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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

The objective of this study was to obtain information on theÂ survival rateÂ of advanced cervical cancer patients withÂ renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death ofÂ ACCRI patients hopetullyÂ could be obtained.Â Design of the study used was retrospective cohort study. Data collectedÂ were retrieved fromÂ medicalÂ records ofÂ ACCRI patients from 1 January 1998 toÂ 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 ofÂ all ACCRI patientsÂ was 8.2 months,Â mean survival at sixth month was 39%, and mean survivalÂ at one year was 3.2%. Median survival wasÂ 5.3 months. Prognostic factors affecting the survival of ACCRI patients includedÂ 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:Â Advance cervical cancer, renal impairment, nephrostomy, survival prognostic factor, scoring system

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

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 â¤ 0.05. However, on multivariate analysis younger age, parity â¥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value â¤ 0.05. Conclusion: Younger age, parity â¥ 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

Comparison of various procedures in the processing of binucleated-lymphocytes on to glass slide to detect chromosomal breakage Pawitan, Jeanne A.; Suryono, Isnani A.; Damayanti, Lia; Purbadi, Sigit
Medical Journal of Indonesia Vol 12, No 1 (2003): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Binucleated lymphocytes can be screened for micronuclei to assess chromosomal damage. There are various procedures to get slides containing binucleated lymphocytes, that are different in harvesting, fixation, and slide preparation methods. Screening binucleated lymphocytes to find a micronucleus needs at least 800 cells with intact cytoplasm. This study aimed to analyze the various procedures and simplified procedures to know which procedure gave the most abundant binucleated lymphocytes with intact cytoplasm and best staining properties for the purpose of micronucleus scoring. Seven heparinized blood samples were obtained from the Dept. of Obstetrics and gynecology, Faculty of medicine, University of Indonesia, Jakarta. The 7 blood samples were subjected to 17 procedures different in harvesting (with or without washing), slide preparation (smear and spot method, and using a cytocentrifuge), and fixation methods (methanol for 1 minute, methanol brief, methanol/glacial acetic acid 3:1 or 9:1). Our results showed that fixatives containing glacial acetic acid are not suitable for micronucleus test. To generate binucleated lymphocytes with intact cytoplasm as much as possible, the procedure should be conducted without washing steps. Methanol fixation either briefly or 1 minute is preferable, and for the ease of screening cytocentrifuge preparation, followed by spot method is preferable. (Med J Indones 2003; 12: 3-7)Â Keywords: cytokinesis blocked, spot, smear, cytocentrifuge, fixatives

Theurapeutic Response of Neoadjuvant Chemotherapy between Platinum and Ifosfamide Combination and Platinum, Vincristine and Bleomycin Combination in Cervical Carcinoma Stage IB2 Nuryanto, Kartiwa H; Purbadi, Sigit
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 1, January 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the theurapeutic response and acute toxicity of neoadjuvant chemotherapy between the combination of Platinum and Ifosfamide, and the combination of Platinum, Vincristine and Bleomycin in Cervical Carcinoma Stage IB2 and then continued with radical hysterectomy and pelvic lymphadenectomy. Method: Thirteen samples received neoadjuvant chemotherapy of Platinum and Ifosfamide and 17 samples received neoadjuvant chemotherapy of Platinum, Vincristine and Bleomycin, after receiving the neoadjuvant chemotherapy, clinically complete response samples underwent radical hysterectomy and pelvic lymphadenectomy (PI VS PVB = 3 VS 1). Histopathology examination was performed to evaluate the presence of malignant viable cells at the cervix, pelvic lymph node metastasis and parametrium metastasis. Acute toxicity evaluation was performed based on gastrointestinal, genitourinarius and hematology sign and symptom. Result: Theurapeutic response of PI is 1.12 higher than PVB (p>0.05). Subanalysis of group response of PI is 1.962 higher than PVB. PI and PVB have the same risk to have pelvic lymph node metastasis, but not parametrial metastasis. There were no differences in terms of the risk of gastrointestinal, genitourinarius and hematologic toxicity between PI and PVB. Conclusion: There was no statistical difference in clinical and pathological response, and also in acute toxicity between the two combination (p>0.05). [Indones J Obstet Gynecol 2016; 1: 47-51] Keywords: acute toxicity, cervical carcinoma stage IB2, neoadjuvant chemotherapy, response

