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The Profile of Cervical Cancer Patients at Soedarso Hospital 索达索医院宫颈癌患者概况
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.845
Sari Eka Pratiwi, Heru Fajar Trianto, Nabilah Nurul Fatinah, M. I. Ilmiawan, I. Fitrianingrum, Desriani Lestari
Background: The prevalence and mortality rates of cervical cancer differ by region with the highest rates found in Latin America, Southeast Asia, and Africa. In Indonesia, cervical cancer is the second-largest contributor to the latest cases in 2020. In West Kalimantan, over 20,000 women were diagnosed with cervical cancer in 2014. This study aims to describe the characteristics of cervical cancer patients in West Kalimantan. Methods: A descriptive observational study was conducted on patients from 2017 to 2019 according to the Soedarso Hospital database. All medical records were reviewed and analyzed to obtain the variable data; they were age, ethnics, origin, stage of cervical cancer, histopathology types, and hemoglobin (Hb) level. Results: Cervical cancer patients for the 2017–2019 period totaled 147 people with 30 deaths. In this study, 97 patients from 2017 to 2019 met the inclusion criteria. Cervical cancer was found from the age of 27 years with a peak at the age of 41–60 years. Most patients came from Pontianak and Kubu Raya cities (45.4% and 14.4%, respectively) with the most ethnic groups being Malays (41.2%). A total of 43.3% of patients had a parity amount of more than five times. Most patients came at stage IIIb (45.4%). The patients present with moderate to severe anemia with the lowest Hb level of around 2.3 g/dL. Based on histopathology, the type of squamous cell carcinoma ranks the highest (70.1%).  Conclusions: Cervical cancer incidence reaches the peak at adults to elderly. The amount of parity seems to contribute to the incidence of cervical cancer in West Kalimantan. Most patients came at an advanced stage and the type of squamous cell carcinoma with moderate to severe anemia
背景:子宫颈癌的患病率和死亡率因地区而异,拉丁美洲、东南亚和非洲的发病率最高。在印度尼西亚,宫颈癌是2020年最新病例的第二大原因。在西加里曼丹,2014年有2万多名妇女被诊断患有宫颈癌。本研究旨在描述西加里曼丹宫颈癌患者的特征。方法:根据Soedarso医院数据库,对2017 - 2019年的患者进行描述性观察研究。对所有医疗记录进行审查和分析,以获得可变数据;年龄、民族、来源、宫颈癌分期、组织病理学分型、血红蛋白(Hb)水平。结果:2017-2019年期间宫颈癌患者总数为147人,其中30人死亡。在本研究中,2017 - 2019年有97例患者符合纳入标准。宫颈癌发病年龄为27岁,发病高峰为41-60岁。大多数患者来自Pontianak和Kubu Raya市(分别为45.4%和14.4%),马来人最多(41.2%)。共有43.3%的患者的胎次超过5次。大多数患者为IIIb期(45.4%)。患者表现为中度至重度贫血,最低Hb水平约为2.3 g/dL。在组织病理学上,鳞状细胞癌的类型最高(70.1%)。结论:宫颈癌发病率以成人至老年人为高峰。在西加里曼丹,胎次数量似乎是导致子宫颈癌发病率的原因之一。大多数患者出现在晚期,鳞状细胞癌类型伴中度至重度贫血
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引用次数: 2
Re-Irradiation of Recurrent Nasopharyngeal Cancer: A 4-year Follow-up Study of Treatment using 3-Dimensional Conformal Radiotherapy 复发鼻咽癌的再照射:三维适形放疗治疗的4年随访研究
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.837
Samuel Kelvin Ruslim, Selviant Selviant, Aviciena Bin Iskandar, Sielvyana Sie, A. Hariyanto, Monika Kencana Dewi
Introduction: Nasopharyngeal cancer (NPC) is a prevalent diagnosis of head and neck cancers (HNC) in Asia. In Indonesia, it is estimated that there are 12,000 new cases per year. Case Presentation: The author reports a 25-year-old male patient with recurrent NPC. This patient was first diagnosed with NPC stage IVB in 2013 and was treated by chemoradiation. In 2016, he found another mass in his neck. The biopsy result showed the recurrence of the NPC with histopathology of Undifferentiated carcinoma (WHO type III). Re-irradiation was planned, and the patient subsequently received 3D-Conformal Radiotherapy (3D-CRT) at our department. Four years after the completion of re-irradiation, the patient was alive and well with no signs of recurrence but still complained about late toxicities like trismus and fibrotic neck.  Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like intensity-modulated radiotherapy (IMRT). However, with careful planning, we can still obtain optimum tumor dose, minimize organs at-risk (OAR) dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on re-irradiation, especially in OAR dose tolerance guidelines.
