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Maas MR, Yang A, Muir MA, Collins JB, Canter C, Tamamyan G, Chitsike I, Kouya F, Nguyen KH, Ahmad A, Alcasabas AP, Gao YJ, Johnson KJ, Ferrara G, Bhakta N, Muluneh B. Evaluating implementation of a hospital-based cancer registry to improve childhood cancer care in low- and middle-income countries. Cancer Med 2024; 13:e70125. [PMID: 39248149 PMCID: PMC11382012 DOI: 10.1002/cam4.70125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/27/2024] [Accepted: 08/09/2024] [Indexed: 09/10/2024] Open
Abstract
PURPOSE Cancer is a leading cause of global childhood mortality, affecting 400,000 children annually. While treatable with modern therapies, children living in low- and middle-income countries (LMICs) have limited access to care and lower survival rates. Hospital-based cancer registries (HBCRs) collect detailed patient information to critically evaluate and evolve care. The St. Jude Global Childhood Cancer Analytics Resource and Epidemiological Surveillance System (SJCARES) is a cloud-based HBCR network facilitating quality data collection of pediatric cancer. Wide variation in the success of implementation has warranted further research into the implementation approach, to create a sustainable and adaptable HBCR in LMICs. METHODS Seven of 89 sites using the SJCARES registry were selected, stratified by global region and stage of implementation. Semi-structured interviews were conducted with key groups (clinicians, administrators, data clerks) using an interview guide developed from the Consolidation Framework for Implementation Research (CFIR). Interviews were conducted via a video-telephone software program and transcribed by a transcription service. Transcripts were thematically coded using rapid qualitative analysis. RESULTS A total of 18 participants (11 clinicians, 4 administrators, 3 data clerks) were interviewed. Several barrier themes were identified, including: difficulty integrating the registry into existing workflow; lack of resources; lack of government or administrative support; and damaged, misplaced, or illegible medical records. Facilitator themes were identified, including: internal support for the registry; clear and extensive training; and dedicated support staff. CONCLUSION Interviewed participants identified key barriers and facilitators to the implementation of the SJCARES registry across multiple phases. We plan to use these results to develop targeted implementation strategies including a readiness assessment tool to help guide more successful implementation of the SJCARES registry and other HBCRs in LMICs.
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Affiliation(s)
- Melissa R Maas
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - Allison Yang
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | | | - James B Collins
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
- GSK, Durham, North Carolina, USA
| | - Courtney Canter
- North Carolina Translational and Clinical Sciences Institute, Chapel Hill, North Carolina, USA
| | - Gevorg Tamamyan
- Pediatric Cancer and Blood Disorders Center of Armenia, Yeolyan Hematology and Oncology Center, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University, Yerevan, Armenia
| | | | | | | | - Alia Ahmad
- University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | | | - Yi-Jin Gao
- Shanghai Children's Medical Center, Shanghai, China
| | - Kimberly J Johnson
- Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
| | - Gia Ferrara
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Benyam Muluneh
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
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Dewi IP, Gartika N, Sanusi S, Suryatiningsih D. Determinants of Spiritual Well-Being That Impact Breast Cancer Patients' Quality of Life. J Holist Nurs 2024; 42:S40-S46. [PMID: 37287242 DOI: 10.1177/08980101231181272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Breast cancer affects patients' quality of life, which is influenced by the body's functional abilities and the patients' spiritual well-being. Currently, there is no research on the spiritual determinants that affect quality of life in the Indonesian context. Purpose: This research analyzes the determinants of spiritual well-being in terms of breast cancer patients' quality of life using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp). Methods: A cross-sectional study was conducted with 112 participants who were selected using purposive sampling. Women with breast cancer who had a Palliative Performance Scale version 2 score of 60 and who were able to read and write were included. The instruments used included the RAND SF-36 Quality of Life Questionnaire, which was modified to the Indonesian context and was used to survey breast cancer patients (Cronbach coefficient of >0.90), in addition to the FACIT-Sp (Cronbach coefficient of 0.768). The multivariate data were analyzed using logistic regression. Results: The determinants of spiritual well-being for the participants' quality of life included meaning (odds ratio of 0.436) and peace (odds ratio of 0.303). Conclusion: The meaning and peace domains of spiritual well-being significantly affect breast cancer patients' quality of life.
