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"Studi analitik kohort untuk membuktikan peningkatan sensitivitas PNI preoperatif ditambah hemoglobin akan lebih tinggi diibandingkan PNI preoperatif dalam memprediksi kesintasan 1 tahun kanker ovarium tipe epitel yang dilakukan pembedahan (complete surgical staging atau optimal debulking) dilanjutkan kemoterapi menggunakan Carboplatin dan Paclitaxel di RSCM, RSP, RSF dan RS Dharmais pada Januari 2017 sampai Desember 2018. Hasil penelitian adalah dari 32 sampel didapatkan 6 sampel mengalami rekurensi dalam 1 tahun pasca pembedahan dan kemoterapi. Secara karakteristik didapatkan kanker ovarium terbanyak terjadi pada usia > 50 tahun (62,5 %), paritas 0 (46,87 %), dengan histopatologi tersering clear cell carcinoma (31,25 %), derajat diferensiasi terbanyak adalah derajat berat (56,25 %) dan stadium terbanyak adalah stadium I-II (56,25 %). Sensitivitas PNI penelitian ini lebih rendah dibandingkan penelitian sebelumnya dan penambahan hemoglobin penelitian ini tidak dapat digunakan untuk dapat meningkatkan sensitivitas. Tidak didapatkan hubungan yang bermakna antara PNI preoperatif, Hb preoperatif, PNI + Hb preoperatif dengan kesintasan 1 tahun kanker ovarium tipe epitel. Kesimpulan adalah penambahan hemoglobin pada PNI preoperatif tidak dapat digunakan untuk menentukan sensitivitas dalam memprediksi kesintasan 1 tahun kanker ovarium tipe epitel. Tidak terdapat hubungan bermakna antara PNI preoperatif, Hb preoperatif, PNI + Hb preoperatif dengan kesintasan 1 tahun kanker ovarium tipe epitel.

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An analytic cohort study to prove sensitivity of hemoglobin level added to PNI will be higher comparing to PNI only in predicting 1 year survival in epithelial ovarian cancer underwent surgery (complete surgical staging or optimal debulking) and chemotherapy (Carboplatin and Paclitaxel) at Cipto Mangunkusumo Hospital, Persahabatan Hospital, Fatmawati Hospital and Dharmais Cancer Hospital on January 2017 until December 2018. The result was from 32 samples, recurrences occurred in 6 samples within 1 year after surgery and chemotherapy. From characteristic finding we found epithelial ovarian cancer occurred mostly in age > 50 years old (62,5 %), parity 0 (46,87 %), histopathology clear cell carcinoma (31,25 %), poor differentiation (56,25 %) and I-II (56,25 %). Sensitivity of PNI is lower comparing to previous studies. Addition of hemoglobin level cannot be used to measure the sensitivity level. There was no statistical correlation between preoperative PNI, preoperative hemoglobin level, and PNI + Hb with the survival. The conclusion was addition of hemoglobin level to preoperatif PNI cannot be used to measure the sensitivity level in predicting epithelial ovarian cancer survival. There was no statistical correlation between preoperative PNI, preoperative hemoglobin level, and PNI + Hb with 1-year survival in epithelial ovarian cancer."

