Indonesian Journal of Cancer

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ISSN / EISSN : 19783744 / 23556811
Total articles ≅ 57
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Jonathan Kevin, Renate Parlene Marsaulina, Alberta J Jesslyn Gunardi, Irena Sakura Rini
Indonesian Journal of Cancer, Volume 13, pp 133-136; doi:10.33371/ijoc.v13i4.664

Abstract:Introduction: Neglected basal cell carcinoma (BCC) of the nose can grow into giant BCCs, rare cases with extensive nasal defects. Such large defects would require complex reconstruction such as free flaps or multiple local flaps. Lateral forehead flap may provide a simpler alternative with good functional and cosmetic results.Case Presentation: We present a case of a 76-year-old man with neglected giant BCC of nose extending to right lower eyelid and upper lip. Wide excision of the tumor leaves a 12cm x 10cm defect. Reconstruction was performed using lateral forehead flap and donor site was covered with split-thickness skin graft from thigh. The second surgery was done after four months to create nostrils and wider eye-opening. Six months later, flap was viable and there was no sign of recurrence. Nasal reconstruction is planned to further improve cosmetics. In this case, neglect is due to low social-economic status and adaptation to painless tumors. The use of lateral forehead flap allows for simpler and faster surgery suitable for elderly. Delayed reconstruction was needed to ensure optimal tissue healing. Conclusions: Neglected BCC causes disfigurement with remarkable morbidity, requiring complex reconstruction. The lateral forehead flap is a simple and reliable reconstruction method for extensive nasal defects with good functional and cosmetic outcomes.
Venansius Herry Perdana Suryanta, Muhammad Naseh Sajadi Budi
Indonesian Journal of Cancer, Volume 13, pp 137-139; doi:10.33371/ijoc.v13i4.665

Abstract:Introduction: Limb salvage surgery involves all of the surgical methods to achieve the eradication of a malignant neoplasm and restoration of the limb with a satisfactory oncologic, functional, and cosmetic outcome. Rates of local recurrence are 4% to 10%. There is a chance of local recurrence from the contamination of biopsy path. Neoadjuvant chemotherapy has a guarding effect on managing neoplasm infiltration at the biopsy location.Case Presentation: An 18 year old male experienced a new painless lump at his right anterior thigh with size about 5 cm in diameter since 5 months ago. Previously, he underwent limb salvage surgery with megaprosthesis about 6 months ago due to osteosarcoma at his right distal femur. He also got neoadjuvant and adjuvant chemotherapy for 6 cycles. Mass removal was done and 1.5 cm mass in diameter was found within quadriceps muscle with a soft consistency and well-defined border from the previous biopsy site that had not been resected. The specimen result was osteosarcoma surrounded by tumor-free tissue. Postoperatively, he still had the same range of motion function as before.Conclusions: We need to consider the previously contaminated biopsy path that could lead to local recurrence. Factors that affect the prediction of the recurrent disease are the disease-free time period, location of recurrence and histological response to therapy and the capability to achieve total surgical removal. Tumor removal followed by the local radiation and chemotherapy is the preferred treatment for recurrence.
Tjandra Kristiana, I Gusti Ayu Sri Mahendra Dewi, Luh Putu Iin Indrayani Maker, Herman Saputra, Ni Putu Sriwidyani, I Made Muliarta
Indonesian Journal of Cancer, Volume 13, pp 127-132; doi:10.33371/ijoc.v13i4.680

Abstract:Background: Prostate cancer is the second most common malignancy in men and the fifth most common cause of death worldwide. In Asia, 59.3% of patients come for the advanced stage treatment. PTEN inactivation is identified in about 20% of primary prostate tumors in radical prostatectomy and the loss of PTEN is associated with poor clinical and pathological outcomes. The purpose of this study is to prove that there is an association between PTEN expression and risk grade group Gleason prostate adenocarcinoma in Sanglah Public Hospital, Denpasar.Methods: This is a cross-sectional study. The sample size of this study was 35 paraffin blocks. These samples were selected by proportional stratified random sampling from hematoxylin-eosin preparation. Prostate adenocarcinoma was regrouped into 3 categories based on NCCN risk stratification: low risk grade group Gleason (Gleason score ≤ 6), intermediate risk grade group Gleason (Gleason score 7), and high-risk grade group Gleason (Gleason score 8–10). Immunohistochemistry examination of PTEN was performed and the expression was evaluated by scoring method. The data were analyzed by Chi-square and logistic regression.Results: The analysis result showed that there is an association between PTEN expression and risk grade group Gleason that is statistically significant. The loss of PTEN expression associated with higher risk grade group Gleason is of the higher proportion with p=0.001; PR 3.339; 95% CI: 1.296–8.599, but there is no association between the proportion loss of PTEN expression heterogeneously or homogeneously and the risk grade group Gleason with p=0.742; PR 0.663; 95% CI: 0.179–2.457.Conclusions: This study has proved that PTEN expression is associated with higher risk grade group Gleason prostate adenocarcinoma.
Mururul Aisyi, Ayu Hutami Syarif, Anita Meisita, Agus Kosasih, Achmad Basuki, Resti Mulya Sari
Indonesian Journal of Cancer, Volume 13, pp 140-143; doi:10.33371/ijoc.v13i4.675

