Indonesian Journal of Cancer

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ISSN / EISSN : 19783744 / 23556811
Total articles ≅ 35
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Rinto Hariwibowo, Agus Rizal Hamid, Chaidir Arif Mochtar, Rainy Umbas
Indonesian Journal of Cancer, Volume 13, pp 21-23; doi:10.33371/ijoc.v13i1.626

Abstract:Background: Inguinal lymph nodes dissection has been the mainstay treatment for penile squamous cell carcinoma with resectable inguinal lymph nodes metastasis. Traditionally, inguinal lymph node dissections were performed with a classical open approach with high complications and morbidity rate. We are reporting our first experience with videoendoscopic inguinal lymph nodes dissection as an alternative to the classic open approach in our center.Case Presentation: This article reports a case of squamous cell carcinoma of the penis. A case report of post partial penectomy with pT3N2M0 squamous cell carcinoma of the penis and palpable bilateral inguinal lymph nodes in a 52-year-old male. In this patient, we perform our first experience with videoendoscopic inguinal lymph nodes dissection as an alternative to the traditional classic open approach inguinal lymph node dissections.Conclusions: Videoendoscopic approach for inguinal lymph nodes dissection in penile cancer is feasible and has been demonstrated to have a better outcome on complications & morbidity compared to the traditional open approach. In the end, we propose that the videoendoscopic approach, if available, could be the main choice for inguinal lymph nodes dissections for the future.
Samuel Johny Haryono, Noorwati Sutandyo, Ramadhan Karsono, Bambang Karsono, Denni Joko Purwanto, Alban Dien, Nugroho Prayogo, Walta Gautama
Indonesian Journal of Cancer, Volume 13, pp 1-4; doi:10.33371/ijoc.v13i1.569

Abstract:Background: Breast cancer is the most diagnosed cancer among Indonesian women. Adjuvant chemotherapy plays a crucial role in the management of early breast cancer patients, with docetaxel-based regimens as a cornerstone therapy. The Asia-Pacific breast initiative II registry was established to evaluate safety parameters of docetaxel-based regimens in the Asia-Pacific region within 2009–2013 period. The result from Indonesia population is presented in this study.Methods: This study was a part of International, longitudinal, multicenter, and observational research which included a group of consecutive early breast cancer patients with an intermediate-to-high risk of recurrence that was being treated with various docetaxel-based (anthracycline and non-anthracycline) adjuvant chemotherapy regimens during 2009–2013 in real-world clinical settings.Results: The analysis included 49 subjects (2.8% of total study population). Majority of subjects received non-anthracycline-containing regimen (79.6%). Docetaxel was mainly prescribed in combination (63.27%). Chemotherapy-related adverse events were reported in all subjects. Mean number of cycles received by subjects was 5.5 cycles with dose intensity of 23.78 mg/m2/week.Conclusions: The Indonesian result, as part of the Asia-Pacific Breast Initiative II Registry, identified some important factors that are relevant to clinical practice, including patient’s characteristics and treatment pattern of docetaxel use as adjuvant chemotherapy regimens.
Syamsu Hudaya, Karina Evelyn Sidabutar
Indonesian Journal of Cancer, Volume 13, pp 13-16; doi:10.33371/ijoc.v13i1.598