"Latar Belakang : Kanker ovarium merupakan penyebab kematian tertinggi pada kelompok kanker ginekologik dengan angka kekambuhan dua tahun sebesar 50%. Tujuan: mengetahui faktor yang berperan pada kekambuhan kanker ovarium. Metode : Penelitian ini menggunakan desain kohort retrospektif dengan teknik analisis kesintasan untuk melihat peran faktor ekspresi Human Epidermal Receptor (HER-2), residu tumor post operasi, jenis subtipe sel kanker dan tingkat diferensiasi sel kanker terhadap kekambuhan kanker ovarium epitelial. Analisis bivariat menggunakan metode log rank test digunakan untuk menilai hubungan antara 2 variabel. Hasil Penelitian : Sebanyak 65 pasien kanker ovarium epitelial (tahun 1998-2012) yang telah remisi diamati selama 24 bulan. Terlihat bahwa median usia 50 tahun dengan proporsi kekambuhan sebesar 36,9% pasien dan mean waktu kekambuhan pertama 19,15 bulan. Volume residu tumor post operasi berukuran lebih dari 1 cm meningkatkan Rasio Hazard kekambuhan dua tahun pasien kanker ovarium epitelial, nilai p: 0,02 dan HR 3,31 (IK95% 1,46-7,49) sementara jenis subtipe histologi dan tingkat diferensiasi sel kanker tidak berhubungan dengan terjadinya kekambuhan ini. Satu dari 38 pasien memperlihatkan adanya cytoplasmic staining pada pemeriksaan ekspresi HER-2 dengan metode imunohistokimia. Simpulan : Volume residu tumor post operasi yang berukuran lebih dari 1 cm meningkatkan Rasio Hazard kekambuhan dua tahun pasien kanker ovarium epitelial, sementara jenis subtipe histologi dan tingkat diferensiasi sel kanker tidak berperan pada kekambuhan ini. Pada pemeriksaan ekspresi HER-2, menggunakan teknik imunohistokimia dilaporkan 1 sampel memperlihatkan cytoplasmic staining.

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Background : Ovarian cancer was the leading cause of death in gynecologic cancer which had the two years recurrency rate of 50%.

Aim : to know factors that influenced on epithelial ovarian cancer recurrency.

Methods : We used retrospective cohort design with survival analysis technique for this study to examine the role of HER-2 expression, residual tumor post operation, cancer cell histological subtype and cancer cell grading on epithelial ovarian cancer recurrency. Bivariate analyze using log rank test methods were done to examine significance between two variables.

Results : Sixty-five epithelial ovarian cancer patient (1998-2012) who had achieved remission were observed for 24 months. We reported median age of 50 years with recurrency rate of 36.9% and mean time of recurrency was 19,15 months. Volume of post surgery residual tumor more than 1 cm increase Hazard Ratio of two years recurrency of epithelial ovarian cancer, p value 0.02 and HR of 3.31 (95% CI 1.46-7.49) but histology subtype and cancer cell grading did not influence the recurrency. One of 38 patients showed cytoplasmic staining in HER-2 expression examination by imunohistochemistry methods.

Conclusion : Volume of post surgery residual tumor more than 1 cm increase Hazard Ratio of two years recurrency of epithelial ovarian cancer while histology subtype and cancer cell grading did not influence the recurrency. One sample showed cytoplasmic staining on HER-2 examination by imunohistochemistry methods."

"Ovarian cancer is one of the largest cause of death in women. It is often refered to as the silent killer because the symtoms remain unseen to the patient. The number of ovarian cancer cases varies in each country. For example, the rate of ovarian cancer in counties such as Asia and Africa lower rather than in most industrialized countries like Europe and North America, Rate of Epithelial ovarian cancer in women ages 45-49 was 16.4 cases per 100,000 people. The risk of being diagnosed increases with age. The risk more than doubles in women 60 and over with 40 cases per 100,000, and the highest rate at 61 cases to 100,000 is in the age group of women 80-84. Currently, informaiion regarding ovarian cancer in Indonesia is limited, but Dharmais Cancer Hospital found about 30 new cases of ovarian caricer every year. The purpose of this study is to determine the probability of serum albumin levels in the survivors of epithelial ovarian cancer at Dharmais Cancer Hospital in Jakarta in 1996-2004. Design study is retvospective cohort usirg secondary data epithelial ovarian cancer patients at Dharmais Cancer Hospital. The study uses observations of 48 patients from the time of their diagnotion until they are cured, their death or they lost to follow up. The data were analyzed using survival analysis. The resu!ts shows that overall probability five-year survival in patients with epithelial ovarian cancer at the Dharmais Cancer Hospital Jakarta in 1996-2004 is 26.2%. the probability of patients surviving five years on the serum albumin with > 3.6 mg / dl was 36.1% whichis higher than those of patients with serum albumin <3.6 mg / di at 15.7%. After controled by stage of the cancer, the ascites and hemoglobin levels of the patients with an albumin level of < 3.6 mg / dl had a risk of death 7.979 times higher than with an a!tumin fevel > 3.6 mg / dl. "

