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All Journal Majalah Kedokteran Bandung Indonesian Journal of Cancer
Dimyati Achmad
Divisi Bedah Onkologi, Kepala dan Leher, Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
Health Professions Medicine & Pharmacology

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Journal : Indonesian Journal of Cancer

 1 
Strategi Pemakaian Epoetin Alfa dalam Mempertahankan Kadar Hemoglobin pada Kemoterapi Ajuvan Berbasis Antrasiklin Karsinoma Payudara Operabel Achmad, Dimyati; Hariady, Yusuf; Isakh, Benny; Abdurahman, Maman
Indonesian Journal of Cancer Vol 7, No 1 (2013): Jan - Mar 2013
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Pada kanker payudara operabel dengan metastasis regional, pemberian kemoterapi ajuvan berbasis antrasiklin dapat menyebabkan terjadinya anemia ringan sampai berat pada sekitar 4% - 63% kasus. Telah dilakukan berbagai penelitian tentang peran epoetin alfa sebagai alternatif pengganti transfusi, tetapi hasilnya masih belum memuaskan. Dilakukan penelitian uji klinik desain paralel dengan randomisasi blok terhadap 64 sampel penelitian yang dibagi atas 2 kelompok, yaitu kelompok perlakuan yang mendapatkan epoetin alfa dan kelompok kontrol. Kadar Hb pasca-operasi yang termasuk dalam kriteria inklusi adalah > 10 gr/dL - 12 gr/dL. Epoetin alfa diberikan 1 minggu pasca-mastektomi diteruskan sampai 6 kali pemberian dengan dosis 40.000 IU/ minggu dan kadar Hb dinilai mulai dari pemberian kemoterapi siklus pertama sampai 3 minggu setelah kemoterapi siklus keenam. Hasil penelitian menunjukkan pemberian epoetin alfa dengan strategi di atas mampu mempertahankan kadar hemoglobin di atas 10 gr/dL dan tidak dibutuhkan transfusi selama kemoterapi. Sedangkan pada kelompok kontrol membutuhkan transfusi sebanyak 28,1% kasus dan kebutuhan transfusi paling banyak terjadi pada kemoterapi siklus keempat. Kesimpulan: strategi pemakaian epoetin alfa yang dapat dipilih adalah mulai 1 minggu pasca-mastektomi yang diteruskan sampai kemoterapi siklus kedua atau 6 kali pemberian dengan dosis 40.000 IU/minggu dan kadar Hb pasca-mastektomi harus > 10 gr/dL - 12 gr/dL.Kata kunci: kanker payudara, anemia, epoetin alfa.
Faktor yang Berhubungan dengan Terinfiltrasinya Areola dan Papilla pada Karsinoma Payudara Operabel HERIADY, YUSUF; ACHMAD, DIMYATI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Mastectomy is one of the most frequent surgery performed for operable breast cancer and included resection of the nipple-areola complex (NAC). The risk of local recurrence behind the nipple areolar complex (NAC) is the main limitating of the nipple-sparing mastectomy (NSM) procedure. The aim of this study is to investigate the incidence and to determine associated risk factors with cancer infiltration to nipple-areola complex (NAC) in operable breast cancer patients. This is an observational analytic, cross sectional study using retrospective medical record of patients with mastectomy, at Soedarso Hospital Pontianak from 2006 to 2013. Results: In a period of 7 year, we included 310 patients, the mean age is 47,3 years (24-78 years). The NAC involvements 30,6%. In bivariate analysis showed that age, tumor size, tumor stage, lymh node status, lymvovascular invasion and tumor distance are associated with NAC involvement. In the multivariate analysis showed that only lymh node status (p = 0,001; prevalence odds ratio [POR], 1.52; 95% confidence interval [CI], 1.18?1.95), tumor distance (p<0.001; POR, 0.47; CI, 0.36?0.61) and tumor size (p = 0.012; POR, 2.05; CI, 1.17?3.60) are the only variables that remain significant predictors of NAC involvement. In the logistic regression analysis showed that high risks of NAC involvement are tumor distance >1?2 cm with T2 and lymph node status > 4 or with T3 and lymph node status negative or positive> 1; tumor distance >2?3 cm with T3 and lymph node status > 4. Conclusions: NAC involvement is 30,6%. Predictor factors of NAC involvement are lymh node status, tumor distance and tumor size. High risks of NAC involvement are tumor distance >1?2 cm with T2 and lymph node status > 4 or with T3 and lymph node status negative or positive> 1; tumor distance >2?3 cm with T3 and lymph node status > 4.
Kontroversi Tindakan Bedah Dalam Penatalaksanaan Karsinoma Tiroid Diferensiasi Baik ACHMAD, DIMYATI
Indonesian Journal of Cancer Vol 6, No 1 (2012): Jan - Mar 2012
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Karsinoma tiroid merupakan keganasan sistem endokrin yang paling sering ditemukan dan dalam tiga dekade terakhir insidensinya meningkat tajam. Hampir 90% kasus tergolong kedalam Karsinoma Tiroid diferensiasi baik yang tumbuh lambat dengan prognosis yang baik. Diagnosis ditegakkan berdasarkan pemeriksaan sitologi dari biopsi jarum halus atau melalui pemeriksaan histopatologi dari lobektomi tiroid.Sampai saat ini tindakan bedah dalam penatalaksanaan Karsinoma Tiroid diferensiasi baik masih kontroversial terutama untuk kasus dengan risiko rendah. Satu pihak menganjurkan untuk tiroidektomi total, pihak yang lain cukup lobektomi tiroid saja. Kontroversi juga terjadi dalam hal perlu tidaknya diseksi limfatik level sentral bersama-sama tindakan tiroidektomi total pada KTP.American Thyroid Association merekomendasikan tindakan tiroidektomi total dan diseksi limfatik level sentral untuk Karsinoma Tiroid Papilifer khususnya untuk tumor primer yang invasif dan untuk Karsinoma Tiroid Folikuler cukup tiroidektomi total saja.Kata kunci: Karsinoma Tiroid diferensiasi baik, tindakan bedah.
Faktor yang Berhubungan dengan Terinfiltrasinya Areola dan Papilla pada Karsinoma Payudara Operabel HERIADY, YUSUF; ACHMAD, DIMYATI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (610.582 KB)