简介:鼻咽癌(NPC)是亚洲头颈癌(HNC)的常见诊断。在印度尼西亚,估计每年有1.2万例新病例。病例介绍:作者报告一位25岁男性复发性鼻咽癌患者。该患者于2013年首次被诊断为鼻咽癌IVB期,并接受了放化疗。2016年,他在脖子上发现了另一个肿块。活检结果显示鼻咽癌复发,组织病理学为未分化癌(WHO III型)。计划再次照射,患者随后在我科接受3d适形放疗(3D-CRT)。再照射完成4年后,患者存活良好,无复发迹象,但仍抱怨晚期毒性,如牙关紧闭和纤维化颈部。结论:在本研究中,我们讨论了3D-CRT在鼻咽癌再照射中的应用,与更复杂和广泛传播的调强放疗(IMRT)等方式相比,它在获得最佳剂量分割方面的局限性。然而,通过仔细的计划,我们仍然可以获得最佳的肿瘤剂量,最小化器官危险(OAR)剂量,以及随后出现的晚期毒性。我们希望这项研究能给设施有限的中心带来希望,我们建议进一步研究再照射,特别是在OAR剂量耐受指南中。
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引用次数: 0
The Unmet Needs of Women Living with Cancer in Community Setting: A Professional Concern 社区环境中未满足的女性癌症患者需求:一个专业问题
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.816
Ni Putu Wulan Purnama Sari
Background: In the community of Surabaya, the 2nd largest city of Indonesia, women living with cancer are mostly the long-term survivors of advanced-stage cervical cancer, but the number of women living with breast cancer cannot be ignored. There were various physical and psychological problems related to the total suffering and worsening phenomena. The limited resources available in the community have led to various levels of unmet needs in their perspective. This study aimed to analyze and describe the unmet needs of female cancer survivors in the community of Surabaya.  Methods: This descriptive study involved five Public Health Centers (PHCs) among 63 PHCs in Surabaya (7.94%), Indonesia, which were selected by one-stage cluster random sampling. There were 41 and 40 women living with breast and cervical cancers, respectively, participating in this study (n = 81). The Supportive Care Needs Survey – Short Form 34 (SCNS-SF34) was used to collect the data of unmet needs (r = 0.234 – 0.821; Chronbach Alpha = 0.939). Descriptive statistic was used in data analysis (frequency, Mean, and Standard Deviation). Ethical clearance was issued. Results: Most respondents were late adult married women with low socioeconomic status. They were mostly short-term survivors and already had surgery. Most of them reported a moderate level of unmet needs (Mean ± SD = 109.30 ± 27.66). Health system and information needs became their top priorities (45.75), followed by patient care and support needs (37.89), physical and daily function needs (32.20), psychological needs (31.11), and sexuality needs (22.00). There were 9.88% of respondents who reported that there were no unmet needs. Conclusions: Female cancer survivors in the community reported a moderate level of unmet needs. Health system and information needs were the most reported unmet needs
背景:在印度尼西亚第二大城市泗水社区,患有癌症的妇女大多是晚期宫颈癌的长期幸存者,但患有乳腺癌的妇女人数也不容忽视。有各种生理和心理问题与总的痛苦和恶化的现象有关。在他们看来,社区可利用的资源有限导致了不同程度的需求未得到满足。本研究旨在分析和描述泗水社区女性癌症幸存者未满足的需求。方法:采用一阶段整群随机抽样的方法,对印度尼西亚泗水市(7.94%)63家公立卫生中心(PHCs)中的5家进行描述性研究。分别有41名和40名患有乳腺癌和宫颈癌的妇女参加了这项研究(n = 81)。使用支持性护理需求调查短表34 (SCNS-SF34)收集未满足需求的数据(r = 0.234 - 0.821;Chronbach Alpha = 0.939)。数据分析采用描述性统计(频数、平均值和标准差)。道德许可被签发。结果:调查对象以晚婚女性居多,社会经济地位较低。他们大多是短期幸存者,已经做过手术。大多数患者报告有中等程度的未满足需求(Mean±SD = 109.30±27.66)。卫生系统和信息需求是他们最优先考虑的需求(45.75),其次是患者护理和支持需求(37.89),身体和日常功能需求(32.20),心理需求(31.11)和性需求(22.00)。9.88%的受访者表示没有未满足的需求。结论:社区中的女性癌症幸存者报告了中等水平的未满足需求。卫生系统和信息需求是报告未满足需求最多的
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引用次数: 0
The Profile of Soft Tissue Sarcoma Patients who Undergo Radiotherapy in Dr. Hasan Sadikin General Hospital Bandung 万隆哈桑·萨迪金医生总医院软组织肉瘤患者放射治疗概况
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.856
Antony A. Adibrata, Marhendra Satria Utama, Adji Kusumadjati
