Gatot N.A. Winarno
Faculty of Medicine University of Padjadjaran/ Dr. Hasan Sadikin General Hospital Bandung

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Paclitaxel-carboplatin chemotherapy induced hematologic toxicities among epithelial ovarian cancer patients Charles, Afandi; Dewayani, Birgitta M.; Sahiratmadja, Edhyana; Winarno, Gatot N.A.; Susanto, Herman
Universa Medicina Vol 35, No 3 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.165-170

Abstract

BackgroundEpithelial ovarian cancer (EOC) is one of the most common cancers diagnosed in Indonesian women. A combination of paclitaxel and carboplatin is used to treat EOC as standard chemotherapy which is known to have hematologic toxicities. This study aimed to investigate the effect of combined paclitaxel-carboplatin chemotherapy on hematologic status in EOC patients managed at Dr. Hasan Sadikin General Hospital, Bandung, West Java.MethodsAll patients with confirmed pathological diagnosis of EOC at Dr. Hasan Sadikin General Hospital in the period of 2013 to 2014 were registered. Only patients with complete hematologic data before and after chemotherapy were collected and compared using the paired non-parametric Wilcoxon and McNemar tests. ResultsIn total there were 147 patients with EOC (median age 46 ± 12 years), with the most dominant pathological diagnosis of mucinous (32.7%) and serous (29.3%) types. Only 33 patients had hematologic data before the initiation of chemotherapy. There was a significant decrease after chemotherapy including hemoglobin level (12.0 vs 10.9 g/dL, p=0.013), erythrocyte count (4.53 vs 3.74 million/mL, p<0.001), leukocyte count (7,700 vs 4,000/mm3 p<0.001) and platelet count (343,000 vs 215,000/mm3, p<0.001). Interestingly, anemia cases after chemotherapy were predominant (87.9%) compared with erythopenia, leukopenia, thrombocytopenia i.e. 39.4%, 57.6%, and 27.3% respectively. ConclusionsThis study confirmed the hematologic toxicities after paclitaxel-carboplatin chemotherapy in EOC patients treated in Hasan Sadikin General Hospital, West Java. The hemoglobin concentration may serve as prognostic factor. Further studies directed to other factors such as genetic factor for polymorphisms may be encouraged to explore the decrease of the hematologic indices.
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