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Waluyo ST, Tjokroprawiro BA, Rahaju AS. Correlation between estrogen receptor and programmed death ligand-1 in type I endometrial cancer. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100293. [PMID: 38433993 PMCID: PMC10907181 DOI: 10.1016/j.eurox.2024.100293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
Objective To determine the effect of estrogen receptor (ER) on programmed death-ligand 1 (PD-L1) expression in type I endometrial cancer (EC). Material and Methods This retrospective study included 85 patients with type I EC who underwent surgery at Dr. Soetomo Hospital between 2018 and 2022. A random sampling technique was employed. Immunohistochemistry (IHC) with ER and PD-L1 antibodies was performed on all samples. In this study, ER expression served as the independent variable, while PD-L1 expression was considered the dependent variable. Data analysis was performed using Spearman's rank correlation coefficient test. Results Out of the 85 patients with type I EC, 58 (68.2%) exhibited positive and 27 (31.8%) exhibited negative ER expression. Meanwhile positive PD-L1 expression was seen in 67 (78.8%) and 18 (21.2%) exhibited negative PD-L1 expression. The study revealed a strong negative correlation between ER and PD-L1 expression in EC (rho value = -0.886, p-value = 0.0001). Conclusion ER downregulates PD-L1 in type I EC. The findings of this study can be used as reference data and as the basis for further research, especially investigations of the prognostic and immunotherapeutic value of ER and PD-L1 expression in type I EC.
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Affiliation(s)
- Setyo Teguh Waluyo
- Subspecialist Education Program, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Dr. Soetomo General Academic Hospital, Medical Faculty –Universitas Airlangga, Surabaya, Indonesia
| | - Brahmana Askandar Tjokroprawiro
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga/Dr.Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Anny Setijo Rahaju
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga/Dr.Soetomo General Academic Hospital/ Universitas Airlangga Hospital, Surabaya, Indonesia
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Situmorang PC, Ilyas S, Syahputra RA, Sari RM, Nugraha AP, Ibrahim A. Rhodomyrtus tomentosa as a new anticancer molecular strategy in breast histology via Her2, IL33, EGFR, and MUC1. Front Pharmacol 2024; 15:1345645. [PMID: 38476328 PMCID: PMC10927741 DOI: 10.3389/fphar.2024.1345645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The prevalence of breast cancer among patients in Indonesia is significant. Indonesian individuals maintain the belief that cancer cannot be cured alone by pharmaceuticals and treatment; herbal remedies must be used in conjunction. Rhodomyrtus tomentosa, also known as Haramonting, is an indigenous Indonesian medicinal plant renowned for its copious antioxidant properties. The objective of study was to assess the impact of haramonting on breast cancer by examining the expression of various biomarker proteins associated with breast cancer. Haramonting was administered to breast cancer model mice at different doses over a period of 30 days. Subsequently, blood and breast samples were obtained for immunohistochemistry and enzyme-linked immunosorbent assays (ELISA). Authors have discovered that there has been a notable rise in the proliferation of epithelial cells in the duct lobes, resulting in the formation of ducts and lobules. Additionally, the researchers discovered that the breasts exhibited distinct clinical and histological alterations. Haramonting possesses the capacity to restore the concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) to normal levels in the blood serum of rats afflicted with cancer. The histopathological analysis of the breast tissue revealed elevated levels of Her2, IL33, EGFR, and MUC1. The authors also discovered a notable increase in the growth of epithelial cells, with two or more layers of cells reaching towards the centre of the duct. The size of the epithelial cells exhibits variability; however, this state ameliorates with the administration of a dosage of 300 mg/kgBW of this botanical specimen. This study proposes that Haramonting may be effective in treating breast cancer.
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Affiliation(s)
- Putri Cahaya Situmorang
- Study Program of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Medan, Indonesia
| | - Syafruddin Ilyas
- Study Program of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Medan, Indonesia
| | - Rony Abdi Syahputra
- Department of Pharmacology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia
| | - Reka Mustika Sari
- Research Center for Food Technology and Processing, National Research and Innovation Agency (BRIN), Yogyakarta, Indonesia
| | - Alexander Patera Nugraha
- Department of Orthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Alek Ibrahim
- Research Center for Animal Husbandry, National Research and Innovation Agency (BRIN), Bogor, Indonesia
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Yu Z, Bai X, Zhou R, Ruan G, Guo M, Han W, Jiang S, Yang H. Differences in the incidence and mortality of digestive cancer between Global Cancer Observatory 2020 and Global Burden of Disease 2019. Int J Cancer 2024; 154:615-625. [PMID: 37750191 DOI: 10.1002/ijc.34740] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
The burden of digestive cancers is increasing worldwide. The Global Cancer Observatory (GLOBOCAN) 2020 and the Global Burden of Disease (GBD) 2019 are two primary cancer databases, which have a significant impact on policy formulation and resource allocation. We aim to compare the incidence and mortality of digestive cancers between them. Digestive cancer (esophageal, stomach, colorectal, liver, gallbladder and pancreatic cancer) incidence was obtained from the Cancer Today and GBD 2019 result tool. The top five countries with the most or minor difference between GLOBOCAN 2020 and GBD 2019 in age-standardized incidence rates (ASIRs) of digestive cancers were identified. A systematic search on the incidence of specific digestive cancer in selected countries from PubMed and Embase was conducted, and 20 of 281 publications were included. The most significant differences in digestive cancers incidence were commonly found in Asian countries (70%), particularly Indonesia, Vietnam and Myanmar, located in Southeast Asia. The ASIRs for most digestive cancers, except liver cancer, in GLOBOCAN 2020 were higher than those in GBD 2019. Gallbladder cancer had the highest average ratio, followed by liver cancer. The most commonly used standard population was Segi's standard population, followed by the World Health Organization standard population. The data sources nor the processing methods of GLOBOCAN 2020 and GBD 2019 were not similar. Low- and middle-income countries without population-based cancer registries were more likely to have selection bias in data collection and amplify regional variations of etiological factors. Better judgments on the quality of cancer data can be made.