Background: Soft Tissue Sarcoma is one of the rare cancers that increased in number in the last few years, but information about soft tissue sarcoma patients was still limited, especially in West Java, Indonesia. This study aimed to find out the patient profile and the histopathological cell distribution of soft tissue sarcoma patients who undergo radiotherapy. Methods: The study design was retrospective descriptive quantitative with the total sampling method. This study was done by observing all patients’ medical records registered from January 1, 2018, until December 31, 2019, in the Hospital-Based Cancer Registry of Radiology Department of Dr. Hasan Sadikin General Hospital Bandung, with the inclusion criterion of patients diagnosed with soft tissue sarcoma.  Results: A total of 5% (n = 75) from 1,388 cases registered were soft tissue sarcoma. The most common patient profile was female (57.3%) and age group 45–54 years (21.3%). The chief complaint was dominated by a painless mass (56.0%) at the lower limb (37.8%) with the most frequent cell of fibrosarcoma (17.3%), the most intention of the radiotherapy of curative adjuvant (78.7%). Conclusions: The number of soft tissue sarcoma is small compared to other malignancies. It is more common in women, the most age group is from 45 to 54 years with the median of 47 years old, ranging from 9 to 90 years, it tends to occur in the lower limb with a chief complaint of a painless mass, and the most frequent cell is fibrosarcoma. The common treatment combination is surgery with radiotherapy
背景:软组织肉瘤是近年来数量增加的罕见癌症之一,但关于软组织肉瘤患者的信息仍然有限,特别是在印度尼西亚西爪哇。本研究旨在了解软组织肉瘤患者放疗后的患者概况及组织病理细胞分布。方法:采用全抽样方法,采用回顾性、描述性、定量研究设计。本研究通过观察万隆哈桑·萨迪金医生总医院放射科医院癌症登记处2018年1月1日至2019年12月31日登记的所有患者的医疗记录进行,纳入标准为诊断为软组织肉瘤的患者。结果:1388例病例中,软组织肉瘤占5% (n = 75)。最常见的患者是女性(57.3%)和年龄45-54岁(21.3%)。主诉以下肢无痛性肿块(56.0%)为主(37.8%),以纤维肉瘤细胞为主(17.3%),以治疗性辅助放疗为主(78.7%)。结论:软组织肉瘤与其他恶性肿瘤相比数量较少。多见于女性,最常见于45 - 54岁,中位年龄47岁,年龄范围9 - 90岁,多见于下肢,主诉为无痛性肿块,最常见的细胞为纤维肉瘤。常见的治疗组合是手术加放疗
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引用次数: 1
Magnetic Resonance Findings in Adolescent Vaginal Rhabdomyosarcoma: A Rare Case Report 青少年阴道横纹肌肉瘤的磁共振表现:一罕见病例报告
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.842
Trifonia Pingkan, Fitri Juniarta, H. Tjahjadi, Meliyana Lai
Introduction: Rhabdomyosarcoma (RMS) is a rare soft tissue tumor, mainly affecting children, adolescents, and adults younger than 15 years, representing 3% to 4% of all childhood malignancies. Genitourinary is the second-most-common location of RMS with around 25% of cases. We describe a rare case of vaginal rhabdomyosarcoma in adolescents with huge polypoid tumors. Case Presentation: A 15-year-old female presented with vaginal bleeding for seven months. Her medical story was unremarkable. The clinical examination showed a polypoid mass prolapsed from the vagina, and the laboratory result was anemia. The pelvic magnetic resonance imaging (MRI) showed a heterogenous bulky solid tumor in the vagina. The histopathological finding revealed a sarcoma, and the immunohistochemical staining result was rhabdomyosarcoma not otherwise specified (NOS). Conclusions: Vaginal RMS is a rare malignant tumor of mesenchymal origin with skeletal muscle differentiation. Vaginal RMS is the most common site of genitourinary RMS and presents as a rapidly growing and aggressive local mass. Imaging plays an important role in the initial diagnosis of vaginal RMS, regarding the presentation of the bulky protruding tumor on the vaginal region
