Ardhanu Kusumanto
Medical Faculty of Gadjah Mada University/ Dr. Sardjito Hospital

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Perbandingan Kualitas Hidup Penderita Kanker Ovarium Epitelial yang Diberikan Kemoterapi Regimen Paclitaxel dan Carboplatin dengan Regimen Cyclophospamide, Adriamicyn dan Cisplatin di RSUP Dr. Sardjito Ahyar, Ibnu; Taufiqurrachman, Irwan; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.793 KB) | DOI: 10.22146/jkr.35428

Abstract

Background: Epithelial ovarian cancer is the dominant type of ovarian cancer. Platinum and Taxane regiment has been proved to increase the survival rate of ovarian cancer patientsObjective: To compare the quality of life of ovarian cancer patients who got Paclitaxel and Carboplatin regiments with Cyclophosphamide, Adriamycin and Cisplatin regiments and risk factors which influence themMethod: The design of the study was retrospective cohort. The total subjects were 156 ovarian cancer patients who consisted of 79 patients with paclitaxel and carboplatin regiments and dan 77 patients who got cyclophospamide, adriamicyn dan cisplatin regiments in DR. Sardjito hospital, Yogyakarta. The quality of life was measured with EORTC QLQ-C30. The data distribution were tested with KolmogorovSmirnov and analysed with D Chi-Squaretest for categorical data and Mann-Whitney for continuous data. Multivariable Analysis was done with logistic regression.Result and Discussion: The bivariable analysis of ovarian cancer stage and the quality of life showed that early stage of ovarian cancer patients had quality of life 19,068 times higher than advance stage of ovarian cancer patients (RR 19,068; 95% CI 2,590-140,362). There were signicant differences in quality of life in ovarian cancer patients with low body mass index <18,5 compared to normal body mass index as well as the titer of tumor marker Ca125. Multivariable analysis showed that there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin.Conclusion: there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin in DR. Sardjito Hospital, Yogyakarta.Keywords: Quality of life, ovarian cancer, paclitaxel plus carboplatin regiment, cyclophospamide, adriamicyn plus cisplatin regiment.
KUALITAS HIDUP SATU TAHUN PASIEN KANKER SERVIKS YANG TELAH DILAKUKAN HISTEREKTOMI RADIKAL DI RSUP DR. SARDJITO YOGYAKARTA Fuadi, Afif; Pradjatmo, Heru; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.511 KB) | DOI: 10.22146/jkr.49348

Abstract

Latar Belakang: Kanker serviks merupakan kanker paling banyak ketiga yang ditemukan pada seorang wanita. Secara keseluruhan lebih dari 85% terjadi pada negara-negara berkembang. Insidensi rata-rata paling tinggi di wilayah Sub Sahara Afrika, Amerika Latin dan Karibia, Melanesia dan Asia Barat, Australia/Selandia Baru. Variasi geografis yang besar mencerminkan ketersediaan skrining yang memungkinkan untuk mendeteksi lesi prakanker dan prevalensi terjadinya infeksi Human Papillomavirus (HPV). Modalitas skrining dan strategi pengobatan telah berevolusi, dengan kemajuan terapi saat ini yang meliputi tindakan pembedahan, kemoterapi dan radiasi, penderita kanker serviks dihadapkan pada efek samping pasca pengobatan lengkap. Sehingga dapat menyebabkan penurunan kualitas hidup mereka.Tujuan: Mengetahui kualitas hidup satu tahun pasien kanker serviks yang telah dilakukan histerektomi radikal.Metode: Penelitian kuantitatif dengan pendekatan cross sectional dengan cara melakukan wawancara dengan pasien saat periksa di poli onkologi menggunakan instrumen dari EORTC QLQ C30 versi 3.Hasil dan Pembahasan: Rata-rata penderita kanker serviks berusia 45-55 tahun yaitu 21 orang (37,5%), tidak menopause, dengan paritas antara 1-2 dan indeks massa tubuh normal. Jenis histopatologi terbanyak adalah karsinoma sel skuamosa dan grade sedang. Sebagian besar tidak terdapat keterlibatan kelenjar getah bening, lymphovascular space invation (LVSI) dan tidak dilakukan kemoterapi adjuvan. Kualitas hidup pasien kanker serviks termasuk dalam katagori baik dengan nilai rata-rata status kesehatan global >87,5% dan pada domain skala fungsi dan gejala >90%. Hanya saja terdapat hubungan yang bermakna yang ditunjukkan pada variable usia dengan nilai p=0,020 dan RR=0,545 dan keterlibatan kelenjar gertah bening dengan nilai p=0,008.Kesimpulan: Pada penelitian ini kualitas hidup pasien kanker serviks yang telah dilakukan histerektomi radikal di RSUP Dr. Sardjito sangat baik.Kata Kunci: Kanker serviks; Kualitas Hidup; Histerektomi radikal
Perbandingan Kualitas Hidup Penderita Kanker Ovarium Epitelial yang Diberikan Kemoterapi Regimen Paclitaxel dan Carboplatin dengan Regimen Cyclophospamide, Adriamicyn dan Cisplatin di RSUP Dr. Sardjito Ahyar, Ibnu; Taufiqurrachman, Irwan; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.35428

