Indonesian Journal of Cancer

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ISSN / EISSN : 1978-3744 / 2355-6811
Total articles ≅ 106
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Harisa Mardiah, Radita Nur Anggaeni Ginting, Heru Rahmadhany, Esther Reny Deswani Sitorus
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.708

Abstract:
Background: Breast cancer is influenced by various risk factors, including age and obesity. Older women who are overweighted and obese have a higher risk of developing breast cancer. This study aims to find the correlation between age and body mass index (BMI) with histopathological features of breast cancer patients in RSUP Haji Adam Malik Medan.Methods: This research is an analytical study using a cross-sectional design with 103 samples obtained from medical record data by random sampling. The data obtained were then adjusted to the research criteria and grouped based on predetermined variables.Results: The majority of the age group was 41-50 years (36.9%), obesity BMI (40.8%), histopathological subtype of invasive carcinoma of no special type (NST) (85.4%), and grade II (46.6%). Kruskal-Wallis test result between histopathological subtypes and breast cancer grading based on age, respectively, obtained p=0.503, r=.325; (α>0.05), and p=0.207, r=0.393; (α>0.05), while based on BMI obtained p=0.017, r=0.021; (α<0.05), and p=0.018, r=0.018; (α<0.05). The OR value (95% CI) obtained on overweight-obese BMI with invasive carcinoma NST subtype was 7.63 (7.27–14.90) and other subtypes were 2.40 (1.14–13.75), and for grades II and III, they were respectively 3.57 (1.32–8.09) and 3.27 (1.17–9.91).Conclusions: There was a correlation between BMI with histopathological subtypes and breast cancer grading, but the correlation tended to be weak. Whereas, with age, there was no correlation. BMI overweight-obese were more likely to have invasive carcinoma NST subtype and higher-grade of breast cancer.
Steven Octavianus, Henry Kodrat
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.784

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Introduction: Salivary gland cancer is an uncommon malignancy in the head and neck. The most common histopathologic type in salivary gland malignancies is mucoepidermoid carcinoma (MEC). Radiotherapy has a role in salivary gland malignancy, especially in inoperable cases and postoperative settings. Definitive or postoperative radiotherapy with or without chemotherapy can improve locoregional control (LRC) in patients with parotid mucoepidermoid carcinoma. Case Presentation: We report a case of a 77-year-old male with inoperable MEC of the right parotid, who received definitive radiotherapy. From the three-month evaluation after radiation therapy, we found a significant reduction in the tumor mass. Conclusions: Surgery remains the treatment of choice for patients with salivary gland malignancies. Definitive radiotherapy can be a treatment modality in inoperable cases or patients who refuse surgery. Although the result is not satisfactory, radiotherapy can still give clinical benefits to patients.
Fauzatun Hadiyati, Ratna Supriastuti, Arifah Mujiharti
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.768

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Background: Cancer patients that are hospitalized often have problems with their nutrient intake. Low nutrient intake can be affected by malnutrition. In cancer patients, the intake of nutrients needs to be considered specifically in relation to the occurrence of metabolic changes that lead to decreased nutritional status. The objective of this study is to analyze the effect of dietary modification and nutritional education on nutrition care process (NCP) for increasing dietary intake, body weight, and nutritional status of malnourished cancer patients and cancer patients at risk of malnutrition.Methods: The study was a quasi-experiment with one-group pretest-posttest design. The population consisted of all new adult hospitalized cancer patients. The data were collected from July to September 2019. The statistical analysis used paired sample t-test. Dietary modification and nutritional education were given individually based on each nutrition problem of the patient and their nutritional needs.Results: There were 83 patients involved for the study. Most of the patients were female (61.4%), aged over 45 years (62.7%), graduated from high school (47%), were housewives (49.4%), and had clinical histories of no comorbidities (90.4%). Most of them had improvement in general condition (74.7%). The study showed significantly increasing dietary intake of energy (889.7 calorie), protein (36.4 gr), fat (49.3 gr), and carbohydrate (131.4 gr) (p = 0.000). The increasing percentage of nutrient intake to nutritional needs before and after intervention of NCP was 39.8 to 88.6% for energy, 44.4 to 104% for protein, 51 to 120% for fat, and 41.5 to 90.1% for carbohydrate. The average increase (but not significant related correlation) in body weight was 0.16 kg (p = 0.141) and body mass index 0.05 kg/m2 (p = 1.94). Conclusions: Dietary modification and nutritional education on NCP improve dietary intakes (energy, protein, fat, and carbohydrate) of cancer patients at risk of malnutrition and being malnourished.
Brahmana Askandar, Andika Adi Saputra
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.757