横纹肌肉瘤(Rhabdomyosarcoma, RMS)是一种罕见的软组织肿瘤,主要影响儿童、青少年和15岁以下的成年人,占所有儿童恶性肿瘤的3%至4%。泌尿生殖系统是RMS的第二常见部位,约占25%。我们报告一例罕见的青少年阴道横纹肌肉瘤合并巨大的息肉样肿瘤。病例介绍:一名15岁女性,阴道出血7个月。她的医疗经历并不引人注目。临床检查显示阴道有息肉样肿块脱出,实验室检查结果为贫血。盆腔磁共振成像(MRI)显示阴道内一异质大体积实体瘤。组织病理学发现为肉瘤,免疫组化染色结果为无特异性横纹肌肉瘤(NOS)。结论:阴道RMS是一种罕见的骨骼肌分化的间充质恶性肿瘤。阴道RMS是泌尿生殖系统RMS最常见的部位,表现为快速生长和侵袭性的局部肿块。影像学在阴道RMS的初步诊断中起着重要的作用,对于阴道区域的巨大突出肿瘤的表现
{"title":"Magnetic Resonance Findings in Adolescent Vaginal Rhabdomyosarcoma: A Rare Case Report","authors":"Trifonia Pingkan, Fitri Juniarta, H. Tjahjadi, Meliyana Lai","doi":"10.33371/ijoc.v16i1.842","DOIUrl":"https://doi.org/10.33371/ijoc.v16i1.842","url":null,"abstract":"Introduction: Rhabdomyosarcoma (RMS) is a rare soft tissue tumor, mainly affecting children, adolescents, and adults younger than 15 years, representing 3% to 4% of all childhood malignancies. Genitourinary is the second-most-common location of RMS with around 25% of cases. We describe a rare case of vaginal rhabdomyosarcoma in adolescents with huge polypoid tumors. Case Presentation: A 15-year-old female presented with vaginal bleeding for seven months. Her medical story was unremarkable. The clinical examination showed a polypoid mass prolapsed from the vagina, and the laboratory result was anemia. The pelvic magnetic resonance imaging (MRI) showed a heterogenous bulky solid tumor in the vagina. The histopathological finding revealed a sarcoma, and the immunohistochemical staining result was rhabdomyosarcoma not otherwise specified (NOS). Conclusions: Vaginal RMS is a rare malignant tumor of mesenchymal origin with skeletal muscle differentiation. Vaginal RMS is the most common site of genitourinary RMS and presents as a rapidly growing and aggressive local mass. Imaging plays an important role in the initial diagnosis of vaginal RMS, regarding the presentation of the bulky protruding tumor on the vaginal region","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89656008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of Penile Cancer at Tertiary Centre Hospital: A Nine Years Study from 2010-2019 三级中心医院阴茎癌的特征:2010-2019年的9年研究
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.832
Christopher Kusumajaya, Ferry Safriadi
Background: Penile cancer is a rare and aggressive disease. The incidence in India, Africa, and South America ranges from 2.3 to 8.3 per 100,000. No data regarding incidence rates in Indonesia. The etiological factors include poor genital hygiene, phimosis, tobacco use, multiple sex partners, human papillomavirus (HPV) infection, and chronic inflammatory states. Squamous cell carcinoma (SCC) represents 95% of penile cancers. Progression and treatment of the disease cause devastating consequences and morbidity such as disfiguring penile amputation. This study aimed to assess the epidemiological characteristics of penile cancer in the city of Bandung, its associated risk factors, clinical manifestations, and compare the results with previous studies. Methods: This was a descriptive study conducted at Hasan Sadikin Hospital Bandung from January 2010 to 2019. The study included all penile cancer patients that came to Urology Department. Variables such as age, history of circumcision, phimosis, HPV infection, marital status, smoking habit, educational level, age of onset, operation, histopathological results, history of multiple sex partners, location of the tumor, comorbidities, and staging are collected from the medical