Abstract

Background: Epithelial ovarian cancer is the dominant type of ovarian cancer. Platinum and Taxane regiment has been proved to increase the survival rate of ovarian cancer patientsObjective: To compare the quality of life of ovarian cancer patients who got Paclitaxel and Carboplatin regiments with Cyclophosphamide, Adriamycin and Cisplatin regiments and risk factors which influence themMethod: The design of the study was retrospective cohort. The total subjects were 156 ovarian cancer patients who consisted of 79 patients with paclitaxel and carboplatin regiments and dan 77 patients who got cyclophospamide, adriamicyn dan cisplatin regiments in DR. Sardjito hospital, Yogyakarta. The quality of life was measured with EORTC QLQ-C30. The data distribution were tested with KolmogorovSmirnov and analysed with D Chi-Squaretest for categorical data and Mann-Whitney for continuous data. Multivariable Analysis was done with logistic regression.Result and Discussion: The bivariable analysis of ovarian cancer stage and the quality of life showed that early stage of ovarian cancer patients had quality of life 19,068 times higher than advance stage of ovarian cancer patients (RR 19,068; 95% CI 2,590-140,362). There were signicant differences in quality of life in ovarian cancer patients with low body mass index <18,5 compared to normal body mass index as well as the titer of tumor marker Ca125. Multivariable analysis showed that there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin.Conclusion: there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin in DR. Sardjito Hospital, Yogyakarta.Keywords: Quality of life, ovarian cancer, paclitaxel plus carboplatin regiment, cyclophospamide, adriamicyn plus cisplatin regiment.
Kualitas Hidup Satu Tahun Pasien Kanker Serviks yang telah Dilakukan Histerektomi Radikal di RSUP DR. Sardjito Yogyakarta Fuadi, Afif; Pradjatmo, Heru; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.511 KB) | DOI: 10.22146/jkr.49348

Abstract

Latar Belakang: Kanker serviks merupakan kanker paling banyak ketiga yang ditemukan pada seorang wanita. Secara keseluruhan lebih dari 85% terjadi pada negara-negara berkembang. Insidensi rata-rata paling tinggi di wilayah Sub Sahara Afrika, Amerika Latin dan Karibia, Melanesia dan Asia Barat, Australia/Selandia Baru. Variasi geografis yang besar mencerminkan ketersediaan skrining yang memungkinkan untuk mendeteksi lesi prakanker dan prevalensi terjadinya infeksi Human Papillomavirus (HPV). Modalitas skrining dan strategi pengobatan telah berevolusi, dengan kemajuan terapi saat ini yang meliputi tindakan pembedahan, kemoterapi dan radiasi, penderita kanker serviks dihadapkan pada efek samping pasca pengobatan lengkap. Sehingga dapat menyebabkan penurunan kualitas hidup mereka.Tujuan: Mengetahui kualitas hidup satu tahun pasien kanker serviks yang telah dilakukan histerektomi radikal.Metode: Penelitian kuantitatif dengan pendekatan cross sectional dengan cara melakukan wawancara dengan pasien saat periksa di poli onkologi menggunakan instrumen dari EORTC QLQ C30 versi 3.Hasil dan Pembahasan: Rata-rata penderita kanker serviks berusia 45-55 tahun yaitu 21 orang (37,5%), tidak menopause, dengan paritas antara 1-2 dan indeks massa tubuh normal. Jenis histopatologi terbanyak adalah karsinoma sel skuamosa dan grade sedang. Sebagian besar tidak terdapat keterlibatan kelenjar getah bening, lymphovascular space invation (LVSI) dan tidak dilakukan kemoterapi adjuvan. Kualitas hidup pasien kanker serviks termasuk dalam katagori baik dengan nilai rata-rata status kesehatan global >87,5% dan pada domain skala fungsi dan gejala >90%. Hanya saja terdapat hubungan yang bermakna yang ditunjukkan pada variable usia dengan nilai p=0,020 dan RR=0,545 dan keterlibatan kelenjar gertah bening dengan nilai p=0,008.Kesimpulan: Pada penelitian ini kualitas hidup pasien kanker serviks yang telah dilakukan histerektomi radikal di RSUP Dr. Sardjito sangat baik.Kata Kunci: Kanker serviks; Kualitas Hidup; Histerektomi radikal
Surgical Management for Resistant Gestational Throphoblastic Neoplasia: Yogyakarta Experience Gulo, Greta S; Darmawan, Nirwan; Irsan, Bob; Prabowo, Wisnu; Kusumanto, Ardhanu
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (130.626 KB) | DOI: 10.19106/JMedScieSup005001201803

