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"Di Indonesia kebanyakan pasien kanker serviks datang pada stadium lanjut (62%) yang merupakan 66% dari penyebab kematian ginekologik. Pemeriksaan Pap Smear merupakan salah satu cara untuk mendeteksi secara dini kanker serviks sehingga penanganan kanker serviks dapat dilakukan sebelum menyebar ke luar rahim.Tujuan penelitian ini adalah untuk mengetahui peranan faktor-faktor yang menyebabkan mereka terlambat memeriksakan diri di RSUPN Dr. Cipto Mangunkusumo Jakarta. Penelitian ini memadukan metoda kuantitatif dan kualitatif. Data primer diambil dengan menggunakan kuesioner, wawancara mendalam dan membaca catatan dokumen.Hasil penelitian menunjukkan bahwa variabel-variabel yang berhubungan seeara statistik dengan keterlambatan pasien kanker serviks memeriksakan diri adalah pengetahuan, sikap, ketersediaan pelayanan Pap Smear dan dorongan suami. Biaya dan dorongan petugas kesehatan tidak berhubungan secara statistik tetapi penting khususnya penghasilan untuk membayar biaya pemeriksaan. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan mempengaruhi variabel dependen.Berdasarkan wawancara mendalam dapat disimpulkan bahwa memang tidak tersedianya pelayanan Pap Smear disamping kurangnya pengetahuan yang menjadi penyebab informan terlambat memeriksakan diri dengan alasan tidak ada satupun petugas kesehatan atau orang lain yang menyampaikan informasi mengenai Pap Smear dan kanker serviks.Mempertimbangkan hasil penelitian maka disarankan kepada semua pihak yang terkait untuk meningkatkan upaya penanganan kanker serviks melalui KIE secara terkoordinir lintas sektoral kepada masyarakat umumnya, terutama kepada wanita masa reproduksi dan lansia agar memperhatikan pelayanan deteksi dini (Pap Smear).

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An Analysis on the Delay of Cervix Cancer Patient in Examining Their selves in The National Hospital of Dr. Cipto Mangunkusumo, JakartaIn Indonesia most of the cervix cancer patients come to see doctors after advanced stadium (62 %) which 66 % ended with gynecological death. The smear test is a method to detect the cervix cancer earlier before spreading outside the uterus.

The purpose of this research is to identify factors related to the delay of the health examination in The National Hospital of Dr. Cipto Mangunkusumo, Jakarta. This research combines quantitative and qualitative methods by using questionnaire, in-depth interview and examine medical records to supplement the primary data.

The research result indicates variables related statistically with the cancer patient delay are; knowledge, attitudes, the availability of the Pap smears service, and the husband's support. Financial problem and encouragement from the health providers are not related statistically but it is important especially the income. The availability of Pap smear service plays as a dominant variable in affecting the dependent variable.

Based on depth interview it is concluded that the unavailability of Pap smear services despite the lack of knowledge has caused the informant did not use the early detection service (Pap smear) with reason there was no health provider or other people gave information about the Pap smear and cervix cancer.

Considering the research result, it is suggested that all related parties improve the handling of the cervix cancer through Communication, Information and Education (KIE), which is coordinated through cross sector way to the public, especially KIE should be focused on women during their reproductive term and the elder women so that they will pay more attention to early detection service (Pap smear)."

"The focus of the study is spiritual experience of women with cervical cancer. A phenomenological qualitative study was used to examine a comprehensive understanding on this particular behaviour and how they interpret those experiences. The research revealed a fact that women with cervical cancer had spiritual experiences as they felt uncertainties and suffers in their whole life but still motivated, the belief in God brings their hopes and made their life brighter. The result of this research has an implication into nursing service so that the holistic nursing process implementation to cervical cancer clients could improved."

