Indonesian Journal of Cancer

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ISSN / EISSN : 1978-3744 / 2355-6811
Total articles ≅ 96
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Lianda Siregar, , Agus Sudiro Waspodo, Siti Nadliroh, Rahmanandhika Swadari, Rizka Andalusia, Leovinna Widjaja
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.767

Abstract:
Background: There is currently no data regarding the efficacy of prophylactic telbivudine in hepatitis B patients undergoing chemotherapy. This study aims to describe the results of preemptive telbivudine and lamivudine to prevent chemotherapy-related HBV reactivation.Methods: The medical records of all patients with HBsAg positive or HBs-Ag negative, anti-HBc positive, who were referred to the hepatology clinic between May 2014 and December 2016, were retrospectively reviewed. As this is a descriptive study, no statistical analysis was done.Results: A total of 52 patients with prophylactic telbivudine or lamivudine therapy were included, with 26 patients in each group. Rituximab-based treatment was given in nine and five patients in the telbivudine and lamivudine group, respectively. The number of patients who completed antiviral treatment up to six months after chemotherapy was 17 patients in each group. There was less incidence of HBV reactivation in the telbivudine group (2 of 17 patients, 11.8%) than in the lamivudine group (7 of 17 patients, 41.2%). Delayed reactivation was noticed in 1 of 2 patients in the telbivudine group and 3 of 7 patients in the lamivudine group. The median log10[HBV DNA] at reactivation was 4.52 (1.70 – 8.35) IU/mL. Severe hepatitis was observed in two patients in the lamivudine group and one patient in the telbivudine group. Of 34 patients who completed antiviral treatment, two patients died due to primary cancer. No interruption of chemotherapy or mortality due to hepatitis was noticed in both groups.Conclusions: Preemptive telbivudine or lamivudine in HBsAg positive or HBsAg negative, anti-HBc positive patients seems to be a good treatment option.
Irmanida Batubara, Arif Rakhman Hakim, Silmi Mariya, Suminar Setiati Achmadi, Valentina Sokoastri Valentina Sokoastri, Agustin Sri Mulyatni, Rohayati Suprihatini
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.780

Abstract:
Background: 9,10-Anthraquinone (9,10-AQ) is a contaminant on some agricultural products and considered as carcinogenic based on EU Regulation No. 1146/2014. Except for little evidence on experimental rats, there is no strong proof regarding the carcinogenicity in humans. Therefore, it is essential to find a safe dose of this compound since the difference in 9,10-AQ levels will affect cancer cell growth. This research aims to find the 9,10-AQ concentration that does not proliferate the human cancer cells under in vitro study.Methods: In determining the 9,10-AQ concentration that does not proliferate the cancer cells growth, 0.01 to 500 mg/L 9,10-AQ was directly tested on four human cancer cells (colorectal carcinoma HCT 116, colon adenocarcinoma WiDr, breast cancer MCF-7, and cervical cancer HeLa), and the viability of the cells was counted via (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay. In the gene expression level, the effects on a selected cancer cell line were determined by qRT-PCR against BAX, BCL-2, PCNA, and P53.Results: The result indicates that 9,10-AQ up to 500 mg/L concentration does not proliferate the cell’s growth but instead inhibits those four cancer cells’ growths. The concentration of 9,10-AQ that inhibits 50% the cancer cells growth (IC50) value was 321.8 mg/L (1.55 mM) against HCT 116 and above 500 mg/L (above 2.40 mM) against WiDr, MCF-7, and HeLa. The 9,10-AQ at 500 mg/L (or 2.40 mM) increases BAX expression and acts as an apoptotic agent on HeLa cells.Conclusions: The investigation has shown that 9,10-AQ up to 500 mg/L concentration does not proliferate the cancer cell growth; instead, it inhibits the HCT 116 and HeLa cells growth. We have preliminary evidence regarding the apoptotic mechanism of 9,10-AQ by increasing BAX gene expression on HeLa cells.
, Sutrisno Sutrisno, Gondo Mastutik
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.750