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Background: Endometrial cancer is the sixth most common malignancy incidence in women worldwide. The surgical staging in endometrial cancer management such as bilateral salpingooophorectomy and lymphadenectomy is not a routine procedure for all endometrial cancer patients. Therefore, a biomarker to estimate the presence of endometrial cancer metastases to adnexa and lymph nodes is needed. This study aims to find out the level of cancer antigen 125 (CA-125) in endometrial cancer endometrioid type and the relationship between the level of CA-125 and the incidence of adnexal metastases, lymph node metastases, clinical stage, and myometrial invasion.Methods: This observational analytic study used a direct observational design. The in-vitro quantitative examination was performed to measure CA-125 levels using CA-125 Advia Centaur CA-125 Kit. Fischer exact test used to analyzed CA-125 levels with the subject characteristics. All the statistical analyses were performed using SPSS v. 21.0.Results: Of the 30 research subjects with the characteristics of the most age groups of 51–60 years (60%), with the most multiparous parity (73.3%), grade III (43.3%), myometrial invasion > 50% by 66.7%, early-stage (63.3%), the incidence of adnexal metastases (30%), and the incidence of lymph node (LN) metastases (10%), a significant relationship between CA-125 levels and lymph node (LN) metastases was found with a p = 0.041 and the phi association of 0.016 and between CA-125 levels and adnexal metastases with a p = 0.035 and the phi association of 0.026. There was also a significant relationship between CA-125 levels and the clinical stage (advanced stage) with p = 0.004 and the phi association of 0.002. There is no significant relationship with a p = 0.702 and a phi association value of -0.098.Conclusions: CA-125 can be used as a tumor marker to predict the presence of extrauterine metastases (adnexa & lymph nodes).
Desak Putu Gayatri Saraswati Seputra, I Gusti Ayu Sri Mahendra Dewi
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.772

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Introduction: Thymoma is a neoplasm of the thymus gland which arises from the epithelial tissue. Thymoma is frequently related to various paraneoplastic syndromes, most commonly myasthenia gravis. Up to 50% of patients with thymoma are reported to develop myasthenia gravis, whereas 10–15% of patients with myasthenia gravis are found to have thymoma. Case Presentation: This case series reported 3 patients with myasthenia gravis which co-occurred with thymoma at Sanglah General Hospital from 2018 to 2019. The patients’ ages range from 33 to 61 years (mean age 46 ± 11 years) with a 2:1 male-to-female ratio. The diagnosis of myasthenia gravis was made by the presentation of typical myasthenia gravis appearances, the fluctuating intensity of ocular and bulbar muscle weakness (all three cases), and limbs and axial muscle weakness (one case); no respiratory muscle involvement was found. Physical and supporting examinations including electroneuromyography results were coherent with myasthenia gravis. The diagnosis of thymoma was made by highly suggestive appearance in Thorax Multi Sliced Computed Tomography (MSCT) scan examination and histopathologic findings. MSCT scan examination showed a well-circumscribed ovoid solid mass in the mediastinum (left anterosuperior, superior, and anterior to middle right mediastinum) sized from 1.8x1.5x2.9 cm to 8.1x9.9x9.7 cm, enhanced with contrast injection with areas of calcification and central necrotic (1 case) and no dissemination to regional lymph node and neighboring organs. All cases received acetylcholinesterase inhibitors and underwent extended thymectomy. Histopathological examination showed accordance with thymoma features of subtype A, AB, and B1.Conclusions: Clinicians should be aware of the thymoma and myasthenia gravis co-existence possibility to ensure early recognition and appropriate management.
Dery Wahyudi, Sari Eka Pratiwi
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.722