"Tesis ini bertujuan Untuk mengetahui pengaruh merokok pada kesintasan penderita kanker serviks stadium lanjut di Rumah Sakit Umum Ciptomangunkusumo. Penelitian ini bersifat kohort retrospektif. Hasil penelitian didapatkan tingkat merokok oleh pasien dan atau suami pasien tidak signifikan secara statistik sebagai faktor prognosis terhadap pasien kanker serviks stadium lanjut di RSCM. Kesintasan 5 tahun pasien kanker serviks stadium lanjut dalam studi kami adalah 22 bulan (4-58 bulan) dengan persentase kesintasan 22,6%. Dengan analisis multivariat didapatkan bahwa hanya ukuran tumor dan stadium kanker bermakna secara statistik terhadap kesintasan.

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This thesis aims to determine the effect of smoking on the survival rate of advanced stage cervical cancer patients in the Ciptomangunkusumo General Hospital. This study is a retrospective cohort. The results showed that smoking levels by the patient or the patient's husband was not statistically significant as a prognostic factor for patients with advanced cervical cancer in RSCM. 5-year survival of patients with advanced cervical cancer in our study was 22 months (4-58 months) with a percentage of 22.6% survival rate. By multivariate analysis. it was only tumor size and stage of the cancer that statistically significant to the survival rate."

"Kanker serviks di Indonesia berdasarkan keganasan pada jenis kelamin wanita, menempati urutan ke 2 dengan prevalensi sebesar 14,4 dan angka mortalitas sebesar 10,3. Dari sisi pembiayaan, pengobatan kanker menempati urutan kedua besar anggaran yang di keluarkan oleh BPJS Kesehatan. Data registrasi kanker sangat dibutuhkan untuk evaluasi dan membuat kebijakan yang tepat guna di rumah sakit dalam rangka meningkatkan kualitas pelayanan kanker. Hospital Based Cancer Registry HBCR merupakan suatu sistem registrasi kanker yang dilakukan di rumah sakit yang dapat menyediakan informasi mengenai informasi umum dari pasien kanker, pengobatan serta hasil dari pengobatan. Penelitian ini dilakukan untuk memperoleh profil kanker serviks di RSCM tahun 2013 berdasarkan data hospital based cancer registry. Penelitian dilakukan dengan mengekstraksi data epidemiologi dan data tumor serviks dari HBCR RSCM tahun 2013 yang kemudian dilakukan analisa deskriptif. Dari hasil penelitian didapatkan bahwa kanker serviks menempati urutan kedua terbanyak dari seluruh keganasan di RSCM 12 ,n= 678, dengan domisili sebagian besar berasal dari luar DKI Jakarta 52,8, n = 358. Usia rata-rata terjadinya kanker serviks adalah 49,48 tahun, tersering terjadi pada rentang usia 45-49 tahun. Dari sisi histopatologi, karsinoma sel skuamosa merupakan jenis histopatologi pada kanker serviks yang paling banyak dijumpai 74,2, n = 447. Tindakan operasi merupakan jenis tindakan yang paling banyak dilakukan pada kanker serviks stadium dini 83,3, n=25, sedangkan tindakan radiasi paling banyak dilakukan pada kanker serviks stadium lokal lanjut 79,9, n=273 .

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Cervical cancer ranks at the second place based on the malignancy among female sex in Indonesia with a prevalence of 14.4 and a mortality rate of 10.3. From a financial perspective, the treatment of cancer ranks second big budget expended by the Indonesian national health insurance. Cancer registration data are needed to evaluate and make appropriate policy in hospitals in order to improve the quality of cancer services. Hospital Based Cancer Registry HBCR is a system of cancer registration in a hospital that can provide information about the general information of cancer patients, treatment, and outcome of treatment. This study was conducted to obtain the profile of cervical cancer in the RSCM in 2013 based on data from RSCM hospital based cancer registry. The study was conducted by extracting the epidemiological data and cervical tumor data from HBCR RSCM in 2013 which was then analyzed descriptively.

The result showed that cervical cancer ranks at the second place from all the malignancy at RSCM 12, n 678, with domicile mostly come from outside Jakarta 52.8, n 358. The average age of cervical cancer was 49.48 years, the most common occurs in the age range 45 49 years. In terms of histopathology, squamous cell carcinoma is the most prevalence type of histopathology of cervical cancer 74.2, n 447. The surgery is a type of action that done for early stage cervical cancer 83,3, n 25, whereas the action of radiation are mostly done in locally advanced cervical cancer 79,9, n 273."

