overcoming resistance. Sources included PubMed, Science Direct, Google Scholar, and Google database using keywords such as ‘CD19,’ ‘CAR T-cell,’ ‘B-ALL,’ and ‘DLBCL’. Most articles were published within the past five years and were selected from journals with a high impact factor, and some older publications were included for foundational and theoretical insights.Results: The review identifies multiple resistance mechanisms, including persistent antigen stimulation leading to T-cell exhaustion, immune checkpoint inhibitors suppressing effector functions, and tumor intrinsic factors like antigen loss and lineage switch. The role of the tumor microenvironment, with its immunosuppressive components, also contributes significantly to treatment failure. These findings underscore the complexity of resistance pathways and the need for combinatory and innovative approaches to enhance therapeutic outcomes.Conclusions: Resistance to CAR T-cell therapy presents a significant challenge in treating B-cell malignancies. Addressing these mechanisms requires further research into combination therapies, multi-antigen targeting, and tumor microenvironment modulation. These strategies have the potential to optimize CAR T-cell efficacy and improve patient survival rates
Effective Use of Transarterial Chemoembolization (TACE) in an 8-Month-Old Infant with Hepatoblastoma PRETEXT III: A Case Study Teuku Muhammad Yus; Hartono Yudi Sarastika
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1420

Abstract

Introduction: Hepatoblastoma (HB) is a rare primary malignant tumor of the liver in children. Treatment procedures for HB usually involve surgery and even liver transplantation, in addition to neoadjuvant or palliative systemic chemotherapy. However, the recent development of transarterial chemoembolization (TACE) procedures has provided an additional option that is considered quite effective in treating HB. This treatment procedure is believed to have many advantages as a treatment option prior to surgery and/or liver transplantation. This case is interesting to discuss because this procedure is still rarely performed in Indonesia. Whereas in many countries it has shown success and is quite desirable option both as a bridge therapy before surgery and palliative therapy. Case Presentation: We present a case of an 8-month-old baby boy diagnosed with HB. The patient had a history of preterm birth. Hemoglobin (Hb) level was 7 g/dL, and platelet count was elevated. Alpha-fetoprotein (AFP) levels were elevated to 122,010 ng/dL. Ultrasonography showed a large solid mass in the right liver lobe, raising suspicion of malignancy. Contrast enhanced 3-phase computed tomography (CT) scan imaging showed a solid mass in the right lobe of the liver that was contrast-enhanced, hypovascularized, contained intra-tumor necrotic components, had ill-defined borders, and was not encapsulated. It measured approximately 9.02 x 9.94 x 9.93 cm, and appeared to cover almost the entire right lobe of the liver. This finding was diagnosed as PRETEXT III hepatoblastoma. An experienced interventional radiologist performed TACE with cisplatin agent. Subsequent evaluation 20 days after the first TACE, the size of the tumor mass had reduced by 20% from the previous size. This finding warrants consideration of the next optimal therapeutic approach, i.e., whether to proceed with surgical intervention or perform subsequent TACE prior to surgery. In our case, we proceeded with a repeat of TACE followed by surgery.Conclusions: Transarterial chemoembolization appears to be one of the effective treatment options for large and invasive HB, as experience has shown that TACE can shrink tumor size, provide clearer borders, and reduce alpha-fetoprotein (AFP) levels after the first TACE. TACE can thus facilitate more optimal surgical and transplantation procedures. Thus, we believe that TACE has the potential to become a recognized HB treatment option in the future.
Clinical Characteristics and Length of Stay of Lung Cancer With Pleural Effusion at Primary Referral Center Hospital in Aceh Regita Ayu Kumuda; Budi Yanti; Novita Andayani; Wilda Mahdani
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1421