Abstract

Gestational trophoblastic neoplasia (GTN) is a highly responsive to chemotherapy, but sometimes can be resistant, or relapse and require salvage chemotherapy with or without surgery.  We use descriptive studies with case series to determine prognosis patient GTN with chemotherapy resistant manage with surgical procedure in Sardjito Hospital, Yogyakarta. GTN-resistant chemotherapy patients that undergoing hysterectomy showed significant decreases in hCG levels. Hysterectomy also help us to stop vaginal bleeding. However, complications from continuous bleeding can worsen patient condition. The decision to take a hysterectomy action varies depending on the patient's condition. At the Sardjito hospital, the patient was diagnosed with the fastest hysterectomy within the first 12 hours of treatment due to continuous bleeding, and shortly after 4 years of treatment with 5 different types of chemotherapy.
Pemeriksaan Tunggal Kadar Osteopontin Serum dan CA 125 untuk Prediktor Keganasan Tumor Ovarium Tipe Epitel: Inferior dibandingkan dengan Pemeriksaan Gabungan Aditiyono, Aditiyono; Harsono, Ali Budi; Winarno, Gatot N.A.; Gandamihardja, Supriadi; Kusumanto, Ardhanu; Susanto, Herman
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (614.179 KB)

Abstract

AbstrakTujuan: Membandingkan penanda tumor osteopontin (OPN), cancer antigen 125 (CA125), kombinasi sebagai prediktor keganasan pada penderita tumor ovarium. Metode: Penelitian cross sectional ini dilakukan pada pasien dengan keganasan pada kista ovarium jenis epitel. Analisis data dilakukan secara univariat dan bivariat. Hasil: 47 pasien dengan hasil hitopatologi jinak dan 43 dengan hasil histopatologi ganas masuk dalam penelitian. Hasil nilai median CA125 kelompok ganas dibanding kelompok jinak (142,2 vs 61,030, p < 0,05), cut off point CA125 99,9 U/mL, sensitivitas 76,7% dan spesifisitas 61,7%. Diskusi: Kombinasi CA125 dan OPN memiliki sensitivitas lebih rendah dibandingkan CA125. Kombinasi CA125 dan OPN akan meningkatkan spesifitas, nilai duga positif dan akurasi yang lebih baik. Tumor marker OPN tidak tepat digunakan untuk proses deteksi dini, tetapi lebih tepat untuk penegakan diagnosis lebih baik dibandingkan dengan gold standard CA125.Kesimpulan: Kombinasi OPN dan CA125 memiliki nilai tingkat akurasi paling tinggi apabila dibandingkan pemeriksaan tunggal CA125, OPN.  Kata Kunci: tumor ovarium tipe epitel, OPN, CA 125, prediktor keganasanSingle Check of Serum Ostepontin and CA 125 Levels as A Predictor of Malignancy in Epitheliaal Ovarium Tumor is Inferior to Combined ExaminationAbstractObjective: To compare the sensitivity, specificity, expected value positive, expected value negative and accuracy among osteopontin (OPN), cancer antigen 125 (CA125), and combination as predictor of malignancy in ovarian tumor patients.Method: A cross sectional study was done to compare parameters OPN and CA125 in determining malignancy of ovarian cysts. Data analysis was performed by univariate and bivariate analysis. Results: A total of 47 subjects were included with benign histopathological result and 43 subjects with malignant histopathological result. The median value of CA125 in malignant group was compared to that of benign group (142.2 vs. 61.030, p value <0.05), the cut-off point of CA125 was 99.9 U/mL with sensitivity of 76.7% and specificity of 61.7%. Discussion: Combination of CA125 dan OPN has lower sensitivity compared to single tumor marker CA125. This combination will increase specificity, positive predictive value and accuracy. The OPN is inappropriate when used for early detection instead is suggested for diagnostic value risk predictor for malignancy in ovarian tumor compared to gold standard CA125.Conclusions: Combination OPN dan CA125 has higher accuracy compared to single CA125, and OPN. OPN was useful biomarker for predicting ovarian malignancy.Keywords: Epithelial ovarian tumor, OPN, CA 125, predictor for ovarian malignancy
HUBUNGAN ANTARA EKSPRESI P53 MUTAN TERHADAP OPERABILITAS KANKER SERVIKS STADIUM IIB PASCA KEMOTERAPI NEOAJUVAN Arsyad, Nur Rohmah; Siswosudarmo, Risanto; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 7, No 1 (2020)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.603 KB) | DOI: 10.22146/jkr.53838