"ABSTRAK Latar belakang. Infeksi human papillomavirus (HPV) pada genital laki-laki selain dapatmenyebabkan kutil kelamin dan kanker penis juga meningkatkan risiko infeksi HPV padapasangan. Walaupun saat ini telah terdapat banyak penelitian mengenai peran HPV risikotinggi terhadap karsinogenesis serviks dan semakin jelas peran laki-laki sebagai vektor virusHPV, namun pemeriksaan HPV pada laki-laki belum rutin dilakukan. Penelitian ini bertujuanmengetahui proporsi kepositivan, variasi genotipe HPV pada suami pasien kanker serviksserta kesamaan genotipe HPV antara suami pasien kanker serviks yang HPV positif denganpasien kanker serviks di RSUPN Dr Cipto Mangunkusumo. Metode. Penelitian potonglintang. Pemilihan SP dilakukan secara berurutan (consecutive sampling). Sampel diambildengan menggunakan kertas amplas dan dacron swab. Pada spesimen dilakukan pemeriksaanmenggunakan HPV express matrix Kalgen®. Hasil. Sebanyak 47 SP dilibatkan dalampenelitian ini, dengan rerata usia 50,7+10,6 tahun. Dari analisis spesimen diidentifikasi HPVgenital pada 9 (19%) SP, terdiri atas genotipe risiko rendah (3 SP) dan risiko tinggi (6 SP).Genotipe HPV yang ditemukan adalah 6, 18, 31, 39, 43, 53, dan 56, dengan tipe terseringadalah 18 dan 43. Tidak didapatkan kesamaan tipe HPV di antara pasangan HPV yangpositif. Kesimpulan. Proporsi kepositivan HPV pada suami pasien kanker serviks sebesar19% dengan tipe 18 dan 43 paling banyak didapatkan, namun tidak didapatkan kesamaan tipe HPV antara SP dengan pasien kanker serviks pasangannya.ABSTRACT Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse.;Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse.;Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse."

"Kanker serviks menempati urutan pertama kanker terbanyak pada wanita di RSCM. Penelitian ini dilatarbelakangi oleh rendahnya ketahanan hidup pasien kanker serviks di Indonesia. Banyak pasien kanker serviks tidak melanjutkan pemeriksaan setetelah didiagnosa kanker serviks karena keterbatasan biaya. Penelitian ini bertujuan untuk mengetahui perbedaaan ketahanan hidup lima tahun antara pasien kanker serviks jaminan pembiayaan asuransi kesehatan dengan pasien pembiayaan pribadi/non asuransi di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta tahun 2007-2010. Penelitian menggunakan desain studi analitik observasional dengan desain kohort retrospektif. Hasil penelitian menunjukkan terdapat perbedaan ketahanan hidup 5 tahun antara pasien kanker serviks jaminan pembiayaan asuransi dengan pasien jaminan pribadi/non asuransi (p = 0,001). Pasien kanker serviks jaminan pembiayaan pribadi/non asuransi memiliki risiko kematian 5,18 kali (CI: 1,97-13,59) dibandingkan pasien jaminan asuransi, setelah dikontrol diferensiasi sel, pendidikan, stadium kanker, dan kadar hemoglobin.

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Cancer servix is the most frequent cancer occured for female in RSCM. The low rate of 5-year survival rate cervical cancer patients caused by several factors. A lot of diagnosed patients do not return to hospital for getting proper treatment motivates by financial reasons.

This research aim to see correlation of health insurance with 5-year survival rate of cervical cancer patients at Dr. Cipto Mangunkusumo National Hospital, Jakarta year 2007-2010.

Result shows there is correlation between health insurance status and 5 year survival rate of cervical cancer patients (p value = 0,001). Patients who are not covered by insurance are 5,18 times (CI1,97-13,59) likely at death risk compare to insurance covered patients. Rate adjusted with sel differentiation, education, stadium of cancer, and hemoglobin rate as confounding variables."