"ABSTRAKNama :Nugraha Utama PelupessyProgram Studi :S3 Ilmu KedokteranJudul :Marker Cancer Stem Cells CD133, CD44, dan ALDH1A1 Sebagai Faktor Prognostik pada Kanker Ovarium Tipe Epitelial Kanker ovarium merupakan penyakit yang bersifat heterogen dan kebanyakan pasien datang dengan stadium lanjut. Kanker ovarium epitelial tipe II mempunyai sifat pertumbuhan tumor yang cepat dan secara genetik labil dibandingkan tipe I. Keberadaan cancer stem cells CSC dianggap sebagai salah satu faktor prognostik terjadinya kemoresisten dan kesintasan hidup yang rendah.Penelitian ini bertujuan untuk membuktikan CSC sebagai faktor prognostik dengan menggunakan marker CD133, CD44, dan ALDH1A1 pada kanker ovarium tipe epitelial.Marker CD133, CD44, dan ALDH1A1 diperiksa dengan imunohistokimia dan flowcytometry. Hasil ekspresi marker CSC pasien kanker ovarium tipe I dan tipe II dimasukkan kedalam suatu tabel yang dihubungkan dengan respons kemoterapi dan kesintasan hidup. Analisis data dilakukan dengan program computer STATA 14. Analisis kesintasan dilakukan dengan analisis Kaplan-Meier dan uji asumsi cox proportional hazard. Analisis multivariat dipakai untuk model prognosis selama 10 bulan. Sistem skoring dibuat dengan menggunakan receiver operating characteristic ROC curve analyses.Data demografi kelompok terbanyak adalah usia ge; 45 tahun; 40 sampel 72,7 , stadium I, 23 sampel 41,8 , diferensiasi buruk 30 sampel 54,5 , dan tipe II 16 sampel 29,1 . Perbedaan yang bermakna antara tipe histopatologi dengan marker CSC hanya terlihat pada marker CD44. Skor Prediksi Kemoresisten SPKr 10 bulan yang dihubungkan dengan 4 variabel yaitu usia ge; 45 tahun, tipe II, stadium III minus;IV, dan CD44 tinggi dengan ROC 72,47 dan probabilitas post test 82,5 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 negatif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841. Skor Prediksi Kematian SPKm 10 bulan yang dihubungkan dengan 3 variabel yaitu stadium III minus;IV, tipe II, dan CD44 tinggi dengan AUC 80,44 dan probabilitas post test 78,7 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 positif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841.Simpulan: Marker CD44 terbukti berperan pada kanker ovarium tipe II. Skor Prediksi Kemoresisten dan Skor Prediksi Kematian dapat ditentukan selain dengan faktor klinikopatologi, juga dengan memakai marker CSC. Kata kunci: ALDH1A1, CD44, CD133, CSC, kanker ovarium epitelial, kesintasan hidup, respons kemoterapi.