record and analyzed. Results: A total of 13 penile cancer patients were involved with the age range from 28 to 67 years and 50.69 years on average. Most of them were smokers (69.2%) and uncircumcised (53.8%). All of the patients came at an advanced stage, and penectomy was done. Histopathologically, 84.6% were SCC. One of our patients was consulted by a haemato-oncologist for adjuvant chemotherapy (6 cycles of cisplatin and 5-fluorouracil). Conclusions: Penile cancer is a rare neoplasm in Bandung, West Java. The characteristics of penile cancer patients found in our hospitals were on average 50.7 years old, and the most risk factors found were smoking and uncircumcised. Histopathologically, most of them were SCC. All patients came to seek medical treatment at an advanced stage and had undergone surgical penectomy.
背景:阴茎癌是一种罕见的侵袭性疾病。印度、非洲和南美洲的发病率为每10万人2.3至8.3人。没有关于印度尼西亚发病率的数据。病因包括生殖卫生不良、包茎、吸烟、多个性伴侣、人乳头瘤病毒(HPV)感染和慢性炎症状态。鳞状细胞癌(SCC)占阴茎癌的95%。疾病的进展和治疗导致毁灭性的后果和发病率,如阴茎截肢毁容。本研究旨在了解万隆市阴茎癌的流行病学特征、相关危险因素、临床表现,并与以往研究结果进行比较。方法:这是一项描述性研究,于2010年1月至2019年在万隆哈桑萨迪金医院进行。该研究包括所有到泌尿外科就诊的阴茎癌患者。从病历中收集年龄、包皮环切史、包茎、HPV感染、婚姻状况、吸烟习惯、教育水平、发病年龄、手术、组织病理学结果、多个性伴侣史、肿瘤位置、合并症和分期等变量并进行分析。结果:共13例阴茎癌患者,年龄28 ~ 67岁,平均年龄50.69岁。其中吸烟者占69.2%,未割包皮者占53.8%。所有的患者都是晚期患者,都做了阴茎切除术。组织病理学上,84.6%为鳞状细胞癌。我们的一位患者接受了血液肿瘤学家的辅助化疗咨询(6个周期的顺铂和5-氟尿嘧啶)。结论:阴茎癌在西爪哇万隆地区是一种罕见的肿瘤。本院发现的阴茎癌患者的特征平均年龄为50.7岁,发现的危险因素最多的是吸烟和未割包皮。组织病理学上多数为鳞状细胞癌。所有患者均在晚期就诊,并已行阴茎切除术。
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引用次数: 1
Survival Analysis of Pediatric Wilms Tumor Based on Risk Identification 基于风险识别的儿童肾母细胞瘤生存分析
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.829
A. Andy, Y. Sigumonrong
Background: Wilms Tumor (WT) or nephroblastoma is the most common primary malignant tumor of the kidney found in children (comprising about > 95% of all kidney tumors). The study of WT prognostic factors has not been elaborated enough in Indonesia. This study aimed to determine the prognostic factors of WT patients in Adam Malik Hospital, Medan. Methods: This study was conducted with a retrospective design due to the rarity of WT cases. A total of 21 WT patients diagnosed from 2003 to 2019 were taken from medical records at Adam Malik Hospital, Medan. Univariate and multivariate Cox regression analyses were performed to determine the independent prognostic factors of WT. The primary endpoint of this study was patients’ overall survival (OS) obtained by the Kaplan-Meier analysis on significant variables. Results: From the univariate Cox regression analysis, gender was found to be the sole significant factor (HR = 0.218, p = 0.005) where males have a lower hazard ratio. The multivariate Cox regression analysis yielded an age of diagnosis (HR = 13.860, p = 0.014) and complete tumor removals (HR = 0.056, p = 0.008). The Kaplan-Meier analysis was performed on three significant variables mentioned before. Only gender yielded a significant Mantel-Cox log-rank score (p = 0.002) with male patients found to have better survivability with a median survival of 476 days compared to that of females of 11 days. The three-year survival of males was 45.45% while all females did not survive until the cut-off. Conclusions: Three prognostic factors, including children’s gender, age of diagnosis, and tumor removal status, were confirmed to be prognostic factors for the overall survival of children with WT. Further studies covering broader demographic areas were suggested to confirm significant results.
