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Karakteristik dan Terapi Penderita Keganasan Penis di RS Cipto Mangunkusumo dan RS Kanker âDharmaisâ Tranggono, Untung; Umbas, Rainy
Indonesian Journal of Cancer Vol 2, No 2 (2008): Apr - Jun 2008
Publisher : "Dharmais" Cancer Center Hospital

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Untuk mengetahui karakteristik dan terapi penderita keganasan penis. Data dikumpulkan dari rekam medik di Klinik Khusus Urologi RSCM dan RSKD, Jakarta, mulai Oktober 1994 sampai dengan September 2005. Faktor-faktor klinis yang diteliti adalah umur, suku, sirkumsisi, dan lesi primer. Faktor-faktor patologis yang diteliti adalah grade histologis, dan staging. Terapi meliputi tindakan terhadap lesi primer, diseksi kelenjar getah bening, radioterapi, dan kemoterapi. Hubungan antara umur dengan stadium penyakit, dan hubungan antara grade dengan stage T dan stage N dianalisis menggunakan Chi-Square Test.Dalam perioda Oktober 1994 sampai dengan September 2005, di RSCM dan RSKD dijumpai 69 orang penderita keganasan penis. Umur tersering pada perioda 40-50 tahun. Suku tersering pada Tionghoa, Betawi, dan Batak. Sedikit lebih banyak pada yang tidak sirkumsisi. Letak lesi primer tersering pada glans dan shaft, dan terjarang pada sulcus coronarius. Penektomi parsial dilakukan pada 33,3 %, penektomi total pada 49,3 %, dan 14,5 % nanya biopsi. Jenis histologis terbanyak aoalah squamous cell carcinoma, diikuti oleh verrucous carcinoma dan leiomyosarcoma. Grade histologis terbanyak adalah grade 1. Sebagian besar penderita dijumpai dalam stage T1 dan T2 (63,9 %), stage N2-3 sebanyak 47,8 %, dan hanya 6,3 % dalam stage Ml. Tidak dijumpai perbedaan grade yang bermakna menurut stage T dan stage N (p>0,05). Tersering penderita dijumpai dalam stadium 4, dan tidak dijumpai perbedaan stadium yang bermakna menurut kelompok umur (p>0,05). Diseksi KGB yang dilakukan sebanyak 36,2 % bilateral dan 5,8 % unilateral.Kasus-kasus keganasan penis di RSCM dan RSKD mempunyai lesi primer terbanyak di glans dan shaft, dengan jenis histologis terbanyak squamous cell carcinoma dalam grade 1. Pada penelitian ini, grade tidak berhubungan dengan staging T dan N walaupun grade 2 dan 3 lebih sering ditemukan pada penderita T2-4 dan N+, dan usia tidak berhubungan dengan staaium penyakit.