Abstract:
Background: CD133 overexpression can increase cell proliferation, migration, and epithelialmesenchymal transition that promotes metastasis. CD133 expression is induced by hypoxiainduced factor (HIF) which requires SOX2 binding in the promoter region. SOX2 is an embryonal transcription factor that plays a role in the development of malignancy. The study aimed to analyze the expression of CD133 and SOX2 with regional lymph nodes (LN) metastatic status in invasive breast carcinoma of no special type (NST). Methods: The study was a cross-sectional design. Forty-five samples were retrieved from pathology archives in Dr. Soetomo Hospital from January to December 2018. Samples were divided into 2 groups, with and without regional LN metastasis. Immunohistochemistry with CD133 and SOX2 was applied to all samples. CD133 expression was assessed by immunoreactive score, and SOX2 expression was assessed by the percentage of tumor positive cells.Results: There was no significant difference in CD 133 expression between invasive breast carcinoma of NST with and without regional LN metastases (P = .990). A positive correlation was found in SOX2 expression between breast carcinoma with and without regional LN metastasis (P = .000; rs = .518). There was no correlation between CD133 and SOX2 expression (P = .082), which means that the high expression of CD133 did not affect SOX2 expression.Conclusions: CD133 expression was not significantly different in breast carcinoma with and without LN metastasis. The high expression of SOX2 was found significantly correlated with regional LN metastasis. SOX2 expression may become a potential prognostic marker in invasive breast carcinoma of NST. regional LN metastasis
Hermin Aminah Usman, Fauzan Ali Zainal Abidin, Akbar Maulana
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.787

Abstract:
Background: Breast cancer (BC) and thyroid cancer (TC) are the types of cancer mostly treated at the Surgical Oncology Department with 24.1% and 6.8%, respectively, of all malignancies at Dr. Hasan Sadikin General Hospital. The delay in managing patients for both types of cancer will increase the risk of cancer stage progression. This study was conducted to determine the Covid-19 pandemic’s impact on delayed surgery due to longer waiting times in BC and TC patients.Methods: This research is a descriptive study. The data were collected from BC and TC patients who received surgery in the Surgical Oncology Department from April to June 2020 at Dr. Hasan Sadikin General Hospital. These data include the time of surgery, gender, age, stage of the disease, chemotherapy history, management, time from diagnosis until surgery, last time receiving neoadjuvant chemotherapy until surgery, and time of surgery on schedule.Results: Thirty-seven patients had undergone surgery; the stages of BC and TC patients were IIIB (66.6%) and II (50.0%), respectively. There were 31 BC patients (93.9%) who received neoadjuvant chemotherapy and underwent surgery, and total thyroidectomy with dissection was performed in 75% of TC patients. Operative procedures that were performed earlier than the schedule have been done in 20 (60.6%) and three patients (75.0%) for BC and TC patients, respectively, while 2 (0.6%) of BC patients were delayed in their management and no patient experienced a delay in management on TC.Conclusions: The management of BC and TC patients with various stages has received operation procedures faster than the previously determined schedule in the period from April to June 2020. These results also suggest a possible advantage for cancer patients requiring surgery, particularly patients with advanced BC who have received neoadjuvant chemotherapy. In certain conditions, it turns out that a pandemic may positively impact, especially in the management surgery of breast and thyroid cancer patients. However, limited time at the early start of the pandemic may change these conclusions.
, Cosphiadi Irawan
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.782

