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Tenri Ashari Wanahari
International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Health Professions Medicine & Pharmacology Public Health

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Prognostic Value of the Systemic Immune-Inflammation Index in EGFR Mutation-Positive Lung Adenocarcinoma Patients Treated with Tyrosine Kinase Inhibitors Marsheilla Riska; Haryati Haryati; Eko Suhartono; Tenri Ashari Wanahari
Jurnal Respirasi Vol. 8 No. 3 (2022): September 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (448.743 KB) | DOI: 10.20473/jr.v8-I.3.2022.133-139

Abstract

Introduction: Inflammatory parameters calculated from complete blood counts such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) are related to poor prognosis in lung cancer patients. This study aimed to explore a correlation between NLR, PLR, and SII to survival rates in advanced lung adenocarcinoma with tyrosine kinase inhibitors (TKIs) as the main treatment choice. Methods: This was a retrospective observational study of patients with epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma treated by TKIs at Ulin General Hospital Banjarmasin from January 2017 to December 2019. The optimal cut-off values for NLR, PLR, and SII were obtained using the receiver operating characteristic curve (ROC). Kaplan–Meier analyses were used to assess the prognostic value of inflammation parameters in overall survival (OS) and progression-free survival (PFS). Results: This study involved 50 samples, 62% male, with an average age of 55.98 years old, 94% in stage IVA, EGFE mutation in exon 19 (58%) and exon 21 (42%). About 58% of patients have a smoking history. The optimal cut-off value for NLR, PLR, and SII was 6.095, 356.935, and 1767.0, respectively. However, only the SII was significantly associated with survival; SII ≥ 1767.0 correlated with shorter OS (18 months vs. 28 months, p = 0.014) and PFS (7 months vs. 12 months, p = 0.004). Conclusion: Pre-treatment SII can be a prognostic factor for survival in EGFR mutation-positive lung adenocarcinoma patients receiving TKIs.
Pathological Characteristics of Fiberoptic Bronchoscopy Procedure in Ulin General Hospital, Banjarmasin Ira Nurrasyidah; Muhammad Ajib Nuzula; Ika Kustiyah Oktaviyanti; Desi Rahmawaty; Tenri Ashari Wanahari
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.117-123

Abstract

Introduction:  Fiberoptic Bronchoscopy (FOB) has emerged into the method of choice for the detection of lung tumors due to its availability of Adequate cytological and histological samples in the form of broncho-alveolar lavage, bronchial brushings, and bronchial forceps biopsy. This study aims to identify characteristics of bronchoalveolar lavage, aspiration cytology, brushing cytology and forceps cytology of patients suspected with malignancy at the Ulin Regional Hospital in South Kalimantan. Methods: A cross-sectional study was carried out utilizing medical documentation of patients suspested lung cancer from March 2018 to March 2020. Data were grouped by gender, age, type of procedure, and cytology and histopathology findings. Results: The result showed that 67.5% of 117 patients who underwent bronchoscopy had positive results and common histological diagnosis The frequent histopathological conclusion was adenocarcinoma (45.6%) tailed by squamous cell carcinoma (40.55). Forceps bronchoscopy showed a greater positivity rate (75.0%) than bronchoscopy without forceps (63.6%), we also found that by combining BAL and brushing and forceps biopsy, the detection rate of lung malignancy increased to 85.7%, but no correlation between the type of procedure and the likelihood of malignancy was discovered. Conclusions: Forceps bronchoscopy showed a greater positivity rate than bronchoscopy without forceps, but no correlation between the type of procedure and the likelihood of malignancy was discovered in our study.
Implementing Palliative and End-of-Life Care in Lung Cancer: When to Start? Haryati Haryati; Desi Rahmawaty; Tenri Ashari Wanahari
Jurnal Respirasi Vol. 9 No. 1 (2023): January 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.1.2023.64-71

Abstract

Lung cancer is among the most prevalent cancers and the primary cause of cancer-related mortality. Despite advances in treatment, patients often have a poor prognosis, with a limited survival period, particularly in advanced stages. Significant morbidity is linked with lung cancer, and symptoms are frequently inadequately controlled, resulting in a considerable symptom burden for patients and their family caregivers. It is typically accompanied by an overall reduction in one's quality of life (QoL). Palliative care is an established therapy paradigm that successfully enhances symptom management and physical and mental health. It can be initiated as soon as the patient develops symptoms (even in the early stage) or is diagnosed with a late stage. Over the past few decades, palliative care has become a vital part of comprehensive care for people, especially those with advanced diseases. Early palliative care (EPC) integration within the oncology setting is more effective than standard care in enhancing the patient's QoL and length of survival, resulting in less intrusive end-of-life care. When caring for lung cancer patients, medical practitioners must remember their duty to cure occasionally, routinely alleviate, and constantly comfort the patient. Treating physical symptoms, illness comprehension, coping, and psychological and spiritual anguish are all vital components. Intervention strategies by multidisciplinary teams concentrating on the patient and their family and dealing with the circumstances are essential. All health providers should prioritize palliative and end-of-life care to enhance care and assist patients and their families in navigating the final period of life.
Co-Authors Desi Rahmawaty Desi Rahmawaty Eko Suhartono Eko Suhartono Haryati Haryati Ika Kustiyah Oktaviyanti Ira Nurrasyidah Muhammad Ajib Nuzula