Abstract

Background: The therapy for stage IIB cervical cancer according to FIGO is concurrent chemoradiation. The neoadjuvant chemotherapy followed by radical hysterectomy is an alternative therapy to improve the survival rate of cancer patients. Cervical cancer is mainly caused by the infection of Human Papilloma Virus (HPV), which contains protein E6 and E7 that downregulate the apoptotic function of p53. The absent of p53 wild-type and the present of p53 mutation play roles on the cervical cancer pathogenesis.Objective: To analyze the association between the expression of mutant p53 to the stage IIB cervical cancer operability after neoadjuvant chemotherapyMethod: This study was a prospective cohort, using 40 of 67 patient who met eligibility criteria. The parafin block from cervical tissue were processed for immunohistochemical staining of p53 using Anti-mutant p53 antibody [Y5] ab32049, Abcam, USA. Two study groups were assessed as: 1) weak and 2) strong expression of mutant p53 expression after neoadjuvant chemotherapy based on H-score. Both group (weak and strong) were comparable in term of mutant p53 expression. In this study, the evaluation of operability was performed clinically. Age, BMI, histopathology, grade of differentiation, and regiment were also evaluated as the external variables. Chi square test, and logistic regression analysis were used for statistical analysis.Results and Discussion: The rate of cervical cancer operability after chemotherapy was 19 out of 40 (47.5%). The strong expression of mutant p53 was observed in 6 subjects (15%). There was no significant association between weak vs strong expression of mutant p53 to the operability of the cancer (RR 1.5, CI 95% 0.46-4.88, p 0.45). Multivariate analysis showed that combination (50 mg/m2 dan 5 fluorourasil 450 mg/m2) was significantly correlated the operability (OR 7.02, CI 95% 1.27-40.07,  p 0.03).  Conclusion: The expression of mutant p53 not correlate with operability after neoadjuvant chemotherapy, but combination  regiment was.Keywords: expression of mutant p53, stage IIB of cervical cancer, neoadjuvant chemotherapy, operability
Hubungan antara Ekspresi P53 Mutan terhadap Operabilitas Kanker Serviks Stadium IIB Pasca Kemoterapi Neoajuvan Arsyad, Nur Rohmah; Siswosudarmo, Risanto; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 7, No 1 (2020)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.53838

Abstract

Background: The therapy for stage IIB cervical cancer according to FIGO is concurrent chemoradiation. The neoadjuvant chemotherapy followed by radical hysterectomy is an alternative therapy to improve the survival rate of cancer patients. Cervical cancer is mainly caused by the infection of Human Papilloma Virus (HPV), which contains protein E6 and E7 that downregulate the apoptotic function of p53. The absent of p53 wild-type and the present of p53 mutation play roles on the cervical cancer pathogenesis.Objective: To analyze the association between the expression of mutant p53 to the stage IIB cervical cancer operability after neoadjuvant chemotherapyMethod: This study was a prospective cohort, using 40 of 67 patient who met eligibility criteria. The parafin block from cervical tissue were processed for immunohistochemical staining of p53 using Anti-mutant p53 antibody [Y5] ab32049, Abcam, USA. Two study groups were assessed as: 1) weak and 2) strong expression of mutant p53 expression after neoadjuvant chemotherapy based on H-score. Both group (weak and strong) were comparable in term of mutant p53 expression. In this study, the evaluation of operability was performed clinically. Age, BMI, histopathology, grade of differentiation, and regiment were also evaluated as the external variables. Chi square test, and logistic regression analysis were used for statistical analysis.Results and Discussion: The rate of cervical cancer operability after chemotherapy was 19 out of 40 (47.5%). The strong expression of mutant p53 was observed in 6 subjects (15%). There was no significant association between weak vs strong expression of mutant p53 to the operability of the cancer (RR 1.5, CI 95% 0.46-4.88, p 0.45). Multivariate analysis showed that combination (50 mg/m2 dan 5 fluorourasil 450 mg/m2) was significantly correlated the operability (OR 7.02, CI 95% 1.27-40.07,  p 0.03).  Conclusion: The expression of mutant p53 not correlate with operability after neoadjuvant chemotherapy, but combination  regiment was.Keywords: expression of mutant p53, stage IIB of cervical cancer, neoadjuvant chemotherapy, operability