背景:肾母细胞瘤(Wilms Tumor, WT)或肾母细胞瘤是儿童肾脏最常见的原发性恶性肿瘤(约占所有肾脏肿瘤的95%以上)。WT预后因素的研究在印度尼西亚还没有得到充分的阐述。本研究旨在确定棉兰Adam Malik医院WT患者的预后因素。方法:由于WT病例的罕见性,本研究采用回顾性设计。从棉兰Adam Malik医院的医疗记录中共提取了2003年至2019年诊断出的21例WT患者。采用单因素和多因素Cox回归分析确定WT的独立预后因素。本研究的主要终点是通过Kaplan-Meier对显著变量进行分析得出的患者总生存期(OS)。结果:单因素Cox回归分析发现,性别是唯一的显著因素(HR = 0.218, p = 0.005),男性的风险比较低。多因素Cox回归分析得出诊断年龄(HR = 13.860, p = 0.014)和肿瘤完全切除(HR = 0.056, p = 0.008)。Kaplan-Meier分析是对前面提到的三个重要变量进行的。只有性别产生显著的Mantel-Cox log-rank评分(p = 0.002),男性患者的生存能力更好,中位生存期为476天,而女性患者的中位生存期为11天。雄性的三年存活率为45.45%,而所有雌性都没有存活到截止日期。结论:三个预后因素,包括儿童性别、诊断年龄和肿瘤切除状态,被证实是WT儿童总生存的预后因素。建议进一步研究涵盖更广泛的人口统计学领域,以确认显著结果。
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引用次数: 0
Differences in Pre-Operative Mean Serum Concentration of Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4) in Patients with Benign Thyroid Nodules and Thyroid Carcinoma at Sanglah General Hospital Denpasar 登巴萨Sanglah总医院良性甲状腺结节和甲状腺癌患者术前平均血清促甲状腺激素(TSH)和游离甲状腺素(FT4)浓度的差异
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.813
I. G. A. S. Mahendra Dewi, Desak Putu Gayatri Saraswati Seputra
Background: Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4) concentration are currently highlighted in their relation to thyroid carcinoma development in thyroid nodule patients. This study aimed to identify the difference in the pre-operative mean serum concentration of TSH and FT4 in patients with benign thyroid nodules and thyroid carcinoma at Sanglah General Hospital Denpasar.Methods: : This study was a case-control study that involved 110 patients with thyroid nodules who underwent thyroidectomy at Sanglah General Hospital from January until December 2019, whose specimens were examined histopathologically at the Anatomical Pathology Laboratory of Sanglah General Hospital. Cases were patients with thyroid carcinoma. Controls were patients with benign thyroid nodules. The data were collected from medical records. Results: Most subjects in the thyroid carcinoma group were female (72.7%). The thyroid carcinoma group had a higher mean age at the time of thyroidectomy (47.33 ± 13.4) compared to the benign thyroid nodule group (46.07 ± 12.5) (p = 0.61). Significant difference was found regarding the nodule size between the two groups (p < 0.001). There were no significant differences in terms of nodule lateralization (p = 0.56) and the number of nodules (p = 0.58). Papillary thyroid carcinoma was the most common type of thyroid carcinoma (89.1%). A significantly higher pre-operative mean serum TSH concentration was found in cases (1.0 ± 0.23 IU/mL) compared to controls (0.8 ± 0.23 IU/mL) (p < 0.001). The pre-operative mean serum FT4 concentration was significantly lower in cases (1.1 ± 0.25 IU/mL) compared to controls (1.2 ± 0.22 IU/mL) (p = 0.006). The optimal TSH and FT4 cut-off values for thyroid carcinoma were > 1.0 IU/mL (61% sensitivity, 71% specificity) and < 1.1 IU/mL (61% sensitivity, 51% specificity), respectively Conclusions: : Higher pre-operative mean TSH concentration and lower mean FT4 concentration were found in patients with thyroid carcinoma. There were statistically significant differences between patients with thyroid carcinoma and benign thyroid nodules in terms of these two laboratory parameters. 