Abstract:Background: Radical cystectomy (RC) and urinary diversion (UD) are among the most complex urological procedures with high postoperative morbidity, That caused only a few urologists are prepared to perform this operation. We dedicated to enroll this procedure since the number of bladder tumor cases is increasing in our third referral general hospital. We evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of radical cystectomy.Methods: This retrospective descriptive study collected medical record of patients with RC in Fatmawati Hospital, Jakarta, Indonesia from 2014-2016. All surgeries were performed by the same surgeon. Variables related to the surgical and postoperative outcomes and complications in the patients were analyzed.Results: There were 11 patients during this study period. The average age of the patients was 60.9 ± 9.6 years old with 7 male and 4 female patients. All patients underwent ileal conduit as urinary diversion. The mean operation time was 392.7 ± 117 minutes. The estimated blood loss was 1,272.7 ± 538.7 mL. No intraoperative death was recorded. The hospital stay length was 15.8 ± 8.3 days, visual analog scale (VAS) score in the first day after surgery was 2.7 ± 0.2, and the drain was kept in for 13.9 ± 7.4 days. All of the histopathology results were urothelial carcinomas.Conclusions: Our initial experience with radical cystectomy results in acceptable blood loss, manageable post-operative pain, and acceptable hospital stay. Therefore it is still a treatment of choice for muscle-invasive bladder cancer in our hospital.
Dinny Gustina Prihadi, Agung Firmansyah Sumantri, Hasyarati Agustina, Indra Wijaya
Indonesian Journal of Cancer, Volume 13, pp 17-20; doi:10.33371/ijoc.v13i1.618

Abstract:Background: Langerhans Cell Histiocytosis (LCH) is a disease characterized by proliferation and infiltration of histiocytes in various organs that is caused by local or systemic effects. LCH could affect bones, lungs, central nervous system, liver, thymus, skin, and lymph nodes. The diagnosis of LCH is difficult to enforce and rarely found in adults, namely 1-2 cases per million per year.Case Presentation: In Indonesia, there were very few cases of LCH in adults, one of which was found in women aged 56 years. LCH does not yet have standard treatments. The treatment is given based on location and severity, including intralesional corticosteroid injection, radiotherapy, surgical or excision curettage, and chemotherapy. Prednisone and vinblastine chemotherapy was one of chemotherapy that is given to LCH patients. Prognosis of LCH consists of various factors, one of which is the number of organs involved. This is a case report of LCH in an adult male patient with skin involvement who received chemotherapy for 6 weeks and experienced improvement.Conclusions: LCH is not only a disease of children; it is also reported in an adult. The prognosis is related to the number of organ involved and involvement of the risk organ. LCH can recur easily and accompany malignant tumors, so follow-up and long-term observations are still needed to be done.
Ni Putu Wulan Purnama Sari
Indonesian Journal of Cancer, Volume 13, pp 5-12; doi:10.33371/ijoc.v13i1.619

Abstract:Background: Cervical and breast cancers are the two top leading cases of female cancer in Indonesia. Nowadays, many survivors with various degree of cancer-related fatigue (CRF) were found in the community context. This study aimed to compare and analyse the differences of CRF intensity in cervical cancer survivors (CCS) and breast cancer survivors (BCS) generally, and in each stage of cancer survivorship, specifically.Methods: This cross-sectional study involved 47 CCS and 55 BCS in the district of Rangkah, Gading, and Pacar Keling, Surabaya, Indonesia (n=102). Instrument of Fatigue Symptom Inventory (FSI) was used for data collection. Descriptive statistic, independent sample t-test, and one way ANOVA test were used for data analysis (α<.05).Results: Most respondents were short term survivors (43.14%) with mild CRF (66.67%) in both cases. Higher intensity of CRF was found in CCS compared to BCS. Worst CRF was found more in acute and short term survivorship in BCS compared to more in long term survivorship in CCS. There was no significant difference of CRF found between CCS and BCS (p=.63), and CRF was not significantly different between each stage of cancer survivorship in both cases (p=.883 and p=.117 for CCS and BCS respectively), but CRF intensity in the worst and lightest time possible was significantly different between CCS and BCS (p=.000).Conclusions: There was no significant difference of CRF between cases and stages of survivorship in CCS and BCS, but CRF intensity in the worst and lightest time possible was significantly different between those groups.
Ramadhan Karsono, Denni Joko Purwanto, Samuel J. Haryono, Bambang Karsono, Lenny Sari, Yulia Pratiwi, Teguh Aryandono
Indonesian Journal of Cancer, Volume 12, pp 109-115; doi:10.33371/ijoc.v12i4.604