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Affiliation(s)
- Ziqing Yu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Runing Zhou
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gechong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyue Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shiyu Jiang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Rani DM, Wongso H, Purwoko RY, Winarto NB, Shalas AF, Triatmoko B, Pratama ANW, Keller PA, Nugraha AS. Anti-cancer bioprospecting on medicinal plants from Indonesia: A review. PHYTOCHEMISTRY 2023; 216:113881. [PMID: 37827225 DOI: 10.1016/j.phytochem.2023.113881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
The Indonesian archipelago is home to the second largest biodiversity in the world and is inhabited by more than 300 ethnic groups with a total population of more than 270 million. The indigenous population still rely on traditional medicine practices, especially the use of plant-based remedies. Although modern science-based exploration on Indonesian medicinal plants started with the European settlement in the archipelago in the 16th century, it was not until the 1970's that the phytochemistry of Indonesian medicinal plants was recognized for its potency. The need for new cancer cures to increase the quality of human life has led to the bioprospecting of medicinal plants including those of Indonesian origin. Despite published reports on the anticancer potency of Indonesian medicinal plants, to date there has been no comprehensive review on this topic. In this manuscript, we review the phytochemical and pharmacological studies on medicinal plants from Indonesia related to cancer therapy. Established databases (GARUDA, SciFinder, and PubMed) were used to collate data from 1990 to 2022, resulting in the description of 134 medicinal plants and their phytochemical and pharmacological properties including examples containing potent agents against breast, leukaemia, cervix, lung, and colon cancer cell lines based on in vitro bioassays and in vivo evaluation. These findings provide valuable insights into the bioprospecting of Indonesian medicinal plant providing directions for future studies, including the development of new therapeutics, both as botanicals or by using conventional dosage.
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Affiliation(s)
- Dinar Mutia Rani
- Drug Utilisation and Discovery Research Group, Faculty of Pharmacy, Universitas Jember, Jember, 68121, Indonesia.
| | - Hendris Wongso
- Research Center for Radioisotope, Radiopharmaceutical, and Biodosimetry Technology, Research Organization for Nuclear Energy, National Research and Innovation Agency, Puspiptek, Banten, 15314, Indonesia; Research Collaboration Center for Theranostic Radiopharmaceuticals, National Research and Innovation Agency, Jl. Raya Bandung-Sumedang KM 21, Sumedang, 45363, Indonesia.
| | - Reza Yuridian Purwoko
- Research Center for Pre-Clinical and Clinical Medicine, Research Organization for Health, National Research and Innovation Agency, Indonesia.
| | - Naura Bathari Winarto
- Drug Utilisation and Discovery Research Group, Faculty of Pharmacy, Universitas Jember, Jember, 68121, Indonesia.
| | - Alvan Febrian Shalas
- Department of Pharmacy, Faculty of Medicine, Brawijaya University, Malang, 65145, Indonesia.
| | - Bawon Triatmoko
- Drug Utilisation and Discovery Research Group, Faculty of Pharmacy, Universitas Jember, Jember, 68121, Indonesia.
| | | | - Paul A Keller
- School of Chemistry and Molecular Biosciences, Molecular Horizons, University of Wollongong, Wollongong, New South Wales, 2522, Australia.
| | - Ari Satia Nugraha
- Drug Utilisation and Discovery Research Group, Faculty of Pharmacy, Universitas Jember, Jember, 68121, Indonesia; School of Chemistry and Molecular Biosciences, Molecular Horizons, University of Wollongong, Wollongong, New South Wales, 2522, Australia.