背景:促甲状腺激素(TSH)和游离甲状腺素(FT4)浓度与甲状腺结节患者甲状腺癌发展的关系目前备受关注。本研究旨在确定登巴萨Sanglah总医院良性甲状腺结节和甲状腺癌患者术前平均血清TSH和FT4浓度的差异。方法:本研究是一项病例对照研究,纳入了2019年1月至12月在Sanglah总医院接受甲状腺切除术的110例甲状腺结节患者,其标本在Sanglah总医院解剖病理学实验室进行了组织病理学检查。病例为甲状腺癌患者。对照组为良性甲状腺结节患者。数据是从医疗记录中收集的。结果:甲状腺癌组以女性居多(72.7%)。甲状腺癌组平均年龄(47.33±13.4)岁高于良性甲状腺结节组(46.07±12.5)岁(p = 0.61)。两组间结节大小差异有统计学意义(p < 0.001)。两组在结节偏侧程度(p = 0.56)和结节数量(p = 0.58)方面无显著差异。甲状腺乳头状癌是最常见的甲状腺癌类型(89.1%)。患者术前平均血清TSH浓度(1.0±0.23 IU/mL)明显高于对照组(0.8±0.23 IU/mL) (p < 0.001)。患者术前平均血清FT4浓度(1.1±0.25 IU/mL)明显低于对照组(1.2±0.22 IU/mL) (p = 0.006)。甲状腺癌最佳TSH和FT4临界值分别为> 1.0 IU/mL(灵敏度61%,特异性71%)和< 1.1 IU/mL(灵敏度61%,特异性51%)。结论:甲状腺癌患者术前平均TSH浓度较高,平均FT4浓度较低。甲状腺癌患者与良性甲状腺结节患者在这两个实验室参数上的差异有统计学意义。
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引用次数: 1
Breast Cancer in Indonesia in 2022: 30 Years of Marching in Place 2022年印度尼西亚的乳腺癌:30年的前进
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.920
W. Gautama
Breast cancer is the most prevalent cancer in Indonesia, 19.2% out of all cancers [1]. In 1992, most breast cancer patients (60-70%) sought medical treatment when the cancers were in late stages (stage III and IV) [2]. Thirty years later data collected from several teaching hospitals in Indonesia shows that 68- 73% of breast cancer patients come to medical centers in the late stages [3,4,5]. It is interesting to learn why the number of late-stage breast cancer patients in Indonesia remains the same despite the advancement in early detection and therapeutical measures. This editorial will mainly discuss one factor contributing to the diagnostic and treatment delay: patients’ accessibility to proper medical attention. Accessibility to proper medical attention for breast cancer patients in Indonesia depends on the number and distribution of trained oncologists, a concise referral system, and supportive regulation. Indonesia is a vast archipelago country with a population of more than 273 million people. In tertiary medical centers, breast cancer patients are attended by surgical oncologists since surgery is the main treatment. As per February 2002, there are only 233 surgical oncologists practicing. This number is far below the ratio proposed by the Indonesian Society of Surgical Oncologists (Perhimpunan Ahli Bedah Onkologi Indonesia/PERABOI) which is 0.2 per 100,000 population (546 surgical oncologists needed). This number is still below the ideal ratio which is twice as much. However, setting a goal too high would make the organization frustrated, hence the revised target. The role of oncologists is vital in breast cancer cases. A multinational analysis shows that being diagnosed with breast cancer by an oncologist correlates with shorter treatment delay [6]. It takes at least 6 years of general surgery training plus 2 more years of surgical oncology training to produce a surgical oncologist. This does not count the 2-5 years of working experience required before a general surgeon could apply for the surgical oncologist training. Acceleration is critical to producing more surgical