Abstract:Background: There are no data of efficacy comparison between primary systemic therapy in stage 3B and 4 breast cancer patients in Indonesia. This study compared long term outcomes of breast cancer patients treated with neoadjuvant hormonal therapy (NAHT) and those treated with neoadjuvant chemotherapy (NACT)Methods: This was a cohort study conducted from 2011 to 2017. A total of 122 patients with stage 3B and 4 breast cancer received NAHT (n = 62) or NACT (n = 60) within a 6 cycles for NACT and 6 months for NAHT were included. Patients were excluded if they had a mastectomy before treatment, were pregnant, had been given hormonal therapy or chemotherapy before, had a contra-indication of chemotherapy, had a contra-indication of salpingo-oophorectomy bilateral for premenopausal patients, and declined to enter this study. The primary outcome of this study was overall survival. The outcomes were analysed using Kaplan-Meier for survival analysis and cox proportional hazard regression to estimate the hazard ratio.Results: There was a statistically significant difference in overall survival (p = 0.038). Median overall survival for NAHT patients was 1265 days and for NACT patients was 654 days. The hazard ratio showed NACT patients had a higher risk than NAHT patients (1.7 95% CI 1.03 – 2.9). Pathological complete response rate was higher in the NACT group than in the NAHT group (3.3% vs. 0%).Conclusions: Neoadjuvant hormonal therapy was superior to neoadjuvant chemotherapy in term of overall survival.
Faradillah Mutiani, I Dewa Gede Ugrasena, Fery Hudowo Soedewo
Indonesian Journal of Cancer, Volume 12, pp 123-6; doi:10.33371/ijoc.v12i4.585

Abstract:Background: Neuroblastoma is a malignant solid tumour in children which attacks sympathetic nervous system. Despite of increment in its number of incidence, it is still rarely investigated. This research aims to improve the understanding of neuroblastoma based on the profile of patients, and further, to improve services for patients.Methods: This was a retrospective study conducted by assessing and descriptively analyzed patients medical record.Results: From 52 patients, 56% were male and 71% were between age of 1-5 years. Neuron Specific Enolase (NSE) examination showed that most patients had high levels in 29 patients (56%) while Lactate Dehydrogenase (LDH) examination showed that 23 patients (44%) had low levels. Based on Fine Needle Aspiration Biopsy (FNAB) examination, 22 patients (42%) showed formation of malignant round cell tumor. Meanwhile, through Bone Marrow Aspiration (BMA) examination, it was found that the tumors had already spread to bone marrow in 17 patients (33%).Conclusions: Based on tumor markers and pathological finding, this study revealed that the majority of neuroblastoma patients had poor prognosis.
Alexandria Stephanie Suparman, Daniel Ardian Soeselo, Dyonesia Arie Harjanti
Indonesian Journal of Cancer, Volume 12, pp 127-30; doi:10.33371/ijoc.v12i4.583

Abstract:Background: MALT (Mucosa Associated Lymphoid Tissue) Lymphoma is an uncommon condition. It is an involvement of extranodal site in hematologic malignancy, Non-Hodgkin Lymphoma.Case Presentation: Pondok Indah, Puri Indah Hospital Jakarta treated a 38-year-old female with acute abdomen due to jejunal MALT Lymphoma perforation, one meter from treitz ligament. Emergency laparotomy was performed, the patient had a resection and end to end anastomose. She was hospitalized in intensive care unit for 4 days after the surgery and died because of prolonged septic shock.Conclusions: MALT lymphoma is an uncommon condition which is often encountered in emergency conditions due to acute abdominal pain caused by intra-abdominal perforation of the hollow viscus. Late diagnosis and treatment may cause severe outcome such as perforation and hypovolemic shock. This case report is expected to provide insight and to increase the awareness of the incidence of jejunal MALT lymphoma in Indonesia.
Ni Putu Wulan Purnama Sari
Indonesian Journal of Cancer, Volume 12, pp 116-122; doi:10.33371/ijoc.v12i4.605

