Andrijono Andrijono
Faculty of Medicine, University of Indonesia, Jakarta

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The Proportion of Lymph Node Metastasis in Patients with Stage IIA1 and IIA2 Cervical Cancer who were Treated for Radical Hysterectomy and Pelvic Lymphadenectomy andrijono, Andrijono; Ginealdy, Wahyu
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (59.963 KB) | DOI: 10.32771/inajog.v7i1.872

Abstract

Objective: This study was designed to determine a difference in prognosis of stage IIA1 cervical cancer compared to stage IIA2 based on the incidence of metastasis to pelvic lymph nodes by radical hysterectomy. Methods:A cross sectional study was conducted among 108 stage II cervical cancer patient post radical hysterectomy in obstetric gynecologic department of Dr. CiptoMangunkusumo hospital since 2006-2016. Results: From 108 patients with cervical cancer stage IIA, 80 (74%) patients are stage IIA1 and the remaining the remaining 28 (26%) patients are stage IIA2. The average age of patients at stage IIA2 (47.79 years) younger than IIA1 (55.85 years) and also patient at stage IIA1 having a higher parity number which is 4 compare to stage IIA2 with the number of parity 2. The Involvement of lymph node metastasis in patients with stage IIA1 and IIA2 cervical cancer were 51 (63.75%) and 16 (57.14%) respectively. Conclusion: Metastatic factor to lymphnode in both stage have the same result. There was no difference in the proportion of lymph node metastasis occurring in both stage IIA cervical cancer stage which was corrected with radical hysterectomy and pelvic lymphadenectomy with p = 0,535. Changing staging does not seem to improve the prognosis. Keywords: cervical cancer, stage IIA, lymphnode metastatic   Tujuan:Membuktikan adanya perbedaan prognosis kanker servik stadium IIa1 dibanding stadium IIa2 berdasarkan kejadian metastasis ke kelenjar getah bening pelvik yang dilakukan histerektomi radikal. Metode: Dengan menggunakan metode potong lintang dilakukan pengambilan data  108 sampel pasien kanker serviks stadium IIA yang dilakukanpembedahanhisterektomiradikal di Departemen OnkologiGinekologi RSUP. Dr. Cipto Mangunkusumo Jakarta sejak tahun 2006 hingga tahun 2016. Hasil: Pasien kanker serviks stadium IIA1 sebanyak 80 (74%) pasien dan stadium IIA2 sebanyak 28 (26 %) pasien. Pada stadium IIA2 (47.79 tahun) didapatkan rata ratausiapasienlebihmudadibandingkan IIA1 (55.85 tahun). Pada stadium IIA1 jugadidapatkanjumlahparitas yang lebihtinggiyaitu 4 sedangkanpada stadium IIA2 denganjumlahparitas 2. Keterlibatan metastasis kelenjar getah bening pada pasien kanker serviks stadium IIA1 dan IIA2 berjumlah 51 (63.75%) dan 16 (57.14%) secara berurutan. Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks pada stadium IIA dengan nilai p = 0,535. Kesimpulan: Faktor metastasis kelenjar getah bening pada kedua stadium memiliki hasil yang serupa.Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks stadium IIA1 dan IIA2 yang ditatalaksna dengan histerektomi radikal dan limfadenektomi pelvis. Perubahan penetapan stadium sepertinya tidak memperbaiki prognosis. Kata kunci : Kanker serviks, stage IIA, kelenjar getah bening, faktor prognostik
Survival rate and prognostic factors in advanced cervical cancer patients accompanied by renal impairment Rasjidi, Imam; Nuranna, Laila; Aziz, M. F.; Andrijono, Andrijono; Purbadi, Sigit; Rochani, Rochani; Supriana, Nana; Dharmeizar, Dharmeizar; Sutrisna, Bambang
Medical Journal of Indonesia Vol 14, No 3 (2005): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (364.409 KB) | DOI: 10.13181/mji.v14i3.193

Abstract

The objective of this study was to obtain information on the  survival rate  of advanced cervical cancer patients with  renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death of  ACCRI patients hopetully  could be obtained.  Design of the study used was retrospective cohort study. Data collected  were retrieved from  medical  records of  ACCRI patients from 1 January 1998 to  31 December 2003 at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, with a total sample of 70 cases. The results of the study showed that mean survival of  all ACCRI patients  was 8.2 months,  mean survival at sixth month was 39%, and mean survival  at one year was 3.2%. Median survival was  5.3 months. Prognostic factors affecting the survival of ACCRI patients included  histopathological type (adenosquamous cell and cell differentiation), cortical thickness of the kidney less than 1 cm, and nephrostomy. (Med J Indones 2005; 14: 173-8)Keywords: Advance cervical cancer, renal impairment, nephrostomy, survival prognostic factor, scoring system
Study on retinol binding protein (RBP) receptor in hydatidiform mole trophoblastic cells Andrijono, Andrijono; Taufik, E.; Hartati, M.; Kodaria, R.
Medical Journal of Indonesia Vol 16, No 3 (2007): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (239.19 KB) | DOI: 10.13181/mji.v16i3.270