oncologists, either by establishing more training centers or by modifying the training system. Establishing a surgical oncology training center is no simple procedure; especially since UU Pendidikan Kedokteran number 20/ 2013 mandates that medical specialist training must be university-based [7]. The government should consider the role of hospital-based training to accelerate the production of surgical oncologists. The revision of the law is underway that would recognize the role of professional society and collegium in medical specialist training. Acceleration can also be carried out through modifying the training system: from subspecialist training to specialist training. A general practitioner can enroll for the surgical oncology training without having to be a general surgeon first. The role of “collegium” is vital to ensure that the training curricula meet the requi
泗水一家三级医疗中心的一项研究表明,只有13.8%的患者通过转诊系统就诊[11]。这反映了我国转诊制度的一些功能失调。有必要为初级和二级医疗中心的医生制定乳腺癌转诊指南。由于缺乏简明的转诊指南,可能会导致一些早期乳腺癌患者在二级医疗中心接受的外科肿瘤治疗不足,后来在较晚期才来到三级医疗中心。改革一些条例是确保病人获得适当医疗照顾的必要条件。规范医学专家培训的法律需要进行改革,以便加快急需的外科肿瘤学家的培养和全国分配。有必要建立乳腺癌转诊制度,以避免二级医疗中心的转诊延误。此外,迫切需要重新评估国家卫生筹资系统的监管,这往往会导致医院延迟乳腺癌治疗。旨在减少印度尼西亚晚期乳腺癌的数量是一项巨大的工作。从医学角度来看,乳腺癌患者尽早获得适当的医疗照顾至关重要。加快外科肿瘤学家的培养,确保其在全国的均匀分布,完善乳腺癌转诊制度,改革一些法规是必不可少的措施。30年前,我们有60-70%的晚期乳腺癌。可悲的是,现在我们有类似的数字。如果我们不采取必要的行动,三十年后,我们将看不到这个数字有多大的不同。看起来印度尼西亚的乳腺癌护理正在到位。
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引用次数: 8
Trichilemmal Carcinoma on the Head (Surgical Challenge to Achieve Free Margin): A Case Report 头部毛突癌(手术切除游离切缘的挑战)1例报告
Pub Date : 2022-04-01 DOI: 10.33371/ijoc.v16i1.861
D. Khambri
Introduction: Trichilemmal carcinoma is a rare tumor derived from the outer hair sheath. It usually appears on the face, ears, neck, scalp, and sun-exposed areas. It generally occurs in patients older than 50 years old, and there is no sex predilection to this disease.Case Presentation: A 60-year-old woman came with a complaint of a lump in the head that often bled. The size of the lump was approximately like a bean seed and broke when she combed her hair. The lump was getting bigger within a year and easier to bleed. She often felt pain. Based on the history of surgery 2 months ago, the examination implies that the patient had trichilemmal carcinoma.Conclusions: Trichilemmal carcinoma generally occurs in the elderly category. Although trichilemmal carcinoma has a benign clinical course and local recurrence cases are uncommon, sufficient free margin and immediate reconstruction are challenging if the predilection is in the head and neck. Surgical excision is the recommended treatment for this disease
毛鞘癌是一种罕见的发源于外毛鞘的肿瘤。它通常出现在脸、耳朵、脖子、头皮和阳光照射的地方。它通常发生在50岁以上的患者中,并且对这种疾病没有性别偏好。病例介绍:一名60岁的妇女来就诊,她自诉头部有肿块,经常出血。肿块的大小大约像一颗豆籽,当她梳头时就碎了。肿块在一年内变得越来越大,也更容易出血。她经常感到疼痛。根据2个月前的手术史,检查提示患者患有滴管癌。结论:毛突癌多见于老年人。虽然毛突癌的临床过程为良性,局部复发的病例并不多见,但如果病变发生在头颈部,足够的游离缘和立即重建是具有挑战性的。手术切除是治疗此病的推荐方法
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引用次数: 0
期刊
Indonesian Journal of Cancer
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