Single vs Multiple Dose of Cefazolin Prophylaxis in Elective Cesarean Section Purbadi, Sigit; Fadli, Muhamad
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Introduction: Caesarean section (CS) is one of port d’ entrée from infection in women and it is related to maternal morbidity during puerpureal period. Until now, there is still lack of consensus regarding prophylactic antibiotic protocol before CS procedure. This study aims to determine the comparative efficacy between single dose and multiple doses of cefazolin prior incision toward the incidence of maternal infection. Methods: This was a single-blind, randomized, clinical trial study with two methods of intervention including 2-gram single dose cefazolin at 30 minutes’ prior incision and 2-gram single dose cefazolin at 30 minutes’ prior incision continued 1-gram cefazolin after 8 hours of procedure. We recruited women undergone elective CS at Fatmawati and Anna Hospital, Jakarta from January to March 2016. The primary outcomes were surgical site infection, urinary tract infection, and endometritis based on clinical findings during 30 days of follow-up period. Results: A total of 46 subjects were recruited which 23 of them were in single dose cefazolin group and the other 23 subjects were in multiple dose of cefazolin group. There were 9 subjects having infection (19.6%). There was no statistical difference in the incidence of infection between two groups (p=1.00; relative risk 0.80, 95% CI 0.25-2.61). Conclusion: Single dose of cefazolin shows similar rates of infection incidence to multiple dose. Therefore, single dose of cefazolin can be a protocol in CS based on its efficacy and efficiency. [Indones J Obstet Gynecol 2017; 5-1: 60-65] Keywords: cefazolin, maternal infection, multipe dose, single dose

Treatment Response of PlatinumBased Chemoradiation on Locally Advanced Cervical Cancer Khonsa, Oni; Purbadi, Sigit; Supriana, Nana; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the efficacy (treatment response), toxicity, and overall survival of concomitant chemoradiation (CRT) with three-weekly cisplatin-ifosfamide compared to CRT with weekly cisplatin in advanced stage cervical cancers (stage IIB-IIIB). Method: This is a historical cohort between 32 patients receiving CRT with three-weekly cisplatin and ifosfamide and 29 patients receiving weekly cisplatin in Gynecologic Oncology division outpatient clinic and ward, Dr. Cipto Mangunkusumo Hospital. Results: There was no significant difference in treatment response, overall and disease-free survival. There was more gastrointestinal toxicity in the cisplatin-ifosfamide arm compared to the other arm (p=0.014), but other toxicity effects were not different. Conclusion: Platinum based-chemoradiation has the same efficacy in terms of treatment response for locally advanced cervical cancer. [Indones J Obstet Gynecol 2015; 3-4: 212-221] Keywords: cisplatin, concomitant chemoradiation, ifosfamide, locally advance stage cervical cancer

The Concept of Gynecologic Oncology Services in Jakarta Related to Academic Health System Purbadi, Sigit
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v5i2.515

An Academic Health System (AHS) is a system in partnership among universities and health care providers that focuses on education, training, service, and research. The final outcome of this partnership is to improve health status. Numerous countries have been using this system, since this system is proven to lead to better sustainable outcome.The vision of Faculty of Medicine, University of Indonesia (FMUI) is "to create infinite experience for all through Academic Health System". The third mission of FMUI is to integrate the AHS to Dr. CiptoMangunkusumo Hospital and its other affiliated hospitals.The division of Oncology Department of Obstetrics and Gynecology is a part of Academic Health System that is responsible to create the Gynecologic Oncology services in this system. We create the gynecologiconcology services in preventive approach from primary to tertiary prevention.The sister hospitals of FMUI’s including Dr. Cipto Manungunkusumo, Persahabatan, Fatmawati, Karawang, and Tangerang General Hospital. Ideally, we should have health provider partners from primary, DistrictHospital (Rumah Sakit Umum Kecamatan/RSUK and Rumah Sakit Umum Daerah/RSUD). Another partner in collaborative project of AHS is Organization of Health Care Professions, such as Indonesian Medical Association, Indonesian Obstetrics and Gynecology Society, and Indonesian Gynecologic Oncology Society, and nongovernmental organization such as Female Cancer Program, Indonesian Cancer Foundation and others are part of partnership in AHS. When talking about public health status, it is also necessary to talk about the role of government as the policy maker and The Social Warranty Institution (Badan Penyelenggara Jaminan Sosial Kesehatan, BPJS) as the public health care insurance regulator. Primary health care should be included in the AHS’s partnership members because primary prevention strategy should be conducted in primary health care.The example of this project is Cervical Cancer Surveilance as a pilot project. We would prepare the project in collaborative meeting with all partners to make proposal in gynecologic oncology services in primary,secondary, and tertiary health care, and finally Dr. Cipto Mangunkusumo Hospital as the national referral Hospital. The proposal should talk about concepts of education, training, service, and research. Primary health care can promote cervical prevention and early detection via visual inspection using acetic acid and Pap test.Cervical precancer lesion can be treated using cryotherapy in primary health care. In secondary health care setting, cervical precancer lesion until microinvasive cervical cancer (stage 1A1) can be treated. Invasive cervical cancer should be managed in tertiary health care. We are preparing concepts where all services should follow the Clinical Practice Guideline. All medical patient database should be recorded digitally as long term cohort data. By applying this system, we’ll have a large number of patients’ data from primary to tertiary health care.This is crucial, considering that the process of education, training, and research of medical students, residents, and fellows is the backbone of AHS in improving health care status.