"Latar Belakang Pada tahun 2020, ditemukan total kasus kanker serviks mencapai 36.633 kasus dengan 21.003 di antaranya adlaah kasus kematian di Indonesia. Pasien kanker serviks stadium awal diberikan pilihan tatalaksana pembedahan umumnya berupa histerektomi. Pilihan terapi ajuvan juga diberikan guna mengurangi risiko terjadinya kekambuhan. Dengan tingginya kasus kematian kanker serviks di Indonesia, diperlukan penelitian lebih lanjut terkait angka kesintasan pasien kanekr serviks yang dilakukan histerektomi radikal di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo pada tahun 2010-2018 dengan memerhatikan dilakukan atau tidaknya terapi ajuvan dan ada tidaknya kekambuhan yang terjadi pada pasien. Metode Penelitian ini adalah penelitian deskriptif analitik dengan desain penelitian kohort retrospektif. Data diambil dari rekam medik dan dianalisis kesintasannya dengan metode Kaplan-Meier. Hasil Didapat sebanyak 9,1% (7 orang) pasien mengalami kematian (event) dan 90,9% (70 orang) pasien bertahan hidup dalam kurun waktu tiga tahun dari tanggal tatalaksana histerektomi radikal dilakukan. Pada analisis bivariat antara variabel usia, stadium, terapi ajuvan, dan kekambuhan terhadap kesintasan tidak ditemukan adanya P Value < 0,05 sehingga tidak ada perbedaan ataupun hubungan yang bermakna. Kesimpulan Kesintasan tiga tahun pasien kanker serviks yang dilakukan histerektomi radikal di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo pada tahun 2010-2018 sebesar 90,9%.

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Introduction In 2020, the total number of cervical cancer cases was found to reach 36,633 cases with 21,003 of them being deaths in Indonesia. Patients with early stage cervical cancer are given surgical treatment options, generally in the form of hysterectomy. Adjuvant therapy options are also given to reduce the risk of recurrence. With the high number of cervical cancer deaths in Indonesia, further research is needed regarding the survival rate of cervical cancer patients who undergo radical hysterectomy in National Referral Hospital Cipto Mangunkusumo in 2010-2018 by paying attention to whether or not adjuvant therapy was carried out and whether or not there was a recurrence. Method This research is a descriptive analytical study and using a retrospective cohort design. Data were taken from medical records and analyzed for survival using the Kaplan-Meier method. Results It is found that 9.1% (7 people) of patients experienced death (event) and 90.9% (70 people) of patients survived within three years from the date the radical hysterectomy was carried out. In the bivariate analysis between the variables such as age, stage, adjuvant therapy, and recurrence, there is no P value < 0.05 was found (no significant difference). Conclusion Three-year survival of cervical cancer patients who undergo radical hysterectomy in National Referral Hospital Cipto Mangunkusumo in 2010-2018 was 90.9%."

"Latar Belakang: Kanker serviks adalah keganasan ginekologi terbanyak kedua pada perempuan di seluruh dunia dengan angka kematian yang tinggi. Stadium IIIB kanker serviks didefinisikan sebagai perluasan tumor yang mengenai dinding panggul atau adanya hidronefrosis. Jika disertai dengan gangguan ginjal, angka morbiditas dan mortalitas pasien akan meningkat. Penelitian ini bertujuan untuk mengkaji perbedaan data patologi, respon terapi, masa rawat, dan angka kesintasan satu tahun pada pasien kanker serviks stadium IIIB dengan dan tanpa gangguan ginjal. Metode: Dengan menggunakan metode potong lintang dilakukan pengambilan data 941 sampel pasien kanker serviks stadium IIIB di RSCM Jakarta antara bulan Juli 2010 - Juli 2015. Hasil: Hasil penelitian menunjukkan terdapat perbedaan signifikan jumlah pasien ditinjau dari keterlibatan dinding panggul, keterlibatan KGB, derajat dan simetrisitas hidronefrosis, rerata kadar ureum, kreatinin, dan kalium serum pada pasien kanker serviks dengan dan tanpa gangguan ginjal (p<0.001). Juga ditemukan perbedaan bermakna jumlah pasien yang menjalani terapi diversi urin , dialisis, dan kemoterapi. Untuk analisis kesintasan, didapatkan hazard ratio 0.307 (IK95% 0,160-0,589). Kesimpulan: Dengan gambaran data tersebut, perlu diusulkan suatu entitas klasifikasi baru untuk kanker serviks stadium IIIB dengan gangguan ginjal (IIIB plus), mengingat kasus ini membutuhkan penanganan yang lebih kompleks dan holistik dengan melibatkan banyak keahlian (penyakit dalam, urologi, ginjal hipertensi, gizi klinik dan paliatif) serta prognosis yang berbeda bermakna secara statistik