Evaluasi Klinis dan Manajemen Kanker Penis di Rumah Sakit Sardjito, Yogyakarta PRAYOGA, DENNY ACHMAD; TRANGGONO, UNTUNG
Indonesian Journal of Cancer Vol 10, No 1 (2016): Jan - Mar 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTThe aim of this study to evaluate clinical and management of penile cancer patients at Sardjito Hospital. Data were collected from medical record of Sardjito Hospital from 2006 - 2013. The clinical factors and therapy were studied from each patient. Correlation between age and stadium of disease were analyzed using Chi-Square Test while the correlation among pathological grade and T, N and M stage were analyzed by using Fisher Test. There are 35 cases of penile cancer with mostly of 40-60 years old man (45.7%) , circumcised (42.9%), squamos cell type (91.4%) and perform partial penectomy (45.7%) followed by chemotherapy (6 patients) and radiotherapy (4patients). There are no correlation between age and stadium of cancer (P>0.05), also among pathological grade with T, N and M Stage (P>0.05). Penile cancers at Sardjito Hospital mostly found on 40-60 years old, and already developed into advanced disease. Thetherapy is consist of partial penectomy followed by chemo- radiotherapy.ABSTRAKPenelitian ini bertujuan untuk mengevaluasi klinis dan manajemen kanker penis di Rumah Sakit Sardjito. Data dikumpulkan dari rekam medis RS Sardjito tahun 2006-2013. Faktor klinis dan terapi dipelajari dari tiap pasien. Hubungan antara usia dan stadium penyakit dianalisis menggunakan tes Chi-Square, sedangkan hubungan antara tingkatan histopatologi dengan stadium T, N, M dianalisis dengan tes Fisher. Ada 35 kasus kanker penis dengandominan pada usia 40-60 tahun (45,7%); telah disunat (42,9%); tipe karsinoma sel skuamosa (91,4%); dan dilakukan penektomi parsial (45,7%) diikuti dengan kemoterapi (6 pasien) serta radioterapi (4 pasien). Tidak ada hubungan antara usia dengan stadium penyakit (>0,05) dan juga antara tingkatan histopatologi dengan stadium T, N, M (p>0,05). Kanker penis di RS Sardjito kebanyakan ditemukan pada usia 40-60 tahun dan telah berkembang menjadi tingkat lanjut. Terapi terdiri dari penektomi parsial diikuti kemo-radioterapi.

SURVIVAL OF PATIENTS WITH BLADDER CANCER WHO HAD PARTIAL CYSTECTOMY IS BETTER THAN THOSE WHO HAD RADIOTHERAPY Prayoga, Denny Achmad; Tranggono, Untung
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.238

Objective: To evaluate the survival on patient who had muscle invasive bladder cancer that had been operated or radiotherapy at Sardjito Hospital Yogyakarta. Material & method: From the year 2004-2010, we were data the patients with muscle invasive bladder cancer that had been operated or radiotherapy at Sardjito Hospital. We studied the age when diagnosed, gender, TNM status, histophatologic finding, histophatologic grade, kinds of surgery and status when follow-up. We evaluated the survival of each patient until 5-years post-surgery. We did bivariate analyze to assess the correlation of patient survival and TNM status, histophatologic grade, clinical stadium and kinds of management. We use Kaplan Meier curve to assess the the survival of patient who had muscle invasive bladder cancer. Results: There were 37 patients with bladder cancer, 3 female patients (8.1%) and 34 male patients (91.9%). Five patients were performed radical cystectomy, 4 patients performed partial cystectomy and 28 patients performed TUR-BT and radiotherapy. There were no significant correlation on the patient survival who had muscle invasive bladder cancer with gender, age, stadium, TNM staging, histopathologic grade and kinds of management (p>0.05). From Kaplan Meier curve, we found that the patients survival was better on stadium I, staging T1, N0, M0 and histopathologic G1 grade. While based on kinds of management, patients were performed partial cystectomy had the survival rate better than the one who only performed TUR-BT and radiotherapy. Conclusion: The surgery of partial cystectomy had a better survival rate than TUR-BT and radiotherapy..

Sensitivity and Specificity of Urinalysis to Diagnose Urinary Tract Infection (UTI) in Patients with Urolithiasis at RSUP Dr. Sardjito Hospital Purnomo, Awang Dyan; Tranggono, Untung
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.247

Objective: Urolithiasis could be caused by urinary tract infection (UTI). UTI in patients with urolithiasis need to be diagnose and manage as soon as possible. This study was aim to determine the diagnostic value of urinalysis examination to diagnose urinary tract infection (UTI) in patients with urolithiasis.Material & method: This study was an observational analytic with cross sectional study design, comparing one diagnostic tool with the gold standard tool to diagnose UTI. Total samples collected were 186 patients at Sardjito General Hospital, Yogyakarta. Urine culture and urinalysis were performed in patients with urinalysis and UTI. The results of urine culture and urinalysis were then compared by 2x2 table.Results: The sensitivity results on leukocyte esterase, eritrocyturia, bacteriuria, and nitrite respectively were 82.7%, 57.14%, 37.59%, and 13.53%. The specificity results on nitrite, bacteriuria, eritrocyturia, and leukocyte esterase respectively were 63.26%, 56.60%, 50.94%, and 33.96%. The highest level of accuracy was leukocyte esterase with 68.81% accuracy.Conclusion: This study showed that leukocyte esterase had good sensitivity with an accuracy of 68.81%. Examination of nitrite had the highest specificity compared to the other variables in urinalysis examination.