Fascin Expression as Prognostic Factor for Survival in Advanced Epithelial Ovarian Carcinoma Vitantri, Fara; Purbadi, Sigit; Siregar, Budiningsih; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate fascin expression as a prognostic factor and its correlation with survival and clinicopathologic factors (degree of differentiation and stage) in epithelial ovarian carcinoma. Methods: This study is prognostic study with historical cohort design. Fascin was analyzed in paraffin block sections of 33 advanced stage ovarian carcinoma patients using immunohistochemistry. Fascin expression was tested for its correlation with overall survival as well as with grade and stage of the cancer. Results: In this study, fascin expression has no correlation with survival. In the period of 17-22 months, samples with high fascin expression had a HR of 1.59 (95% CI=0.38-6.67, p=0.449), but in the period of 17-23 months, both groups had comparable HR. In the period of more than 23 months, samples with high expression of fascin had a better HR of 0.40 (95% CI=0.04-4.38, p=0.449). No significant correlation was found between fascin expression with grade (OR=2.08, 95% CI=0.44-9.84, p=0.442) and stage (OR=2.70, 95% CI=0.39-18.96, p=0.360). Conclusion: In this study, there was no correlation between fascin expression and survival, and also no correlation between fascin, grade and stage. Further study with a larger, more homogenous sample, analyzing confounding factors is needed. [Indones J Obstet Gynecol 2015; 3-4: 222-229] Keywords: advanced stage ovarian carcinoma, fascin, survival

Treatment Response of PlatinumBased Chemoradiation on Locally Advanced Cervical Cancer Khonsa, Oni; Purbadi, Sigit; Supriana, Nana; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the efficacy (treatment response), toxicity, and overall survival of concomitant chemoradiation (CRT) with three-weekly cisplatin-ifosfamide compared to CRT with weekly cisplatin in advanced stage cervical cancers (stage IIB-IIIB). Method: This is a historical cohort between 32 patients receiving CRT with three-weekly cisplatin and ifosfamide and 29 patients receiving weekly cisplatin in Gynecologic Oncology division outpatient clinic and ward, Dr. Cipto Mangunkusumo Hospital. Results: There was no significant difference in treatment response, overall and disease-free survival. There was more gastrointestinal toxicity in the cisplatin-ifosfamide arm compared to the other arm (p=0.014), but other toxicity effects were not different. Conclusion: Platinum based-chemoradiation has the same efficacy in terms of treatment response for locally advanced cervical cancer. [Indones J Obstet Gynecol 2015; 3-4: 212-221] Keywords: cisplatin, concomitant chemoradiation, ifosfamide, locally advance stage cervical cancer

Fascin Expression as Prognostic Factor for Survival in Advanced Epithelial Ovarian Carcinoma Vitantri, Fara; Purbadi, Sigit; Siregar, Budiningsih; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate fascin expression as a prognostic factor and its correlation with survival and clinicopathologic factors (degree of differentiation and stage) in epithelial ovarian carcinoma. Methods: This study is prognostic study with historical cohort design. Fascin was analyzed in paraffin block sections of 33 advanced stage ovarian carcinoma patients using immunohistochemistry. Fascin expression was tested for its correlation with overall survival as well as with grade and stage of the cancer. Results: In this study, fascin expression has no correlation with survival. In the period of 17-22 months, samples with high fascin expression had a HR of 1.59 (95% CI=0.38-6.67, p=0.449), but in the period of 17-23 months, both groups had comparable HR. In the period of more than 23 months, samples with high expression of fascin had a better HR of 0.40 (95% CI=0.04-4.38, p=0.449). No significant correlation was found between fascin expression with grade (OR=2.08, 95% CI=0.44-9.84, p=0.442) and stage (OR=2.70, 95% CI=0.39-18.96, p=0.360). Conclusion: In this study, there was no correlation between fascin expression and survival, and also no correlation between fascin, grade and stage. Further study with a larger, more homogenous sample, analyzing confounding factors is needed. [Indones J Obstet Gynecol 2015; 3-4: 222-229] Keywords: advanced stage ovarian carcinoma, fascin, survival

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