Abstract:
Cyclin D1 is a protein that plays a role in the transition from the G1 to S phase of the cell cycle. Cyclin D1 expression has been found to increase in various malignancies and, in many studies, was associated with tumor growth, stage, lymph node involvement, distant metastases, and poor prognosis. Until now, studies on the association of cyclin D1 expression level with chemotherapy response have shown different results. An in-depth understanding of the cell cycle will allow doctors to develop target therapies that work when specific interventions are carried out at certain stages. Some studies reported that cyclin D1 expression was inversely related to chemotherapy response, while others showed opposite results. A significant number of studies have attempted to elucidate this ambiguous effect of cyclin D1. The suggested mechanism involves the difference of cancer cell types, the effect of chromosome instability in a few malignancies, trigger to an excessive DNA repair protein expression stimulus, and the response to DNA damage severity. The ambiguous effect of cyclin D1 towards chemotherapy was thought to arise from the difference in tumor type, chemotherapy agents used, and cell damage severity caused by cytostatics as per different research works. More in-depth research with parallel evaluation of other possible mechanisms such as DNA repair should elucidate the reason behind the inconsistent findings.
Mutiara Adelina, Fifi Dwijayanti
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.823

Abstract:
Infectious diseases are one of the biggest threats to humans. Currently, the world is in the outbreak condition causes of the COVID-19 virus which is started from Wuhan, China in December 2019. This disease was spread out rapidly throughout the World and was announced as a pandemic by the World Health Organization (WHO) on March 11, 2020(1). The infected number of SARS-CoV-2 was over 84 million people and caused over 1 million death cases in the worldwide. Indonesia had more than 800.000 infectious cases and 23.000 of death cases with the highest cases in Jakarta (2). This virus can be transmitted by two ways, such as direct contact (cough, sneeze, and droplet inhalation) and contact transmission (contact with oral, nasal, and eye mucous membranes) of person with COVID-19 (3). The current COVID-19 pandemic makes various challenges in prevention and control of infections in hospitals. Health care workers (HCWs) have been providing care to suspected, probable or confirmed COVID-19 patients that make them in high-risk condition. Several study indicated that many HCWs have been infected with SARS-CoV-2 in many hospitals worldwide (4)(5)(6).
Felais Hediyanto Pradana, Achmad Fauzi Kamal
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.793

Abstract:
Introduction: Schwannoma is a benign, encapsulated, tumor that arises from Schwann cells of myelinated nerves. In this report, we present a case of schwannoma in a hemophilic patient and its surgical considerations related to bleeding complications. Case Presentation: We present a case of a 27-year-old male coming to our center with a chief complaint of a painless, non-progressive growing mass on the back of his head since a year prior to admission. Physical examination showed that the mass was mobile, firm, and had a welldefined margin beneath the scalp. His radiograph showed a soft tissue mass beneath the scalp. MRI demonstrated a dense-multilobulated mass without intracranial infiltration. The patient had hemophilia A from the age of 5. We performed marginal excision of the mass with regiments of factor VIII (FVIII) concentrates preoperatively, intraoperatively, and postoperatively. Pathology was consistent with schwannoma.Conclusions: Schwannoma management in hemophilic patients needs several considerations. Perioperative planning plays a major part in the management of patients with tumors and hemophilia to prevent bleeding complications.
Mugi Wahidin, Rini Febrianti
Indonesian Journal of Cancer, Volume 15; doi:10.33371/ijoc.v15i1.783

Abstract:
Background: Human Papilloma Virus (HPV) is the leading risk factor of cervical cancer. World Health Organization (WHO) has recommended including HPV vaccination in national immunization programs in all countries. Specifically, Jakarta Province has been implementing HPV vaccination since 2016. In this case, several factors influence vaccination coverage. However, there is limited evidence about determinants associated with HPV vaccination. Therefore, this study aimed to investigate the factors associated with HPV vaccination among elementary students in Central Jakarta.Methods: This was a cross-sectional study conducted from March until June 2020. The study population involved 167 female students of the 6th level of the elementary school in Central Jakarta. There were eight elementary schools in Kemayoran and Cempaka Putih Sub Districts selected purposively. Primary data was collected employing an online questionnaire, which was fulfilled by respondents (mothers and students). Data were analyzed utilizing statistic software for descriptive and bivariate analysis. For the bivariate analysis, Chi-Square Test was performed.Results: The HPV vaccination coverage was 80.84%. It was also showed that the last education level of the respondents’ father and mother was mainly senior high school (SMA) for 50.3% and 47.9%, respectively. The mothers’ knowledge was mainly in the middle (56.9%), and they had a positive attitude/support (67.1%). There were only 2.4% of the respondents with a family history of cervical cancer. In terms of family economic status, the main part of respondents had low expenditure for 2-3 million IDR (59.3%) a month. Meanwhile, human resources (vaccination providers) and HPV vaccine were 100% available in the vaccination service. Of the respondent, 47.9% of those said that the vaccine price was affordable. Children who had no support to get HPV vaccination from their father, mother, and siblings were 14.4%, 6.6%, and 21.6%, respectively. Besides, children who were not supported by their teachers was 3.6% and not supported by their peers was 23.4%. Meanwhile, father and mother’s supports were significantly associated with HPV vaccination.Conclusions: Factors associated with HPV vaccination were the support from the father and mother.
Tonny Loho, Agus Rizal A. H. Hamid, Rainy Umbas, Na'Imatul Mahanani
Indonesian Journal of Cancer, Volume 14; doi:10.33371/ijoc.v14i4.759