Abstract

Hydatidiform mole is an abnormal pregnancy characterized by the proliferation of cytotrophoblastic, syncytiotrophoblastic, and intermediate trophoblastic cells in histological specimens. Vitamin A plays a role in controlling cell proliferation, and decrease in vitamin A level will cause an uncontrollable proliferation. To date, it is not known whether there is a relationship between vitamin A deficiency and hydatidiform mole. This study aimed to demonstrate the presence of retinol binding protein (RBP) receptors in the hydatidiform mole trophoblastic cells, that would provide explanation on the relationship of vitamin A and hydatidiform mole. The study was a descriptive study. The specimens of the study were paraffin blocks of hydatidiform mole made in 2005, and the examinations were performed by indirect immunohistochemistry. We examined the distribution of the cells showing expression of RBP receptor, the strength of expression, and location of the expression. As many as 21 specimens were collected, and the distributions of RBP receptor expression in hydatidiform mole trophoblastic cells ranged from moderate to dense. The expression in syncytiotrophoblastic cells was stronger than that in cytotrophoblastic cells. Furthermore, the expressions were found in the cell membranes and cytoplasm. (Med J Indones 2007; 16:146-50) Keywords: cytotrophoblastic, syncytiotrophoblastic, intermediate trophoblastic cells
Surgical management of stage I and II vulvar cancer:The role of the separated incision Andrijono, Andrijono; Aziz, M. F.; Kampono, N.
Medical Journal of Indonesia Vol 12, No 2 (2003): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (198.186 KB) | DOI: 10.13181/mji.v12i2.97

Abstract

Vulvar cancer is a gynecological cancer whose incidence rate is relatively low. Patients generally were admitted at advanced stage, and radiation therapy at advanced stage does not provide favorable prognosis. Two main modalities in the treatment of vulvar cancer are surgery and radiation therapy. However, radiation can be performed in early stage vulvar cancer but surgery is thought to have more benefits, such as in side effect on the ovary/ reproductive function disorder, patients hygiene factor, and the ease in performing therapy if recurrence occurs. There are various techniques of vulvar cancer surgery, such as radical vulvectomy with butterfly incision (RVBI) and radical vulvectomy with separated incision (RVSI). The objective of this study was to identify the benefits of radical vulvectomy with separated incision in comparison with radical vulvectomy with butterfly incision in terms of the length of surgery, wound recovery, infection incidence, length of hospital stay. This study was a clinical trial performed during the period of 1990-2000. Fifteen cases of vulvar cancer were found and underwent surgery. Fourteen cases were at stage II and 14 cases were histologically defined as squamous-cell carcinoma and 1 case was adenocarcinoma. The average length of surgery in RVSI was 168 minutes, this was shorter than that in VRBI which reached an average of 275 minutes. The incidence of infection in RVSI group was 3 of 11 cases (27.27%), while in RVBI group all cases had infection in surgical wound. Failure of surgical wound approximation was 1 of 12 cases (9.99%), while in RVBI all cases experienced the failure such that cosmetic surgery was required. Length of postoperative care in RVSI group was 12.3 days, while in RVBI 21.5 days. Thus, complications in VRBI were lower, and length of surgery and length of postoperative care were shorter. (Med J Indones 2003; 12: 103-8) Keywords: vulvar cancer, separated incision
Diagnostic test of endometrial cytobrush in cases of perimenopausal and postmenopausal hemorrhage Andrijono, Andrijono; Prayitno, Gunawan D.; Hamdani, Chairil
Medical Journal of Indonesia Vol 14, No 2 (2005): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (178.054 KB) | DOI: 10.13181/mji.v14i2.181

Abstract

Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypical hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The group that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes in endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was to evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was a diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology was performed with a modification of cytubrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its deposits were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the process was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them were examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curetage specimens as gold standard. During the period of study 45 study samples were collected, among which 12 (26.66%) were endometrial adenocarcinoma, 6 (13.33%) with atypical hyperplasia, 11 (24.44%) with non-atypical hyperplasia, 15 (33.33%) were samples without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%, and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. It was concluded that cytological examination of the endometriurn with cytobrush could be employed as a screening method in the abnormalities of endometrial thickness, with sensitivity of 62.5% and specificity of 62.2%. (Med J Indones 2005; 14: 87-91)Keywords: Endometrial cencer, endometrial cytology
A Case-control study of vitamin A level in hydatidiform mole Andrijono, Andrijono; Kurnia, Kukung; Asikin, Nur
Medical Journal of Indonesia Vol 6, No 3 (1997): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (591.667 KB) | DOI: 10.13181/mji.v6i3.819

Abstract

[no abstract available]
Presurgical cytologic diagnostic test of uterine cavity in ovarian malignant tumor Andrijono, Andrijono; Ilyas, Isrin; Hamdani, Chairil
Medical Journal of Indonesia Vol 14, No 2 (2005): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.69 KB) | DOI: 10.13181/mji.v14i2.182