PREDICTIVE FACTORS OF POST EXTRACORPOREAL SHOCK WAVE LITHOTRIPSI COMPLICATION EVENTS Yuniarso, Fajar Nugroho; Tranggono, Untung
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.252

Objective: To know if pre-morbid factors such as maximum power, maximum frequency, repeated extracorporeal shock wave lithotripsy (ESWL), age, hypertension, diabetic, nutrition, blood coagulation disorders, kidney function disorders, pain perception, stone burden, and stone location, can be use to predict ESWL complication. Material & methods: This study is done retrospectively. Analysis was done on 50 patients undergoing ESWL between July 2014 to December 2015. Free variables which evaluated were maximum power, maximum frequency, repeated ESWL, age, hypertension, diabetic, nutrition, blood coagulation disorders, kidney function disorders, pain perception, stone burden, and stone location. Dependent variable which evaluated was steinstrasse event, post ESWL fever, post-ESWL renal colic, post-ESWL hematuria. Age variable were distributed normally and done bivariate analysis by student T-test. Others were abnormally distributed and analyzed univariately by Mann U Whitney. Results: During study period, 50 patients were collected. Among them, 60% were men and 40% were women. Mean age of patients undergo ESWL were 50.9 +12.7 years. Mean stone size that undergo ESWL were 172.7 + 277.8 mm2. Patients with hypertension before ESWL were 9 patients. Stones were mostly located on kidney pyelum (29 patients), inferior calix (11 patients), superior calix (5 patients), middle calix (4 patients), and 1 patients has staghorn stone. After ESWL, none of the patients complaining severe pain, 35 patient complaining mild pain, and 15 patient complaining moderate pain. Repeated ESWL done in 16 patients (32%). Post-ESWL complication such as hematuria happened on 12 patients, steinstrasse on 1 patient, and colic on 6 patients. None of patients complaining fever. Repeated ESWL happened on 32% patients and have complication risk of hematuria (p=0.043). Hypertension is significantly effecting on hematuria event after ESWL (p=0.015). Conclusion: Hypertension and repeated ESWL can be used as predicting factor of hematuria complication.

PREDICTIVE FACTORS OF BLOOD TRANSFUSION AFTER TURP AT SARDJITO GENERAL HOSPITAL YOGYAKARTA Arifin, Bobbi; Tranggono, Untung
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.254

Objective: To know the factors that can predict the need for blood transfusions after transurethral resection of the prostate (TURP) at Dr. Sardjito General Hospital. Material & method: This is a retrospective study. Analysis performed on 250 patients who underwent TURP between the years 2013 to 2015. The independent variables evaluated were age, body mass index (BMI), the estimated size of the prostate by transabdominal ultrasonography (TAUS), duration of surgery, hemoglobin level (Hb), the value of international normalized ratio (INR), history of hypertension, diabetes mellitus (DM) and the use of aspirin, and leukosituria. The dependent variable evaluated was the estimated amount of bleeding which was described by the blood transfusion requirements in patients after TURP. Results: Hb levels before surgery (p=0.000), history of hypertension (p=0.001) and a history of aspirin consumption (p=0.008) had a significant association with blood transfusion after TURP. The Hb cut-off value was 12.45 g/dl. Age, BMI, the estimated size of the prostate by TAUS, duration of surgery, history of diabetes and leukosituria did not have a significant association with blood transfusion after TURP. Conclusion: The results showed that Hb levels before surgery, a history of hypertension and aspirin usage can be predictive factors for blood transfusions after TURP.

