Indonesian Journal of Cancer

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ISSN / EISSN : 19783744 / 23556811
Total articles ≅ 36
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Siti Nurkasanah, Aida S D Hoemardani, Evlina Suzanna Sinuraya
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.638

Abstract:Background: Squamous cell carcinoma (SCC) is an invasive skin cancer that is found in the human skin. SCC growth from the precancerous lesion is known as a wart or papilloma. Ki67 is a protein expressed by cells during proliferation. Cells with higher Ki67 expression showed abnormal regulation of apoptosis. 5-FU is an antimetabolite compound that works as a DNA/RNA pyrimidine antagonist molecule that can induce cell apoptosis. The main objective of this research is to evaluate the inhibition proliferation of precancerous squamous cell in skin lesion induced by DMBA/croton oil treated by using 5-FU cream topically compared to 5% imiquimod cream. Methods: This research assesses three different concentrations of 5-FU cream namely 1%, 2%, and 5% topically on 24 wild type mice divided into 6 groups of 4 each including positive control (with carcinogenesis but without treatment), negative control (without treatment ; normal), carcinogenesis with treatment 5-FU cream (1%, 2%, and 5%) or 5% imiquimod cream. The expression of Ki67 was analyzed using immunohistochemistry. Statistical analysis was performed by one-way ANOVA using SPSS version 23. Results: Based on this research, 5-FU cream treatment during 4 weeks (week 10-week 14) showed the decrease of cumulative number of papilloma (p
Toar Jean Maurice Lalisang, Yarman Mazni, Sahat Matondang
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.640

Abstract:Background: Pancreaticoduodenectomy (PD) is associated with major morbidity and mortality especially in low volume centers. A centralized model is not suitable for Indonesia, due to its geographical characteristics and the underlying structure of its health funding. As an alternative, an outreach program was developed and delivered by a dedicated hepatopancreatobiliary (HPB) team. The aim of this study was to describe the outcomes of such approach. Methods: A retrospective study of all patients undergoing Pancreaticoduodenectomy or total pancreatectomy by a single HPB team was performed. A “hub and spoke” model /decentralization strategy was used to deliver the care between a tertiary center and eight peripheral centers. Patient demographics, system measures, and outcomes were collected. Results: A total of 213 patients were identified as undergoing a resection within the period of 1993–2017. A total of 47 resections (22%) were performed at a peripheral center. The median age was 51 years and 91(46%) of patients had ampullary carcinoma. The perioperative mortality was 17% but improved over time. Only 19/198 (9.5%) patients with the malignant disease received adjuvant therapy. The median (95%CI) survival for patients with pancreatic and ampullary cancer was 12 (9-15) and 24 (14-34) months respectively. Conclusions: A hub and spoke model as a decentralization strategy for managing patients with peri-ampullary tumors can lead to an improvement in access and outcomes. However further work is required if they are to achieve outcomes achieved by international high-volume centers within centralization programs.
Mururul Aisyi, Ayu Hutami Syarif, Nur Asih Anggraeni, Adhitya Bayu Perdana, Hutomo Rezky, Agus Kosasih, Achmad Basuki
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.622

Abstract:Background: Osteosarcoma is the most common bone malignancy in childhood and adolescence. Despite significant advances in diagnostic and therapeutic modalities, osteosarcoma has generally poor prognosis. Several studies highlighted the prognostic significance of demographic and clinical parameters in the pediatric population. Controversy exists about which obvious factors of mortality in some institutions. Meanwhile, little is known about the overall survival (OS) of pediatric osteosarcoma in Dharmais Cancer Hospital.The aim of this study is to estimate the OS in pediatric osteosarcoma.Methods: This retrospective cohort study enrolled 41 children with osteosarcoma during the period of January 2010-September 2017. Patients were selected using inclusion and exclusion criteria. Overall survival (OS) and patient variables were plotted using Kaplan-Meier.Results: Our result showed that all patients admitted to our hospital in advanced stages (IIB and III). Their median OS was 23 months (12.3-33.7 months) with the survival probability was 29.4%.Conclusions: Median OS of pediatric osteosarcoma in our institution was 23 months and the survival probability was 29.4%. It can be used as evidence showing lack of cancer awareness and early detection in our country.
Zahra Tolou-Ghamari
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.631

Abstract:Background: Previous publication reported a significant disparity of genital cancer incidence between genders. The aim of this study is to investigate period prevalence (PP) and incidence (Irs) of genital cancer in Isfahan/Iran. Methods: Information equivalent to those collected by the USA Surveillance, Epidemiology, and End Results (SEER) program was obtained from the Isfahan Cancer Registry. Period prevalence (PP) was calculated per 100.000 persons. The cancer sites studied were defined according to the International Classification of Diseases (ICD-O; Third Edition) and recorded by topography code. Results: Between the years 2011 to 2015, among all registered cases (3024 cases), 60% applied to the male genital system. The mean (SD) age at diagnosis was higher for men 69.4 (14.7) than women 57.8 (15) (t-test; P
Rasha Mohamed Abdel Latif, Kamel Farag Selim
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.635