Abstract

Mastectomy is one of the most frequent surgery performed for operable breast cancer and included resection of the nipple-areola complex (NAC). The risk of local recurrence behind the nipple areolar complex (NAC) is the main limitating of the nipple-sparing mastectomy (NSM) procedure. The aim of this study is to investigate the incidence and to determine associated risk factors with cancer infiltration to nipple-areola complex (NAC) in operable breast cancer patients. This is an observational analytic, cross sectional study using retrospective medical record of patients with mastectomy, at Soedarso Hospital Pontianak from 2006 to 2013. Results: In a period of 7 year, we included 310 patients, the mean age is 47,3 years (24-78 years). The NAC involvements 30,6%. In bivariate analysis showed that age, tumor size, tumor stage, lymh node status, lymvovascular invasion and tumor distance are associated with NAC involvement. In the multivariate analysis showed that only lymh node status (p = 0,001; prevalence odds ratio [POR], 1.52; 95% confidence interval [CI], 1.18?1.95), tumor distance (p<0.001; POR, 0.47; CI, 0.36?0.61) and tumor size (p = 0.012; POR, 2.05; CI, 1.17?3.60) are the only variables that remain significant predictors of NAC involvement. In the logistic regression analysis showed that high risks of NAC involvement are tumor distance >1?2 cm with T2 and lymph node status > 4 or with T3 and lymph node status negative or positive> 1; tumor distance >2?3 cm with T3 and lymph node status > 4. Conclusions: NAC involvement is 30,6%. Predictor factors of NAC involvement are lymh node status, tumor distance and tumor size. High risks of NAC involvement are tumor distance >1?2 cm with T2 and lymph node status > 4 or with T3 and lymph node status negative or positive> 1; tumor distance >2?3 cm with T3 and lymph node status > 4.
Co-Authors Benny Isakh Bethy S. Hernowo Jeremy Sebastian Kiki A. Rizki Maman Abdurahman Yusuf Hariady, Yusuf YUSUF HERIADY, YUSUF