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ABSTRACTName : Nugraha Utama PelupessyStudy Program : Doctoral Program Medical SciencesTitle :Cancer Stem Cell CD133, CD44 andALDH1A1 Markers As Prognostic Factors on Epithelial Ovarian Cancer. Ovarian cancer is a heterogeneous disease and most of the patients came with an advanced stage. Epithelial ovarian cancer type II has the characteristic of rapid tumor growth and genetically more labile than that of type I. The presence of cancer stem cells CSC is considered as one of the prognostic factors of low mortality and survival.The aims of this study was to prove CSC as prognostic factors using CD133, CD44, and ALDH1A1 markers on epithelial ovarian cancer.Clinicopathology and demographic data were collected from medical records. CD133, CD44, and ALDH1A1 markers were examined with flowcytometry and immunohistochemistry. CSC marker expression of the patients with ovarian cancer type I and II was connected with chemotherapy and survival response. Data analysis was done by using STATA 14 software. Survival analysis was done by using Kaplan-Meier analysis and Cox proportional hazard test. Multivariate analysis is used for prognosis model for ten months. Receiver Operating Characteristic ROC curve analyses was used as the system scoring. The highest group demographic data were age ge; 45 years; 40 samples 72.7 , stage I, 23 samples 41.8 , poor differentiation 30 samples 54.5 , and type II 16 samples 29.1 . A significant difference between the histopathologic type and the CSC marker was seen only in CD44 marker. Chemoresistance Prediction Score in 10 months was associated with 4 variables ie age ge; 45 years, type II, stage III minus;IV, and CD44 high with ROC 72.47 and posttest probability 82.5 . The highest chemoresitency scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, negative CD133, high CD44, and high ALDH1A1, was 0.841. Mortality Prediction Score in 10 months was associated with 3 variables is stage III minus;IV, type II, and CD44 high with AUC 80.44 and posttest probability 78.7 . The highest mortality scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, positive CD133, high CD44, and high ALDH1A1, was 0.841. Conclusion: The CD44 marker has a role in type II ovarian epithelial cancer. Chemoresistance Prediction Score and Mortality Prediction Score can be determined from clinicopathological factors and using CSC marker. Keywords: ALDH1A1, CD44, CD133, chemotherapy response, CSC, Epithelial Ovarian Cancer, survival"

"Kuantitas dan kualitas asupan protein belum sepenuhnya diketahui perannya terhadap kualitas hidup. Prognostic Nutritional Index (PNI) juga belum diketahui dapat mencerminkan kualitas hidup dan apakah bisa ditingkatkan dengan asupan protein. Penelitian dengan desain potong lintang ini bertujuan untuk mengetahui korelasi antara asupan protein dengan PNI dan kualitas hidup serta korelasi PNI dengan kualitas hidup pada pasien kanker kepala leher dengan radioterapi di Departemen Radioterapi Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Sebanyak 61 subjek didapatkan dari consecutive sampling. Rerata usia subjek adalah 46,3 ± 12,4 dan 65,6% subjek berada pada kanker stadium IV dan mendapatkan terapi kemoradiasi. Sebanyak 32,8% subjek yang memiliki status gizi kurang. Median asupan protein adalah 1,42 (0,26-4,11) g/kg/hari. Nilai PNI pada subjek penelitian memiliki median 45,9 (29,4-54,2). Hasil penelitian menunjukkan adanya korelasi bermakna antara kuantitas asupan protein berdasarkan Food Frequency Questionnaire (FFQ) semikuantitatif dan beberapa aspek gejala pada kualitas hidup yaitu pada aspek pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37;p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). Kualitas asupan protein tidak berkorelasi bermakna dengan kualitas hidup. PNI berkorelasi bermakna terhadap 1 aspek fungsional yaitu physical function (r=0,378; p=0,003) dan 2 aspek gejala yaitu opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Meskipun tidak signifikan secara statistik, namun PNI memiliki arah korelasi yang positif terhadap aspek fungsional lainnya dan memiliki arah korelasi negatif terhadap aspek gejala lainnya yang berarti semakin tinggi PNI maka aspek fungsional semakin baik dan gejala semakin ringan. Studi ini tidak menemukan adanya korelasi bermakna antara asupan protein, baik kualitas maupun kuantitasnya, terhadap PNI. Hasil ini diduga berkaitan dengan penemuan bahwa sebagian besar penderita masih memiliki pola asupan yang mampu mencukupi kebutuhan kalori dan protein harian. Diperlukan studi prospektif yang menelusuri aspek prognostik kanker kepala leher dari segi kualitas hidup untuk mengetahui apakah PNI dapat memprediksi aspek kualitas hidup dengan lebih rinci.