Abstract

There are several methods for diagnosing ovarian carcinoma, such as gynecological examination, ultrasonographic examination, and tumor marker examination. However, all these combinations have not yielded high specificity antl sensitivity results. For this reason, it is necessary to perform other examinations to enhance both specificity and sensitivity, and one of them which is of interest to be studied is cytological examination of uterine cavity. By cytological examination of uterine cavity, it is hope that malignant cells originating from ovarian malignant tumor can be found. Discovery of ovarian malignant cells is possible because of peristaltic mechanism in the fallopian tube and negative pressure from uterine cavity, that makes possible the transportation of ovarian malignant cells into uterine cavity through the tube. The objective of this study is to understand the sensitiviry and specificity of cytological examination of uterine cavity in detecting ovarian malignancy. This stucty was a diagnostic test with histological examination as the gold standard, to understand sensitivity, specificity, positive prediction value, and negative prediction value of cytological examination of uterine cavity. A total of 30 cases were included in the study. A nurnber of factors enhanced positive results in cytology of uterine cavity. Those factors were stage and ascites. The more advanced the stage, the greater the positive results, and the presence of ascites increased positive results. On diagnostic test, sensitivity of uterine cavity cytology was 48%, specificity 60, positive predictive value 85.7%, and negative predictive value 18.8% respectively. In conclusion, cytological examination of uterine cavity could be used as one of the methods in assistirtg the diagnosis of ovarian carcinoma. (Med J Indones 2005; 14: 92-6)Keywords : cytology, uterine cavity, ovarian malignant tumor
VEGF-C level as a predictor of pelvic lymph node metastases of cervical cancer at early stage Andrijono, Andrijono; Priyanto, Heru
Medical Journal of Indonesia Vol 18, No 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (85.182 KB) | DOI: 10.13181/mji.v18i4.372

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Aim: Vascular endothelial growth factor (VEGF) works to stimulate angiogenesis and lymphogenesis which is one of the factors in the metastasis process. This study aimed to identify whether VEGF level could be used to predict metastasis into pelvic lymph node of stage IB-IIA cervical cancer.Methods: The study was case control study, a case (cervical cancer metastasis into pelvic lymph node), a control (cervical cancer without metastasis). Independent variables included primary lesion size, histological type, grade of cell differentiation, lymph vascular space involvement, and VEGF level. Dependent variable was metastasis into pelvic lymph node.Results: Based on cut-off point, VEGF-C serum level, i.e., 10,066.90 pg/ml, 11/47 patients or 23.41%, had the level above that value, and 10/11 of the group of patient or 90.91% were found to develop metastasis into pelvic lymph node. Sensitivity of the examination of VEGF-C level in relation to the risk for the incidence of lymph node in this study was 71.43%, with a specifi city of 96.97%, positive predictive value (PPV) of 90.91%, and negative predictive value (NPV) of 88.89%.Conclusion: VEGF-C level in the serum could be used to predict lymph node metastasis of stage IB-IIA cervical cancer, with a sensitivity of 71.43% and specifi city of 96.97%. (Med J Indones 2009; 18: 257-61)Keywords: cervical cancer, metastasis, VEGF
Clinical-pathologic factors, as predictor of lymph nodes metastasis in cervical cancer stage IB and IIA Aziz, M. F.; Andrijono, Andrijono; Nuranna, Laila; Purbadi, Sigit; Mangunkusumo, Rukmini T.; Siregar, Budiningsih; Cornain, Santoso; Saifuddin, Abdul B.; Tjarta, Achmad; Sutrisna, Bambang
Medical Journal of Indonesia Vol 13, No 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.052 KB) | DOI: 10.13181/mji.v13i2.574

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The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors. (Med J Indones 2004; 13: 113-8)Keywords: cervical cancer, radical hysterectomy, node metastases, case control study, predictor
A Simple Ultrasound Examination as Diagnostic Tool for Malignant Ovarian Tumor Wigin, Christin; Andrijono, Andrijono
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (98.519 KB) | DOI: 10.32771/inajog.v4i4.452

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Objective: To know the diagnostic value of simple ultrasound examination to detect malignant ovarian tumor. Method: This study used cross-sectional design in gynecology outpatientclinic at Dr. Cipto Mangunkusumo Hospital. We recruited the patients with ovarian tumor undergoing surgery between March and July 2015. Samples were taken using consecutive sampling. Analysis was done using Chi-square test and logistic regression to find the relationship between ultrasound morphologic patterns with histopathologic findings, where the significant relationship was p value less than 0.05. Furthermore, a model derived from logistic regression was made to calculate the probability having ovarian malignancy. Result: There were 80 subjects which 58 subjects (72.5%) had benign tumor and 22 subjects (27.5%) had malignant tumor. Ultrasound examination result using  2 morphologic patterns gave malignant result in 53.8% subjects with the sensitivity of 100%, specificity of 82.8%, positive predictive value of 68.8%, and negative predictive value of 100%. The most important patterns were irregular internal cyst wall, multilocular, presence of papillary projection, and presence of solid component. The probability of subject having ovarian malignancy with  3 morphologic patterns was more than 88.9%. Conclusion: Simple ultrasound examination can be used to detect malignant ovarian tumor. [Indones J Obstet Gynecol 2016; 4-4: 222-226] Keywords: diagnostic, histopathology, morphology pattern; ovarian tumor; ultrasonography