Abstract

Background: Lung cancer is the leading cause of death worldwide, with the most common complication being pleural effusion. This complication is often associated with poor outcomes and has a significant impact on treatment duration in the hospital. Therefore, this study aimed to assess the clinical characteristics of lung cancer patients with pleural effusion and their relationship with length of stay.Methods: A cohort retrospective design was adopted, and data from patient medical records from January 2022 to December 2023 were collected at Zainoel Abidin Hospital, Banda Aceh. Lung cancer patients with pleural effusion at diagnosis or during the disease were identified based on thoracic CT scans or ultrasonography of the thorax. The risk factors related to the length of hospitalization were identified using a multivariate regression.Results: This study showed that the clinical characteristics of lung cancer with pleural effusion were mostly 40—60 years old (57.7%), male (79.2%), smokers (79.2%), squamous cell carcinoma (57%), without comorbidities (69.1%), malignant pleural effusion only (19.5%), shortness of breath (49%), treated with thoracentesis (37.6%), and Water Sealed Drainage (37.6%). Furthermore, Water-Sealed Drainage (WSD) significantly affected the length of hospitalization. Patients with WSD management showed lower hospitalization with the outcome of being discharged from the hospital (p < 0.05; OR 0.019; 95% CI: 0.006—0.061).Conclusion: Squamous cell carcinoma is the most prevalent histological subtype among lung cancer patients with pleural effusion. Water-sealed drainage is associated with lower length of stay. Furthermore, management with WSD had a lower risk of poor therapeutic outcomes and prolonged hospitalization.
Diagnostic Challenge of Acute Lymphoblastic Leukemia (ALL)-L2 in an Adult: A Case Report Leonardo Suryawan; Jusak Nugraha; Ari Christy Muliono
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1442

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) is one of the rare hematologic malignancies that commonly occurs in children and less commonly in adults. The prior cases reported adults with ALL were having varied clinical manifestations, which sometimes confused the physicians. Additionally, elevated white blood cells are not always present in hematologic malignancies like ALL. Moreover, diagnosing ALL in a tropical country like Indonesia is more challenging because many infection cases have similar manifestations to hematologic malignancies like ALL. Therefore, in this study, we reported a case report of ALL in Indonesia in ordered steps. Case Presentation: We reported a 40-year-old Indonesian male with a 2-week fever, general weakness, and bloody stool who was first suspected as infection. The diagnosis became confusing when the physicians found the laboratory result of anemia (hemoglobin of 8,6 g/dL) and thrombocytopenia (42k/uL), but normal white blood cells and negative markers of any infections or autoimmune disease. Peripheral blood examination resulted in normochromic normocytic anemia and leucopenia without any blast cells found, suggesting bone marrow aspiration (BMA). A proportion of 89% lymphoblast was found in BMA, further confirmed with immunophenotyping, which resulted in positive expression of CD19, CD34, CD79a, CD10, and HLA-DR, impressing ALL-B lineage.Conclusions: It is more challenging to diagnose ALL in a tropical country with many mimicking infectious diseases and varied laboratory findings. The physicians and clinical pathologists should be alert when finding nonspecific clinical manifestations and laboratory findings.
The Effect of Curcumin, Piperine, and Taurine Combination in Hepatocellular Carcinoma Patients: A Systematic Review and Meta-Analysis Steven Alvianto; Erty Sundarita; Nicolas Daniel Widjanarko; Danniel Loogman Prayogo
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1445

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer death and the sixth most diagnosed cancer. Curcumin (C) has anticancer effects toward HCC and may enhance the antitumor effects of certain traditional chemotherapeutic and molecular target drugs. Co administration with piperine (P) improves curcumin’s bioavailability, while taurine (T) also exhibits antitumor properties. This study aimed to assess the potential effects of the CPT combination on biochemical and immunological parameters in HCC patients. Following the PRISMA guidelines, a systematic review and meta-analysis were conducted using data from several databases, focusing on HCC and CPT studies. Review Manager 5.4 was used to perform the meta-analysis. Four studies involving 81 HCC patients met the inclusion criteria, with three included in the meta-analysis. Over three successive 30-day cycles of CPT treatment, significant reductions were observed in biochemical parameters including AST (SMD = 1.13, 95% CI: 0.29—1.97, p = 0.008), ALT (SMD = 0.33, 95% CI: 0.13—0.53, p = 0.001), and total bilirubin (SMD = 0.65, 95% CI: 0.45—0.85, p < 0.00001), while albumin levels showed no significant change (SMD = 0.00, 95% CI: -0.33—1.34, p = 0.98). Included studies indicated significant reductions in IL-10, CD25, miR-21, VEGF, CD4+CD25+%, and CD8+CD25+%, alongside increases in IFN-γ, CD4, CD8, IL-2, and IL-12 following CPT treatment. In conclusion, CPT combination therapy induced significant improvements in biochemical and immunological parameters across three treatment cycles, highlighting its potential as a promising natural therapeutic option for HCC management. Further research is necessary to validate these findings
The Role of Age in Breast Cancer Prognosis and Biomarker Expression among Chemotherapy Patients Akhmad Azmiardi; Kristanto Yuli Yarso; Meirisa Ardianti
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1448