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Background: Pancreatic cancer has a poor prognosis, and the symptoms are difficult to be detected early in the early stages. Indonesia Statistics on 2004–2007 states that pancreatic cancer is not included in the 10 cancers with the highest incidence. In West Kalimantan. There are no published data related to pancreatic cancer cases. This is the reason for the researchers because this data is sufficiently needed to support other studies related to pancreatic cancer.Methods: Epidemiological studies were conducted in the form of data collection at Dr. Soedarso Hospital Pontianak. Data were retrieved from cases of pancreatic cancer regression in annual Morbidity Data of Pancreatic Cancer Patients in Dr. Soedarso Hospital Pontianak from 2018 until 2009 consisting of the frequency of new cases and deaths, as well as demographic data such as age and gender of patients. Data were processed using Microsoft Excel.Results: A total of 79 cases and 9 deaths caused by pancreatic cancer were recorded in Dr. Soedarso Hospital Pontianak from January 2009 to December 2018. The highest incidence rates occurred in 2014 with 17 out of 79 cases (21.5%). As many as 63.3% of pancreatic cancer cases are dominated by men. Most cases of pancreatic cancer in patients with the age range of 45-64 years (67.1%) and the average age is 53.8 years.Conclusions: Incidence of pancreatic cancer in Dr. Soedarso Hospital Pontianak each year of 7.9 cases. Men and elderly people dominate cases of pancreatic cancer. Further study of the clinical characteristics and analysis of risk factors in patients with pancreatic cancer needs to be done to support preventive strategy development.
Etty Hary Kusumastuti, Nurdhani Hi Djafar, Alphania Rahniayu
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.771

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Background: Papillary thyroid carcinoma (PTC) that has metastasized has a higher risk because of the poor prognosis, ranging from decreased quality of life of the patient to death. There is a need for markers that can understand the image of the tumor so that it can predict earlier the level of aggressiveness and the ability of tumor cells to metastasize. Tumor cells that proliferate excessively will cause CXCR4 expression. Activation of CXCR4 will increase MMP-9 via the MAPK/ ERK line. MMP-9 will degrade the extracellular matrix causing tumor cell metastasis. This study is aimed to analyze the correlation of CXCR4 and MMP-9 expressions with lymph node metastasis (LNM) in PTC.Methods: This cross-sectional analytic observational study was conducted in 43 PTC samples taken from the Anatomical Pathology Laboratory of Dr. Soetomo Hospital from January 2011 to December 2018. The samples were divided into 2 groups based on the regional cervical LNM status. Immunohistochemical staining was used to assess the expression of CXCR4 and MMP-9. Spearman test was used to analyze the correlation of CXCR4 and MMP expression with cervical LNM status.Results: The expression of CXCR4 and MMP-9 was higher in the papillary thyroid carcinoma group with cervical regional LNM (p = 0.007 and p = 0.030). There was a significant positive relationship between CXCR4 and MMP-9 expressions with regional LNM status with rs = 0.468 and p = 0.001 (p < 0.05). Conclusions: Expression of CXCR4 and MMP-9 was proven to correlate with regional cervical LNM status in papillary thyroid carcinoma. Both can be used as predictive markers for metastasis in papillary thyroid carcinoma.
Bagus Gilang Samudra, Aria Danurdoro, Danarto Danarto
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.789