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Quality and quantity of protein intake has not been well understood that it can affect quality of life. Moreover, Prognostic Nutritional Index (PNI) also has not been well studied upon its usage to reflect quality of life of head and neck cancer patients undergoing radiotherapy. This cross sectional study was aimed to determine the correlation between protein intake and PNI and also the correlation between PNI and quality of life in head and neck cancer patients undergoing radiotherapy at Radiotherapy Department, dr. Cipto Mangunkusumo General Hospital, Jakarta. Total of 61 subjects were recruited with consecutive sampling method with mean age of 46,3 ± 12,4 years old and 65,6% subjects were on stage IV cancer and were getting a combination of chemo and radiotherapy. Only 32,8% subjects were on low nutritional status. Median of total protein intake was 1,42 (0,26-4,11) g/kg/day. Median of PNI was 45,9 (29,4-54,2) among subjects. The result of the study showed a significant correlations between quanitity of protein intake based on semiquantitative Food Frequency Questionnaire (FFQ) with several aspects of quality of life, that were pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37; p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). This aspects were all symptomatics. PNI was significantly correlated with 1 functional aspect, which was Physical function (r=0.378; p=0,003) and 2 symptomp aspects, which were opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Although not statistically significant, but there were positive direction of correlation with other functional aspects and negative direction of correlation with other symptomps aspects. This implicates that the higher the PNI, the lower the symptoms and the better the functional status of head and neck cancer patients undergoing radiotherapy. This study did not show a significant correlation between quality and quantity of protein intake with PNI. An adequate intake of calorie and protein in most subjects were found in this study which might explain the result. More studies, preferably prospective one, may be needed to show the usage of PNI to reflect quality of life, especially involving quality of life progresivity."

"Latar belakang: Kanker ovarium khususnya jenis epitelial merupakan salah satu kanker tersering yang diderita oleh perempuan dengan angka mortalitas dan morbiditas yang tinggi. Hingga saat ini, beberapa penelitian telah meneliti berbagai faktor prognostik pada kanker ovarium, khususnya trombosit yang secara patofisiologi memiliki hubungan dengan berbagai marker inflamasi pada kanker. Tujuan: (1) Membuktikan bahwa trombositosis sebagai faktor prognosis pada pasien kanker ovarium jenis epitelial (2) Membuktikan angka OS selama 3 tahun pada pasien kanker ovarium jenis epitelial dengan trombositosis lebih buruk dibandingkan tanpa trombositosis. Metode: Penelitian ini menggunakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014- Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis kanker ovarium hingga terjadi peristiwa hidup, meninggal, atau hilang dari pengamatan dalam waktu 3 tahun. Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Meski begitu, ada atau tidaknya trombositosis secara statistik tidak bermakna pada OS selama 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399). Pada penelitian ini, didapatkan faktor prognostik yang bermakna pada OS selama 3 tahun antara lain adalah ada tidaknya asites (HR=3,425; p=0,025), stadium (HR=9,523; p=0,029) dan residu tumor ≥ 1 cm (HR=4,137; p=0,015) dengan stadium kanker ovarium merupakan faktor independen (HR=9,162; p=0,033). Sensitivitas dan spesifisitas trombositosis terhadap kanker ovarium stadium lanjut didapatkan sebesar 50,75% dan 69,32%. Kesimpulan: Trombositosis sebagai faktor prognostik pada pasien kanker ovarium jenis epitelial tidak dapat dibuktikan dan angka OS selama 3 tahun pada pasien dengan trombositosis dibandingkan dengan pasien tanpa trombositosis tidak bermakna secara statistik.

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Background: Ovarian cancer, especially, epithelial ovarian cancer is one of the most common cancer in women with high rate of mortality and morbidity. Some studies have found that some biological factors that can be used as a prognostic factor for epithelial ovarian cancer, particularly, thrombocytes which pathophysiologically correlates with inflammation markers in cancer. Aim: (1) To determine thrombocytosis as a prognostic factor for epithelial ovarian cancer. (2) To determine that 3-year overall survival in epithelial ovarian cancer with thrombocytosis is significantly shorter than patients without thrombocytosis. Method: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer which are registed in the cancer registry of Oncology Division in Obstetric and Gynecology Department, Cipto Mangunkusumo Hospital from January 2014 until July 2016. Datas were collected when subjects were first diagnosed with epithelial ovarian cancer until diseases outcomes (survive, death, or loss to follow up) were identified in 3 years. Result: Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42,7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0,005;OR=2,329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0,555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups. In this study, several prognostic factors of epithelial ovarian cancer were identifed such as ascites (HR=3,425; p=0,025), stage of disease (HR=9,523; p=0,029), and post-operative residual tumor ≥ 1 cm (HR=4,137; p=0,015) with stage of disease being the independent prognostic factor (HR=9,162; p=0,033). Sensitivity and specificity of thrombocytosis to advance stage of epithelial ovarian cancer were found to be 50,75% and 69,32%, respectively. Conclusion: Thrombocytosis as a prognostic factor in patients with epithelial ovarian cancer cannot be proven statistically. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis."