Abstract:Introduction: Chronic Myeloid Leukemia is a hematological malignancy driving from myeloproliferative process. It is typified by the presence of the Philadelphia chromosome manifesting in certain distinct complications, including pathological fracture. Pathological fracture is recognized as an extramedullary disease that occurs as a result of transformation of CML into blast crisis phase.Case Presentation: Here, we report a case of pediatric male CML. After being failed with imatinib therapy, he turned to nilotinib and was unable to achieve a major molecular response. He presented with high blast count and pain in the left arm. He was diagnosed with pathological fracture and blast crisis phase CML. Taken the young age and displacement of fracture into consideration, he was conservatively treated by a combination of immobilization and a higher dose of targeted therapy, nilotinib. The 2-month evaluation revealed clinical union and reduction of blast cells.Conclusions: Regarding the minimal displacement and age presentation, pathological fracture in pediatric CML requires non-invasive treatment and optimization of antileukemic therapy.
Aisyiah Rahmi Putri, Siti Khaerunnisa, Indra Yuliati
Indonesian Journal of Cancer, Volume 13, pp 104-109; doi:10.33371/ijoc.v13i4.610

Abstract:Background: Cervical cancer ranks fourth of all cancers in women worldwide and linked to human papillomavirus (HPV) infection. Despite the evidence of methods for cervical cancer prevention, such as pap smear test and HPV vaccination, most of the women remain unscreened and never get HPV vaccination. Most cervical cancer cases are not diagnosed early enough, leading to poor outcomes. This study aims to examine the association of risk factors with cervical cancer incidence in Dr. Soetomo Hospital Surabaya and also records the patients’ knowledge of cervical cancer preventions, history of HPV vaccination, and pap smear screening test.Methods: This is a case-control study. Questionnaires were given to 60 newly diagnosed cervical cancer patients and 60 non-cervical cancer patients at The Gynecologic-Oncology Clinic of Dr. Soetomo Hospital Surabaya in the period of March 2016 until August 2016. The analysis was made using bivariate and multivariate logistic regression analysis.Results: The bivariate logistic regression analysis confirmed that parity more than two times (p=0.001), history of birth control pills consumption more than 10 years (p=0.04), passive smoking (p=0.001) and not knowing that cervical cancer can be prevented (p=0.001) were significantly associated to the incidence of cervical cancer. The multivariate logistic regression analysis confirmed that not knowing that cervical cancer can be prevented (OR=6.85), the history of passive smoking (OR=4.04), parity more than two times (OR=2.89) and history of birth control pills consumption more than 10 years (OR=6.52) were the independent factors that were associated with the cervical cancer incidence.Conclusions: Parity more than two times, history of birth control pills consumption more than 10 years, history of passive smoking, not knowing that cervical cancer can be prevented and never having a pap smear test were the factors associated with cervical cancer incidence.
Yesiana Dwi Wahyu Werdani
Indonesian Journal of Cancer, Volume 13, pp 110-115; doi:10.33371/ijoc.v13i4.654

Abstract:Background: Cancer and its therapeutic management trigger the multiorgans physical disorders, that can cause the patient to worry and become anxious about the condition. Three acupoints of acupressure therapy stimulates relaxation of the body and can reduce anxiety. The purpose was to determine the influence of three acupoints of acupressure therapy to improve the anxiety level in cancer patients based on types of cancer therapy.Methods: This was an interventional study using pre-experiment pre-test post-test design. Samples were 30 cancer patients living at the Indonesian Cancer Foundation East Java Branch Surabaya Indonesia, taken by purposive technique sampling based on inclusion criteria. The instrument was Beck Anxiety Inventory that it was valid and reliable based on the test. Ethical feasibility tests has been carried out. Acupressure therapy is given on acupoint St36, Li4 and Li11. It conducted 2 times per week for 4 weeks. Wilcoxon Signed Rank Test was applied to analyze this result with p < 0.05.Results: There was a significant effect of acupressure for improving anxiety levels in both groups with p value in the chemotherapy group 0.001 and in the chemoradiotherapy group 0.002. But a greater influence occurred in the chemotherapy group compared to chemoradiotherapy group.Conclusions: Acupressure therapy in three acupoints can stimulate relaxation condition, it can decrease the anxiety level for cancer patients with all types of cancer therapy.
Moamar Andar Roamare Siregar, Chaidir Arif Mochtar, Rainy Umbas, Agus Rizal Hamid
Indonesian Journal of Cancer, Volume 13, pp 116-126; doi:10.33371/ijoc.v13i4.658