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Background: Cervical cancer is the second most common gynecological cancer in women globally. Stage IIIB cervical cancer is defined as a local extension of tumor that affects the pelvic wall or hydronephrosis or kidney disease. If accompanied by kidney disease, the complication will increase thereby increasing patient's morbidity and mortality. The aim of this study is to know whether there are differences in the clinical data, therapy, duration of hospital, and one-year survival rate in cervical cancer patient with and without kidney disease.

Methods: This research uses cross-sectional method with samples of stage IIIB cervical cancer patients in Cipto Mangunkusumo between July 2010 and July 2015.

Results: The results showed significant difference in the number of patients with pelvic wall involvement, lymph node involvement, degree and symmetry of hydronephrosis, the serum urea, creatinine, and potassium level between cervical cancer patients with and without kidney disease (p <0.001). There are also significant differences in the number of patients undergoing urinary diversion therapy, dialysis and chemotherapy. For survival analysis, the hazard ratio obtained is 0.307 (IK95% 0.160 - 0.589).

Conclusion: With the results obtained, we suggest new entitiy for cervical cancer stage IIIB with kidney disease ( IIIB plus), according to there is an obligation of more complex involvement of specialist (internist, urologist, renal hypertension expert, clinical nutrition and palliative expert) and statistically the prognosis is different"

"Latar Belakang: Kanker serviks menduduki peringkat ke tiga di seluruh dunia sebagaipenyebab kematian perempuan dan merupakan penyebab kematian utama perempuan dinegara berkembang. Diperlukan evaluasi kesintasan berkala yang secara tidak langsungmenjadi cermin tatalaksana.Tujuan: Mengetahui kesintasan pasien kanker serviks di RSCM.Metode: Penelitian ini menggunakan desain kohort retrospektif terhadap data rekammedis pasien kanker serviks pada tahun 2012-2014 dengan metode total populationsampling. Analisis data dilakukan menggunakan kurva Kaplan Meier, uji Log Rank dan Regresi Cox untuk mencari kemaknaan hubungan antarvariabel.Hasil: Terdapat 1.303 subjek penelitian dengan angka kesintasan kanker serviks hingga tahun ke-5 sebesar 76%, 66%, 60%, 43% dan 36% dengan median kesintasan sebesar 1355 hari secara keseluruhan. Terdapat perbedaan hazard bermakna pada variabel stadium kanker (p<0,001). Analisis regresi cox menunjukkan faktor yang berpengaruh terhadap kesintasan adalah stadium kanker. Kesimpulan: Kesintasan 5 tahun kanker serviks di RSCM tahun 2012-2014 sebesar 36%.

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Background: Cervical cancer is ranked third as female cause of death worldwide and isthe leading cause of death of women in developing countries. A periodic survivalevaluation is required that implies the treatment implicitly.Objective: To know the survival rate of cervical cancer patients at CiptoMangunkusumo Hospital.Methods: This retrospective cohort study used medical records data of cervical cancerpatients in 2012- 2014 using total population sampling method. Data analysis was doneusing Kaplan Meier curve, Rank Log test and Cox Regression to find the associationbetween variables.Results: There were 1.303 subjects with overall kesintasan rates of cervical cancer up tothe fifth year of 76, 66, 60, 43 dan 36 with a median survival 1355 days. There were significant hazard differences in cancer stage variables (p <0.001). Cox regression analysis showed that factors affecting survival were cancer stage. Conclusion: The 5-year kesintasan rate of cervical cancer at Cipto Mangunkusumo hospital in 2012-2014 is 36%."