Abstract

Background: Breast cancer is the most common malignancy among women worldwide, representing a significant public health problem due to its high incidence and mortality rates. Among various prognostic factors, age has been inconsistently reported in the literature, despite its potential biological implications. This study aims to clarify the prognostic relevance of age in breast cancer by analyzing its association with survival outcomes and tumor biomarker expressions, particularly Human Epidermal Growth Factor Receptor 2 (HER2) and Ki-67.Methods: A retrospective cohort study was conducted on breast cancer patients treated at public hospitals and Private Hospitals in Surakarta, Indonesia, diagnosed between 2013 and 2015. Data were gathered from 70 subjects, selected based on complete biomarker, chemotherapy, and follow-up records. Patient age was categorized into three groups: < 40 years, 40-59 years, and ≥ 60 years. Immunohistochemical methods determined HER2 and Ki-67 expressions. Statistical analyses included Kaplan-Meier survival curves and Chi-square tests. Results: Patients aged 40-59 years exhibited superior survival outcomes (mean survival of 106.77 months) compared to younger (< 40 years) and older subjects (≥ 60 years), whose mean survivals were approximately 52 months. HER2 expression showed no significant age-related variation (p = 0.726), whereas Ki-67 expression did, correlating higher proliferation rates with middle-aged patients (p = 0.020).Conclusions: Age appears to be a clinically relevant factor associated with breast cancer prognosis and tumor proliferative characteristics. Incorporating age-related biological differences into prognostic evaluation may enhance risk stratification and inform more tailored treatment and follow-up strategies for breast cancer patients.
Effect of Hormonal Therapy Type, Treatment Duration, and Menopausal Status on Lipid Profiles in Breast Cancer Patients Widyanti Soewoto; Dea Alberta Setiawati
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1451

Abstract

Background: Hormonal therapy is widely used in breast cancer treatment, yet its long-term effects on lipid profiles remain a concern, especially regarding the duration of treatment. This study aimed to analyze the association between the type and duration of hormonal therapy and changes in lipid profiles, including total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), among breast cancer patients with different menopausal statuses.Methods: A retrospective observational study was conducted using secondary data from 358 female breast cancer patients who received hormonal therapy, such as aromatase inhibitors, selective estrogen receptor modulators, or GnRH agonists, in 2024 at Dr. Moewardi Hospital. Clinical data included the type of hormonal therapy, treatment duration, age, menopausal status, and lipid profile parameters. Data were analyzed using non-parametric tests, with p-values < 0.05 considered statistically significant.Results: A statistically significant association was found between therapy duration and total cholesterol levels (p = 0.023). The highest mean total cholesterol was observed in the 1—2 years group (193.22 ± 58.56 mg/dL), followed by > 2 years (188.04 ± 41.72 mg/dL), and the lowest in < 1 year (174.40 ± 44.91 mg/dL). Post hoc analysis confirmed significant differences between the < 1 year group and both the 1—2 years (p = 0.042) and > 2 years groups (p = 0.032). No statistically significant associations were found between therapy duration and levels of TG, HDL, or LDL, nor between lipid profiles and menopausal status. Conclusions: The duration of hormonal therapy significantly affects total cholesterol levels in breast cancer patients, with longer durations associated with higher levels. These findings emphasize the importance of lipid profile monitoring during extended hormonal therapy to mitigate potential cardiovascular risks.

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