Abstract:Background: Cervical cancer and breast cancer are the two top leading cases of female cancer in Indonesia. Being the 2nd largest city in Indonesia, Surabaya is being populated by more than 1.5 million females in 2017. This study aimed to describe the demographic characteristic of women living with cervical and breast cancer in order to show the current picture of female cancer situation in Surabayan communities nowadays. Substantial to it, the correlation between time of first diagnosis and type of therapy with current stage of cancer were analyzed to evaluate the cancer management effectiveness in community context.Methods: This cross-sectional study involved six (9.68%) Public Health Centers (PHCs) among 62 PHCs in Surabaya, Indonesia, which were selected by one stage cluster random sampling. There were 140 and 139 women living with cervical and breast cancer participated in this study respectively (n=279). Self-developed demographic questionnaire was used to collect the data. Descriptive statistic, Spearman Rank correlation test, and Mann-Whitney U test were used in data analysis (α<.05).Results: Overall, most respondents were married (77.06%) and were housewives (59.14%). They were high school graduated at majority (44.44%). Family support came from spouse and children (70.25%). Those with breast cancer mostly aged middle-up adulthood (56.12%), while older aged were found in respondents with cervical cancer (72.86%). The majority had been diagnosed with cancer for less than five years (81.36%), but there was a tendency that the longer life expectancy was found in those with cervical cancer. More cervical cancer respondents with advanced stage were found to be long-term survivors (25%). The first time of diagnosis and the type of therapy were significantly different between cases (p=.039 and p=.000 respectively), but the current stage of cancer was not significantly different (p=.239). There was a quite strong correlation between time of first diagnosis and current stage of cancer (ρ = -.409; p=.000), but there was no significant correlation between type of therapy and current stage of cancer (p=.147).Conclusions: The demographic characteristic of women living with cervical and breast cancer has been slowly shifting from elderly or late adulthood, to middle and early adulthood. The first time of diagnosis and the type of therapy were significantly different between cases, but the current stage of cancer was not significantly different. There was a strong significant correlation between time of first diagnosis and current stage of cancer in cervical and breast cancer.
Rasha Hamdy, Amal Halim
Indonesian Journal of Cancer, Volume 12, pp 102-108; doi:10.33371/ijoc.v12i4.596

Abstract:Background: Egyptian hospital–based statistics showed that head & neck carcinomas represent 18% of all cancers and mostly diagnosed at advanced stages. Our Clinical Oncology & Nuclear Medicine Department of Mansoura Faculty of Medicine serves a large rural area of the Delta region of Egypt. There is no previous study in our institution that focused on oral tongue carcinoma alone. This study aims in establishing the demographics, treatment outcome and prognostic factors of oral tongue squamous cell carcinoma (SCC).Methods: We retrospectively reviewed data of 50 cases with oral tongue SCC treated in our department from January 2014 to December 2016 to evaluate the demography, pathological characteristics, and therapeutic modalities. We estimated the survival rates during the entire follow-up period by the Kaplan–Meier method. The univariate and multivariate Cox proportional hazards analysis were performed for prognostic factors determination.Results: The median follow-up was 30 months (range: 4-45 months). The 3-year overall survival (OS) and disease-free survival (DFS) rates were 68% and 60% respectively. By univariate analysis, both advanced stages (III, IVA) and depth of invasion >0.5 cm were statistically significant as prognostic factors for 3-year DFS and OS rates. DFS rates were 34% vs. 98% for stage III and IVA vs. stage I and II respectively (p = 0.001); 52% vs. 78% for >0.5 cm vs. ≤0.5 cm depth of invasion (p = 0.003). OS rates were 36% vs. 99% for stage III and IVA vs. stage I and II respectively (p = 0.002); 52% vs. 80% for >0.5 cm vs. ≤0.5 cm depth of invasion (p = 0.001). Multivariate analysis of prognostic factors affecting 3-year DFS and OS rates confirmed the statistical significance of the same 2 factors.Conclusions: The majority of our patients were males below 60 years. Tumors were mainly found at stage III and were moderately differentiated. Vascular invasion and lymphatic permeation were uncommon. Staging and tumor invasion depth significantly affected the outcome. The 3-year OS and DFS were 68% and 60% respectively.