Abstract:Background: The metastatic renal cell carcinoma (mRCC) patients treated with upfront cytoreductive nephrectomy (CN) combined with immunotherapy results in overall survival (OS) improvement. It is unclear whether mRCC patients treated with target therapy will also benefit from CN. The aim of the study was to identify the benefit of upfront CN followed by targeted therapy (TTs) versus TTs alone on OS of patients with mRCC, and to evaluate pre-operative variables for selection of patients who would benefit from CN, and also the response rate (RR) and the progression-free survival (PFS). Methods: A retrospective study was performed in our Department on patients diagnosed with mRCC within the period of January 2013 to April 2018. Data that were collected included patients and tumor characteristics. Patients were divided into two groups: 1) received upfront CN followed by TTs, and the 2) one treated with TTs alone. Survival analysis was performed using Kaplan-Meier method, univariate analysis with log-rank test was used to estimate predictors of survival in the CN group, and Cox regression was used for multivariate analysis. Results: The median OS of all patients was 14 months, and was 19 and 10.5 months in CN and non-CN respectively with significant difference (P˂0.001). Lower hemoglobin level (P=0.012), high neutrophil count (P˂0.001), low albumin level (P=0.006), number of metastatic sites ≥3 (P˂0.001), and patients with number of risk factors ≥3 (P˂0.001) have a negative impact on OS in CN group. Conclusions: Upfront CN before TTs in mRCC carries better survival than TTs alone. Five pre-operative variables (i.e. hemoglobin level, neutrophil count, albumin level, number of metastatic sites, and number of risk factors) were identified as suitable for selection of patients who will benefit from CN.
Zhafirah Ramadhanty, Kristanto Yuli Yarsa, Ari Probandari
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.621

Abstract:Background: The number of breast cancer patients in Indonesia is increasing but there are still only a few researches that assess their quality of life. RAND SF-36 is a quality of life instrument that is widely used. In Indonesia, the validity and reliability of the instrument is still under development, especially in breast cancer patients. Various health status questionnaires have been used in physical rehabilitation studies involving patient with pacemaker, but for women with breast cancer, the usefulness of these questionnaires as measures of physical, mental, and social well-being has not been firmly established. Methods: A previously validated RAND SF-36 questionnaire in patients with pacemaker was given to 252 breast cancer survivor community members. We assessed the construct validity and the reliability by referring to its Pearson’s r table value and Cronbach’s α coefficient. Results: One hundred and fourteen breast cancer survivor community members participated and completed all 36 questions of the instrument between September- November 2018. Questions number 2, 28, and 35 showed lower Pearson’s r value (r0.1548 indicating that these questions were valid. Cronbach’s α coefficient >0.90 indicated good internal consistency. Conclusions: The Indonesian version of the SF-36 quality of life questionnaire is a suitable instrument and can be used for research in Indonesian breast cancer patients.
Bagus Ramasha Amangku, Syaiful Ichwan, Septelia Inawati Wanandi, Novi Silvia Hardiany
Indonesian Journal of Cancer, Volume 13; doi:10.33371/ijoc.v13i2.633

Abstract:Background: HIF-2α is a transcription factor in hypoxic condition, and high expression levels of it correlate with the concepts of metastasis, therapy opposition and reduced quality of prognosis in various forms of cancerous growth. Due to the exceedingly infiltrative ability of brain glioma cells, gliomas cannot be completely deteriorated with surgery and the relapse rate is high. This study goal to identify the relative expression of HIF-2α gene in the direction of glioma malignancy and its classification. Methods: Specimens used in this research comprise of 20 glioma samples obtained from glioma patients in Cipto Mangunkusumo Hospital. Relative expression of HIF-2α was measured by utilizing quantitative Real Time-Polymerase Chain Reaction (RT-PCR). Cycle threshold (CT) values were achieved correlated with the amplified DNA, and then the relative expression was attained by using Livak method of calculation. Results: The results produced a greater average of relative expression of HIF-2α in the grade III and IV types (18.64; n=7) rather than in the lower grades (5.68; n=13). However, the data is statistically inconsequential. Conclusions: High-grade glioma tends to express HIF-2α mRNA higher compared to the lower grade. Therefore, it is possible to use HIF-2α as a prognostic marker for glioma- diagnosed patients, although additional experiments need to be performed to strengthen these facts.
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.
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.
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.