Abstract:Background: The number of men with benign prostate hyperplasia undergoing transurethral resection of prostate (TURP) with the subsequent development of prostate cancer has been increasing. This study aimed to compare the surgical, oncological, and functional outcomes of robotic and laparoscopic radical prostatectomy techniques in patients with the history of TURP.Methods: Literature search of electronic databases was performed through Pubmed, Science Direct, SCOPUS, and CENTRAL databases. Cochrane Risk of Bias Tool was then employed to assess the risk of bias in each study. Grey literature was also searched from sources such as Cancer Care Ontario and conference abstracts. Critical appraisals of included studies were conducted using the Newcastle-Ottawa Scale.Results: The searches located 1258 citations, but only 11 studies were included in the final selection. Most studies had a good methodological quality based on the Ottawa Scale. The mean age of samples was varied among each study from 61.8 to 70.8 years. The TURP history significantly affects biochemical recurrences (OR 2.29, 95% CI 1.14–4.59), intraoperative blood loss (MD 57 ml; 95% CI 6–108 m), prolonged operative duration (MD 20 minutes; 95% CI 3–37 minutes), and surgical complications (OR 2.54, 95% CI 1.79–3.60) following radical prostatectomy for prostate cancer. In the subgroup analysis, only prolonged operative duration and surgical complications were significant both in laparoscopic and robotic radical prostatectomy. There was no association between the TURP history and the positive surgical margin rate in total and subgroup analyses. Conclusions: The previous TURP history affects the outcomes of patients who underwent radical prostatectomy, either laparoscopic or robotic.
Syamsu Hudaya, Adianti Khadijah
Indonesian Journal of Cancer, Volume 13, pp 86-90; doi:10.33371/ijoc.v13i3.659

Abstract:Background: Bleomycin, etoposide, and cisplatin (BEP) is a standard first-line therapy for metastatic germ cell tumor (GCT), while paclitaxel, ifosfamide, and cisplatin (TIP) are commonly used as salvage therapy after failed BEP treatment. The unavailability of first-line drugs can be the reason for the use of second-line therapy. In this paper, we reviewed two initial cases of patients with metastatic GCT treated with TIP as first-line chemotherapy in our center.Case Presentation: We reviewed the medical record and followed up two patients who had been treated with TIP as first-line chemotherapy for metastatic GCT due to lack of BEP regiment. We evaluated efficacy and toxicity of this treatment. These two patients were diagnosed with seminoma, with intermediate-risk according to International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Both achieved complete response after four courses of TIP chemotherapy with toxicities mainly consisted of myelosuppression.Conclusions: TIP demonstrated efficacy serves as the first-line therapy for germ cell tumors with an acceptable safety profile. Further studies with larger subjects are still needed for evaluation. However, TIP is more expensive compared to BEP, making BEP is still superior to TIP in public hospital setting where cost-effectiveness of treatment is important.
Widiyono Widiyono, Sri Setiyarini, Christantie Effendy
Indonesian Journal of Cancer, Volume 13, pp 59-68; doi:10.33371/ijoc.v13i3.632

Abstract:Background: Depression is a psychological distress that often occurs on cancer patients. Depression can increase patient perception about pain, resulting reduced drug efficacy and longer length of stay. Drug treatment for depression sometimes has side effects. Another intervention to decrease depression on cancer patients is music therapy. Music therapy might avoid polypharmacy in cancer patients. The purpose of this study was to determine the effects of self-selected individual music therapy toward depression of cancer patients.Methods: The method used in this study was the randomized control trial (RCT). Simple Random Sampling was assigned randomly by three researcher assistants to participants (N=70) of intervention and control group. The intervention used was self-selected individual music therapy (SeLIMuT). SeLIMuT was applied four times in 2 days with a duration of 15 minutes each session. Beck Depression Inventory (BDI) was employed for selection purposes. The data were analyzed using Mann-Whitney with p < 0.05 and 95% CI. The effectiveness of therapy was analyzed by the effect size test using abs r.Results: Based on the result of the bivariate analysis, there was an effect of giving self-selected individual music therapy to reduce depression with depression gap in both groups with p-value of 0.001 (p < 0.05). The value of the effect test obtained abs r = 0.82 (r > 0.5). At the end, the self-selected individual music therapy had moderate effect toward depression of cancer patients.Conclusions: Music therapy is safe, inexpensive, and easy to use, for and by patients. The nurse can safely recommend any of these interventions for depression on cancer patients. Specific selections or types of music may have different effects on different patients and may provide different effects at different time, so the use of self-selected individual music therapy is recommended.
Rendy Cahya Soetanto, Muhammad Naseh Budi, Darmadji Ismono
Indonesian Journal of Cancer, Volume 13, pp 91-95; doi:10.33371/ijoc.v13i3.663

Abstract:Background: Pelvic chondrosarcoma may be difficult to manage due to its proximities with vital structures. The study aimed to explain an alternative surgical technique for acetabular reconstruction.Case Presentation: We present a case of a 48-year-old female with large chondrosarcoma of the superior and inferior pubic rami with medial acetabular wall involvement. Pelvic type 3 resection was performed. There was a defect at medial acetabulum after resection. The defect was covered by autograft from iliac and fixation using screws. Rotational pelvic stability was maintained using a reconstruction plate. The functional outcome was assessed 6 months after operation using MSTS and the score was 30, which was painless, full weight bearing, normal gait, and no pain. Conclusions: Reconstruction of the pelvis after tumor resection requires a careful preoperative patient evaluation and extensive bone and soft tissue resection to achieve negative tumor margins and stable reconstruction of the osseous and soft tissue defects.