Abstract:
Background: Fluoroquinolone has been routinely given as a prophylactic antibiotic to patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy. Currently, there is no data on the profile of fluoroquinolone-resistant bacteria, its association with post-biopsy sepsis, and alternative prophylactic antibiotics.Methods: A cross-sectional study was conducted in patients undergoing TRUS-guided prostate biopsy at Urology Clinic, Cipto Mangunkusumo National Central General Hospital between August and December 2015. Specimens were taken from rectal swabs prior to biopsy. Gramnegative bacilli and Gram-positive cocci were characterized on the Vitek®2 using GN and GP cards (BioMérieux, USA). Antimicrobial susceptibility testing was done by Kirby Bauer disc diffusion method. Post-biopsy infection was monitored within one week after biopsy by telephone call and diagnosed by clinical examination.Results: A total of 52 patients aged 52-80 years were enrolled. Sixty-six isolates grew from 52 swabs; 14 swabs among them grew 2 isolates. The commonest pathogen was Escherichia coli (78.8%), followed by Klebsiella pneumoniae (13.6%), Enterococcus faecium (3.0%), Acinetobacter haemolyticus, Morganella morganii subsp. morganii, and Enterococcus faecalis (1.5%), respectively. Ciprofloxacin-resistant bacteria were found in 33 (50.0%) isolates which were predominated by E. coli. Meanwhile, 90.4% and 96.2% of isolates were sensitive to amoxicillinclavulanate and ampicillin-sulbactam, respectively. Post-biopsy infection was established in 7 patients requiring no hospitalization.Conclusions: The proportion of ciprofloxacin-resistant bacteria in the rectum among patients undergoing prostate biopsy was 50.0%. Escherichia coli is the commonest resistant pathogen to fluoroquinolone. The recommended alternatives for prophylactic antibiotics are amoxicillinclavulanate and ampicillin-sulbactam. Routine pre-biopsy rectal swab cultures should also be encouraged.
Indah Jamtani, Adianto Nugroho, Syamsu Hudaya, Rofi Y. Saunar, Aditomo Widarso, Taslim Poniman
Indonesian Journal of Cancer, Volume 14; doi:10.33371/ijoc.v14i4.770

Abstract:
Introduction: Resection of renal cell carcinoma liver metastases (RCCLM) is known to provide a good survival outcome. Simultaneous RCCLM resection with the primary tumor is commonly done in cases with direct extension of locally advanced RCC to liver parenchyma. Cases of safe simultaneous resection of liver and kidney in malignancy have not been reported before in Indonesia. Case Presentation: We aim to describe two cases of left-sided RCC with right-sided RCCLM who underwent simultaneous kidney and liver resection. Both patients had good short-term survival with no intra-operative and post-operative complications.Conclusion: Although simultaneous kidney and liver resection poses challenges of substantial morbidity, a safe surgical and multidisciplinary approach could be implemented in selected cases with a good surgical outcome.
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