EFEK KATETER TERHADAP FUNGSI PSA SERUM SEBAGAI PREDIKTOR VOLUME PROSTAT PADA PASIEN YANG TERBUKTI BENIGN PROSTATIC HYPERPLASIA PADA PEMERIKSAAN HISTOPATOLOGIS Tranggono, Untung; Mochtar, Chaidir A; Umbas, Rainy
Indonesian Journal of Urology Vol 16 No 1 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i1.359

Objective: To define the use of Prostate Specific Antigen (PSA) as a predictor of prostate volume in catheterized BPH patients. Material & methods: Data were collected from medical record of symptomatic BPH patients who underwent prostate biopsy at Cipto Mangunkusumo Hospital Urology Clinic since 1994 until 2006. Data of age, serum PSA, indwelling catheter, maximal flow, urine residue, and prostate volume were recorded as variables. Patients who had histopathological result of BPH with or without prostatitis were included; while who had prostate carcinoma, high grade prostatic intraepithelial neoplasm (HGPIN), and BPH with atypical small acinar proliferation (ASAP) were excluded. Subject were then divided into 2 groups, catheterized or not. Data were analyzed using Mann-Whitney test, analysis of variance, correlation test and linear regression test. Results: Of 2283 patients were performed prostate biopsy, 1036 patients had results of BPH with or without prostatitis, 766 patients had prostate carcinoma, while 581 patient’s biopsy result were not recorded. Of the 1036 patients, 347 were catheterized, 192 non-catheterized, and 457 were not recorded. In the catheterized group the average age were 67,04 years old, serum PSA 26,88 ng/ml, prostate volume 54,33 ml, PSA density 0,39. In non-catheterized group the average age were 66,32 years old, serum PSA 16,58 ng/ml, prostate volume 53,94 ml, PSA density 0,33. Regression test showed that serum PSA could be used as a predictor of prostate volume (F=12,830; p < 0,001); in non-catheterized group it was stronger (F=12,989; p<0,001) than in catheterized group (F=6,814; p<0,01). The accuracy of serum PSA as a prostate volume predictor based on Receiver Operating Curve (ROC) as indicated by Area Under the Curve (AUC), in the catheterized group was 0,678 - 0,725 (p<0,001); in non-catheterized group was 0,723 - 0,784 (p<0,001). Conclusion: Serum PSA could be used as a predictor of prostate volume in patients with BPH wether catheterized or not. This predictor function is stronger in non-catheterized patients. Catheter has the effect of lowering the function of serum PSA as a prostate volume predictor in patients with BPH.

PREDICTIVE FACTOR OF METASTATIC RENAL CELL CARCINOMA PATIENT IN SARDJITO HOSPITAL PERIOD 2010 - 2015 Kohar, Moch Abdul; Tranggono, Untung
Indonesian Journal of Urology Vol 25 No 1 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i1.398

Objective: To analyze the association between various prognostic factors and the incidence of renal cell carcinoma (RCC) metastatic. Material & methods: This is a descriptive retrospective study. In this research, the dependent variable is metastatic RCC while the predictor factor as independent variable influencing renal cell carcinoma metastasis. The study population were all patients with renal cell carcinoma that were diagnose in Sardjito Hospital from period 2010 to 2015. Results: In this study there were 34 patients who became the object of research. Consisting of men as many as 20 people (58.8%) while women as many as 14 people (41.2%), while for the age category <51 years as many as 16 people (47.1%) while RCC patients aged > 51 years old 18 People (52.9%). In this study, patients with RCC mostly found in stage 2 were 15 people (44.1%), stage 3 of 6 people (17.6%), stage 4 were 13 people (38.2%). These results are consistent with previous studies which suggest that RCC is found most frequently in stage 2 (Soblin et al, 1997). The p value = < 0.038 indicates that there is a significant correlation between tumor staging and metastatic occurrence in RCC, the result of this study is similar to the previous study which stated that the higher the staging of the tumor the greater the risk of metastasis with p value = 0.001 (Vina et al., 2016). Conclusion: There was a significant association between staging of renal cancer and metastatic events.