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Background: Renal cell carcinoma (RCC) is one of the most common malignancies in the kidney and causes a mortality rate of more than 100,000 each year globally. The neutrophil-lymphocyte ratio (NLR) is one of the markers in the inflammatory response that also correlate with the alteration of any cancer cells. We investigated the correlation between the NLR on tumor stage, Fuhrman nuclear grade, length of stay (LOS), mortality, and recurrence rate in renal cell carcinoma.Methods: We investigated 52 patients with renal cell carcinoma retrospectively from the databases of the patients who underwent radical and partial nephrectomy in Sardjito Hospital Yogyakarta between 2012 and 2017. Patients were classified as lower stage (T1-T2) and higher stage (T3-T4). We also classified it as a group of Fuhrman nuclear grade (G1, G2, G3, and G4). Two sample t-test or one-way ANOVA was used for the continuous variables and a chi-square test or Fisher’s exact test for the categorical variables. Pearson test was used to do the correlation test.Results: Among a total of 52 patients analyzed in our study, there were 36 males (69%) and 16 females (31%). A normal distribution of datasets was verified. The mean of preoperative NLR in these 52 patients was 6.35 (+4.01), with a range of 1.48 - 21.0. The value of NLR was positively correlated with tumor pathologic stage (p = 0.020), length of stay of the patients (p = 0.00), and the mortality rate (p = 0.012). Neutrophil lymphocyte ratio was not significantly correlated with Fuhrman tumor grade (p = 0.357) and tumor recurrence (p = 0.670).Conclusions: We compared the relationship of preoperative NLR with renal cell carcinoma tumor stage (T), Fuhrman grade, length of stay, mortality, and tumor recurrence. NLR was found to have a statistically significant higher T stage, mortality, and length of stay of the patients. Further studies with more patients are needed to confirm our study.
Cindy Angelina Limantara, Ario Djatmiko
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.766

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Background: The quality of life (QoL) of breast cancer (BCa) patients is an outcome of therapy that is often overlooked. In real life, postoperative breast cancer patients experience deep trauma in view that breasts are a symbol of femininity, which are very valuable for any female. This study aims to compare the QoL in patients who received mastectomy only and mastectomy with reconstruction.Methods: A retrospective comparative study of 25 post-mastectomy to 25 post-mastectomy with reconstruction BCa patients in Onkologi Surabaya Hospital. The subjects are patients who visited between July 2019 until March 2020, as many as 50 samples in accord with the inclusion and exclusion criteria. The assessment was performed using 3 instruments, including the hospital anxiety and depression scale (HADS), body image scale (BIS), and female sexual function index (FSFI). The collected data were analyzed using SPSS 15.0 for Windows.Results: A significant difference in mean values was seen in body image and sexual function. Post-mastectomy BCa patients presented more body image disturbance (p < 0.05). Better sexual function is claimed by post-mastectomy with reconstruction BCa patients in Onkologi Surabaya Hospital (p < 0.05). Meanwhile, the depression and anxiety values did not differ significantly in both groups (p > 0.05).Conclusions: Patients who underwent mastectomy and breast reconstruction have a better QoL in comparison with patients who received mastectomy only, in the domains of body image and sexuality function.
Iin Kurnia Hasan Basri
Indonesian Journal of Cancer, Volume 15; https://doi.org/10.33371/ijoc.v15i2.764

Abstract:
Thyroid cancer is one of the most common endocrine malignancies. Although the 10-year survival rate of differentiated thyroid cancer (DTC) is about 90% after conventional treatments, a small proportion of patients still suffer from tumor recurrence or drug resistance. DNA doublestrand breaks (DSBs) are important cellular lesions that can result from ionizing radiation exposure. The biomarker for DSB formation is the phosphorylated form of the histone H2 variant H2AX (γ-H2AX). We propose the use of γ-H2AX as a DNA DSB biomarker in thyroid cancer patients receiving radioiodine treatment as a possibility to detect the potential of instability genome after receiving the treatment. Evaluating DNA DSB damage with γ-H2AX biomarker might be important in managing thyroid cancer.
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