"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh dunia setiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadap metastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakan salah satu penentu surgical staging. Surgical staging yang optimal merupakan sebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yang baik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitian ini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengan kanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiks yang dilakukan pembedahan primer di RSCM Metode: Penelitian ini merupakan studi potong lintang menggunakan data rekam medis pasien kanker ovarium epitelial yang menjalani pembedahan primer dan apendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhi kriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43 subjek (53,8%) sebagai stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek (37,5%) stadium III, dan tidak terdapat stadium IV (0%). Dari 80 subjek yang menjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19 subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar. Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4 musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjek terdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinis satu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuan histologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukan pembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atas jenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapat dipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadium lanjut.

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Background: Around 152,000 women were death every year because of ovarian cancer. Appendix is an intraperitoneal organ which prone to ovarian epithelial cancer metastasis. Appendix involvement is one of surgical staging scoring. Optimal surgical staging is one of key point to determine post operation treatment, accurate prognosis, and better chemotherapy response. This research was done to see appendix involvement from primary surgery in ovarian epithelial cancer at RSCM Aim: To determine prevalence of metastasis to the appendix from primary surgery in ovarian epithelial cancer at RSCM Method: This cross sectional study used ovarian epithelial cancer patient medical record which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutive random sampling were used. Result: Eighty subjects which were taken from inclusion and exclusion criteria has average age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadium I patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, and none of them as stadium IV. Appendectomy were done and eight subjects (10%) has metastasis to the appendix. On the other hand, 19 subjects (23.8%) have chronic appendicitis and 53 subjects (66.3%) doesn't have metastasis to the appendix. From eight subjects which has appendix involvement, four were defined have mucinous histology, two serous, and two endometrioid. Six out of eight were diagnosed at clinical stadium III and two were diagnosed at stadium I. These two stadium I subjects has mucinous histology. Conclusion: There are 10 percent appendix metastases from primary surgery in ovarian epithelial cancer at RSCM which consist of mucinous, serous, and endometrioid histological types. Based on this research, appendectomy can be considered done on surgery whether in early or late stadium."

"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh duniasetiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadapmetastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakansalah satu penentu surgical staging. Surgical staging yang optimal merupakansebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yangbaik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitianini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengankanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiksyang dilakukan pembedahan primer di RSCMMetode: Penelitian ini merupakan studi potong lintang menggunakan data rekammedis pasien kanker ovarium epitelial yang menjalani pembedahan primer danapendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhikriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi daneksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43subjek (53,8%) sebagai stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek(37,5%) stadium III, dan tidak terdapat stadium IV (0%). Dari 80 subjek yangmenjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar.Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjekterdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinissatu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuanhistologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukanpembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atasjenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapatdipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadiumlanjut.

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Background: Around 152,000 women were death every year because of ovariancancer. Appendix is an intraperitoneal organ which prone to ovarian epithelialcancer metastasis. Appendix involvement is one of surgical staging scoring.Optimal surgical staging is one of key point to determine post operation treatment,accurate prognosis, and better chemotherapy response. This research was done tosee appendix involvement from primary surgery in ovarian epithelial cancer atRSCMAim: To determine prevalence of metastasis to the appendix from primary surgeryin ovarian epithelial cancer at RSCMMethod: This cross sectional study used ovarian epithelial cancer patient medicalrecord which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutiverandom sampling were used.Result: Eighty subjects which were taken from inclusion and exclusion criteria hasaverage age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadiumI patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, andnone of them as stadium IV. Appendectomy were done and eight subjects (10%)has metastasis to the appendix. On the other hand, 19 subjects (23.8%) have chronicappendicitis and 53 subjects (66.3%) doesnt have metastasis to the appendix. Fromeight subjects which has appendix involvement, four were defined have mucinoushistology, two serous, and two endometrioid. Six out of eight were diagnosed atclinical stadium III and two were diagnosed at stadium I. These two stadium Isubjects has mucinous histology.Conclusion: There are 10 percent appendix metastases from primary surgery inovarian epithelial cancer at RSCM which consist of mucinous, serous, andendometrioid histological types. Based on this research, appendectomy can beconsidered done on surgery whether in early or late stadium."