"Latar Belakang: Insiden kanker serviks di RSCM masih tinggi, sebagian besar datang pada stadium lanjut, dan angka harapan hidup yang masih rendah. Jika respon radiasi komplit dan eradikasi tumor lokoregional dapat tercapai pada pasien kanker serviks, diperkirakan dapat meningkatkan kesintasan. Oleh karena itu, kami bermaksud mengadakan penelitian terhadap respon terapi radiasi dan karakteristik klinis serta patologi yang berhubungan pada pasien kanker serviks di RSCM. Metode: Penelitian kohort ini dilakukan dengan menggunakan data sekunder terhadap 123 pasien kanker serviks stadium IIA-IIIB yang menjalani radiasi kuratif definitif sesuai protokol standard bulan Januari 2014-Des 2015 di RSUPN CiptoMangunkusumo. Dilakukan pencatatan karakteristik klinis dan patologis sebelum radiasi, Dicatat juga efek samping akut gastrointestinal, traktus genitourinaria, dan hematologis selama menjalani protokol radiasi sampai 3 bulan pasca radiasi. Data respon tiga bulan pasca radiasi lengkap berdasarkan klinis dan pemeriksaan ultrasonografi transrektal/transvaginal dicatat dan diklasifikasikan sesuai Response Evaluation Criteria in Solid Tumors RECIST. Hasil: Dari 123 kasus, 84 kasus 68,29 diperoleh respon komplit, 30 kasus 24,39 respon parsial, 6 kasus 4,88 respon stabil, dan 3 kasus 2,44 respon progresif. Berdasarkan efek samping akut gastrointestinal, tidak didapatkan efek samping derajat 0 pada 99 kasus 80,49, derajat 1 pada 20 kasus 16,26, derajat 2 pada 4 kasus 3,25, derajat 3 pada 0 kasus 0. Berdasarkan efek samping akut genitourinaria, tidak didapatkan efek samping derajat 0 pada 105 kasus 85,37, derajat 1 pada 17 kasus 13,82, derajat 2 pada 1 kasus 0,81, dan derajat 3 pada 0 kasus 0. Berdasarkan efek samping akut hematologis, tidak didapatkan efek samping derajat 0 pada 108 kasus 87,80, derajat 1 pada 15 kasus 12,20, derajat 2 pada 0 kasus 0, dan derajat 3 pada 0 kasus 0. Dengan membandingkan kelompok respon komplit dan tidak respon parsial, stabil, progresif didapatkan faktor usia dengan p=0,266 RR 0,87;IK95 0,67-1,12, klasifikasi tekanan darah dengan p=0,882 RR 0,98; IK95 0,76-1,27, Indeks Masa Tubuh dengan p= 0,397 RR 1,06;IK95 0,83-1,34, kadar hemoglobin dengan p= 0,193 RR 0,71;IK95 0,40-1,27, jumlah leukosit darah dengan p=0,969 RR=1,00; IK95 0,78-1,29, kadar albumin darah dengan p= 0,198 RR 0,73;IK95 0,44-1,20, stadium FIGO dengan p=0,526 RR 1,08; IK95 0,85-1,38, diameter tumor terbesar dengan p=0,034 RR 1,30; IK95 1,03-1,63, jenis histopatologis dengan p=0,159 RR 1,18;IK95 0,90-1,55, dan derajat diferensiasi dengan p=0,469. Pada analisa multivariat, didapatkan hubungan bermakna antara diameter tumor p=0,036;RR 2,64; IK95 1,07-6,56 dengan respon radiasi komplit. Kesimpulan: Gambaran respon radiasi kuratif definitif pada kanker serviks stadium IIA-IIIB di RSCM adalah 68,29 respon komplit, 24,39 respon parsial, 4,88 respon stabil, dan 2,44 progresif. Efek samping akut gastrointestinal, genitourinaria, dan hematologis pada umumnya tidak terjadi selama dan sampai 3 bulan pasca radiasi, yaitu 80,49 tidak mengalami efek samping akut gastrointestinal, 85,37 tidak mengalami efek samping akut genitourinaria, dan 87,80 tidak terjadi efek samping akut hematologi. Sebagian besar efek samping akut yang terjadi berderajat rendah yaitu grade 1 dan 2 traktus gastrointestinal, masing-masing 16,26 dan 3,25, grade 1 dan 2 traktus genitourinaria, yaitu masing-masing 13,82 dan 0,81, dan grade 1 hematologi, yaitu 12,20. Terdapat hubungan bermakna antara diameter tumor terbesar dengan respon komplit radiasi. Tidak terdapat hubungan bermakna antara usia, Indeks Masa Tubuh, kadar hemoglobin, jumlah leukosit darah, kadar albumin serum, stadium FIGO, jenis histopatologis, dan derajat diferensiasi dengan respon terapi radiasi.