SURVIVAL OF PROSTATE CANCER PATIENTS WITH COMBINATION HORMONAL-RADIOTHERAPY BETTER THAN HORMONAL THERAPY Hadibrata, Exsa; Tranggono, Untung
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.583

Objective: This study aims to determine the survival of prostate cancer (PCa) patients who did not undergo radical prostatectomy, but received hormonal therapy or a combination of radiotherapy and hormonal therapy. Material & Methods: This study was an observational analytic study with a retrospective cohort design, using secondary data to determine baseline data and diagnosis of patients, and using primary data to determine the survival of prostate cancer patients who received combination hormonal and radiotherapy therapy compared with hormonal therapy alone. The analysis was performed using chi-square and contingency coefficients to assess the relationship between survival with factors such as age, stage T, N, M, clinical stage, type of therapy, and prognosis. It also used the Kaplan Maeier curve to assess the survival picture of prostate cancer patients at Sardjito General Hospital. Results: 79 patients met the inclusion criteria. The mean age of the patients was 68 ± 8.4 years. A total of 52 (65.8%) patients received hormonal therapy, and 27 (34.2%) patients received combination hormonal and radiotherapy. There were 41 (51.9%) patients remain life, while 38 (48.1%) of patients died during the monitoring. We found that the Gleason score, PSA level, and clinical stage were significantly associated with patient survival with p <0.005. The 5 years survival rate patient with local, locally advanced clinical stage and PSA level ≤20 ng/ml who received combination hormonal and radiotherapy achieved 100%. Conclusion: Combination of hormonal and radiotherapy was more improving patient survival compared with hormonal therapy only in patient with locally advanced clinical stage, PSA level ≤20 ng/ml and Gleason score ≤7.

SURVIVAL OF PROSTATE CANCER PATIENTS WITH COMBINATION HORMONAL-RADIOTHERAPY BETTER THAN HORMONAL THERAPY Hadibrata, Exsa; Tranggono, Untung
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.583

Objective: This study aims to determine the survival of prostate cancer (PCa) patients who did not undergo radical prostatectomy, but received hormonal therapy or a combination of radiotherapy and hormonal therapy. Material & Methods: This study was an observational analytic study with a retrospective cohort design, using secondary data to determine baseline data and diagnosis of patients, and using primary data to determine the survival of prostate cancer patients who received combination hormonal and radiotherapy therapy compared with hormonal therapy alone. The analysis was performed using chi-square and contingency coefficients to assess the relationship between survival with factors such as age, stage T, N, M, clinical stage, type of therapy, and prognosis. It also used the Kaplan Maeier curve to assess the survival picture of prostate cancer patients at Sardjito General Hospital. Results: 79 patients met the inclusion criteria. The mean age of the patients was 68 Â± 8.4 years. A total of 52 (65.8%) patients received hormonal therapy, and 27 (34.2%) patients received combination hormonal and radiotherapy. There were 41 (51.9%) patients remain life, while 38 (48.1%) of patients died during the monitoring. We found that the Gleason score, PSA level, and clinical stage were significantly associated with patient survival with p <0.005. The 5 years survival rate patient with local, locally advanced clinical stage and PSA level â‰¤20 ng/ml who received combination hormonal and radiotherapy achieved 100%. Conclusion: Combination of hormonal and radiotherapy was more improving patient survival compared with hormonal therapy only in patient with locally advanced clinical stage, PSA level â‰¤20 ng/ml and Gleason score â‰¤7.

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