"Latar Belakang: Kemoradiasi merupakan upaya yang dapat dilakukan untuk meningkatan kesintasan sel. Diperlukan penelitian in-vitro untuk mengembangkan potensi-potensi agen kemoradiosensitiser tersebut, namun sayangnya tidak banyak laboratorium yang melakukan protokol uji radiosensitivitas sel di Indonesia. Tujuan: Penelitian ini ditujukan untuk membangun protokol clonogenic assay agar radiosensitivitas dan efek radiosensitiser dapat diukur dengan baik. Metode: Lini sel yang digunakan adalah MCF-7 adenokarsinoma payudara dan HeLa yang merupakan adenokarsinoma cervix uteri. Linear accelerator digunakan sebagai cell irradiator. Clonogenic assay digunakan untuk menilai radiosensitivitas sel MCF-7 dan HeLa serta mengexplorasi efek cisplatin sebagai radiosensitiser pada dua sel tersebut. Radiosensitivitas sel akan dipresentasikan pada kurva quadratic linear. Hasil: Didapatkan bahwa Radiosensitivitas sel MCF-7 dan HeLa didapatkan dengan α/β ratio 4.56 dan 4.94. IC50 cisplatin pada Hela adalah 10.4 uM dan MCF-7 adalah 250nM. Cisplatin memiliki potensi sebagai radiosensitiser pada lini sel kanker payudara dengan SER-D10 dan SER-D50 1.83 dan 2.87 pada dosis 50nM, serta SER-D10 dan SER-D50 2.23 dan 3.31 pada dosis 100nM. Kesimpulan: Protokol colony assay dapat dimanfaatkan untuk menentukan kesintasan sel terhadap radiasi, kemoterapi, dan kemoradiasi. Cisplatin memiliki potensi sebagai radiosensitizer terhadap sel MCF-7, yang merupakan lini sel adenokarsinoma payudara.

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Background: Chemoradiation is a therapeutic approach aimed at improving treatment results. There is a lack of laboratories in Indonesia that conduct cell radiosensitivity testing protocols, which hinders the development of potential chemo-radiosensitizer agents through in-vitro research. Methods: The purpose of this research is to develop a clonogenic assay protocol in order to accurately measure radiosensitivity and the impact of the radiosensitivity. We use MCF-7, a breast adenocarcinoma cell line, and HeLa, a cervical cervix adenocarcinoma cell line. The study uses a linear accelerator as a device to irradiate cells. We explore the radiosensitivity of MCF-7 and HeLa cells and investigates the impact of cisplatin, a radiosensitizer, on these two cell types. Clonogenic assays are employed to assess the in-vitro susceptibility of cells to radiation, chemotherapy, and chemoradiation. The cell's radiosensitivity to these three interventions will be presented in a quadratic linear curve. Results: The radiosensitivity of MCF-7 and HeLa cells was determined to have an α/β ratio of 4.56 and 4.94, respectively. The IC50 of cisplatin in Hela cells is 10.4 μM, while in MCF-7 cells it is 250nM. Cisplatin demonstrates potential as a radiosensitizer on the breast cancer cell line, with SER-D10 and SER-D50 values of 1.83 and 2.87 at a dose of 50nM, and SER-D10 and SER-D50 values of 2.23 and 3.31 at a dose of 100nM. Conclusion: the colony assay protocol is a reliable method for assessing cell sensitivity to radiation, chemotherapy, and chemoradiation. Cisplatin exhibits potential as a radiosensitizer against MCF-7 cells, a specific type of breast adenocarcinoma cells."