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Background: The incidence of cervical cancer was still high in RSCM, whom most of them was found in advanced stage. The issue that still become a problem related to radiotherapy on those patients was non satisfying local tumor control, which range 20 50. If we can reach complete response and eradication of locoregional tumor on cervical cancer patients, it is estimated that the survival rate will increase. Therefore, we conducted a research to find out response of radiotherapy and related clinic pathologic characterictics on cervical cancer patients in our hospital.

Methods: This cohort study used secondary data on 123 patients of cervical cancer stage IIA IIIB who had undergone radiation therapy based on standard protocol in our hospital, during Januari 2014 to Dec 2015. The clinical factors of those patients, such as age, Body Mass Index, blood pressure, hemoglobin level, blood leucocyte count, serum albumin, largest tumor diameter FIGO staging and pathologic characteristic, i.e histopathology and grading were recorded. During radiation protocol until 3 months post radiation, we also noted any side effects of gastrointestinal tract, genitourinary tract, and hematologic. Evaluation of radiotherapy response was based on Response Evaluation Criteria in Solid Tumors RECIST.

Results: Among 123 cases, 84 cases or 68.29 was complete response, 30 cases or 24.39 was partial response, 6 cases or 4.88 was stabile response, and 3 cases or 2.44 was progressive. Based on gastrointestinal side effect, there was no side effect or grade 0 on 99 cases 80.49, grade 1 on 20 cases 16.26, grade 2 on 4 cases 3.25, grade 3 on 0 case 0. Based on side effect of genitourinary, there was no side effect or grade 0 on 105 cases 85,37, grade 1 on 17 cases 13.82, grade 2 on 1 case 0.81, grade 3 on 0 case 0. Based on hematologic side effects, there was no side effect on 108 cases 87.80, grade 1 on 15 cases 12.20, grade 2 on 0 case 0, grade 3 on 0 case 0. On bivariate analysis, p of each factors were age p 0.266 RR 0.87 0.67 1.12, Body Mass Index p 0.397, blood pressure classification p 0.658 RR 0.98 0.76 1.27, largest tumor diameter p 0.034 RR 1.30 1.03 1.63, haemoglobin level p 0.193 RR 0.98 0.76 1.27, blood leucocyte count p 0.969 RR 1.00 0.78 1.29, FIGO staging II vs III p 0.526 RR 1.08 0.85 1.38, histopathology result squamous cell carcinoma vs nonsquamous cell carcinoma p 0.159 RR 1.18 0.90 1.55, and grading p 0.469. on multivariate analysis, tumor diameter was statistically significant, with p 0.036 RR 2.64 1.07 6.56.

Conclusion: Most of definitive curative radiotherapy response on cervical cancer stage IIA IIIB was complete 68.29. Partial response was 24.49, stable response was 4.88, and progressive was 2.44. The Acute side effect of gastrointestinal tract, genitourinary tract, and hematologic were commonly can be tolerable during and 3 months post radiation therapy. Clinico pathologic characteristic that significantly related to complete response of radiotherapy were largest tumor diameter."