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Waluyo ST, Tjokroprawiro BA, Rahaju AS. Estrogen receptor and programmed death ligand-1 expression in type 1 endometrial cancer and its associated clinicopathological characteristics. Cancer Treat Res Commun 2023; 37:100766. [PMID: 37797425 DOI: 10.1016/j.ctarc.2023.100766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/13/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND This study aimed to determine the association of estrogen receptor (ER) and programmed death ligand-1 (PD-L1) expression with the clinicopathological characteristics of type 1 endometrial cancer. MATERIALS AND METHODS A total of 85 patients with type 1 endometrial cancer who underwent surgery at the Dr. Soetomo Hospital, Surabaya, Indonesia were retrospectively studied. Data about the age, menopausal status, body mass index, disease stage, cell differentiation, angiolymphatic invasion, myometrial invasion, and adjuvant therapy of the patients were collected from medical records. Immunohistochemistry with ER and PD-L1 antibodies was performed on all samples. The association between ER and PD-L1 expression and clinicopathological characteristics was statistically analyzed. RESULTS The positivity rates of ER and PD-L1 in type 1 endometrial cancer were 68.2 % and 78.5 %, respectively. ER positivity was significantly correlated with body mass index (BMI) ≥25, premenopausal status, early stage of disease, <1/2 myometrial invasion, negative nodal metastasis, and lack of adjuvant therapy. It was also associated with age <55 years, low-grade cells, and angiolymphatic invasion, but the correlation was not significant. Meanwhile, PD-L1 positivity was significantly correlated with BMI <25, menopausal status, advanced stage of disease, high-grade cells, angiolymphatic invasion, and adjuvant therapy. It was also associated with age ≥55 years and nodal metastasis, but the correlation was not significant. CONCLUSION ER and PDL-1 positivity is associated with the clinicopathological characteristics of type 1 endometrial cancer.
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Affiliation(s)
- Setyo Teguh Waluyo
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Subspecialist Education Program, Dr Soetomo General Academic Hospital, Medical Faculty - Universitas Airlangga, Surabaya, Indonesia
| | - Brahmana Askandar Tjokroprawiro
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
| | - Anny Setijo Rahaju
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital/Universitas Airlangga Hospital, Surabaya, Indonesia
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Asmara OD, Tenda ED, Singh G, Pitoyo CW, Rumende CM, Rajabto W, Ananda NR, Trisnawati I, Budiyono E, Thahadian HF, Boerma EC, Faisal A, Hutagaol D, Soeharto W, Radityamurti F, Marfiani E, Romadhon PZ, Kholis FN, Suryadinata H, Soeroto AY, Gondhowiardjo SA, van Geffen WH. Lung Cancer in Indonesia. J Thorac Oncol 2023; 18:1134-1145. [PMID: 37599047 DOI: 10.1016/j.jtho.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Oke Dimas Asmara
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
| | - Eric Daniel Tenda
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Gurmeet Singh
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ceva Wicaksono Pitoyo
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Cleopas Martin Rumende
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wulyo Rajabto
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Nur Rahmi Ananda
- Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Ika Trisnawati
- Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Eko Budiyono
- Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Harik Firman Thahadian
- Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - E Christiaan Boerma
- Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands
| | - Achmad Faisal
- Division of Cardiothoracic and Vascular surgery, Department of Surgery, Fatmawati General Hospital, Jakarta, Indonesia
| | - David Hutagaol
- Division of Cardiothoracic and Vascular surgery, Department of Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wuryantoro Soeharto
- Division of Cardiothoracic and Vascular surgery, Department of Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Fahmi Radityamurti
- Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erika Marfiani
- Department of Internal Medicine, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Pradana Zaky Romadhon
- Department of Internal Medicine, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Fathur Nur Kholis
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Diponegoro, Dr. Kariadi Hospital, Semarang, Indonesia
| | - Hendarsyah Suryadinata
- Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital Bandung, Indonesia
| | - Arto Yuwono Soeroto
- Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital Bandung, Indonesia
| | - Soehartati A Gondhowiardjo
- Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wouter H van Geffen
- Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, The Netherlands
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Rahadiani N, Habiburrahman M, Stephanie M, Handjari DR, Krisnuhoni E. Estimated projection of oral squamous cell carcinoma annual incidence from twenty years registry data: a retrospective cross-sectional study in Indonesia. PeerJ 2023; 11:e15911. [PMID: 37663292 PMCID: PMC10473041 DOI: 10.7717/peerj.15911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Background The incidence of oral squamous cell carcinoma (OSCC) has not been well documented in Indonesia. Thus, we aimed to analyze trends and clinicopathological profiles of OSCC cases in Indonesia, focusing on differences between age and sex groups. Methods A cross-sectional study was conducted in Indonesia's main referral hospital, analyzing 1,093 registered OSCC cases from 2001 to 2020. Trend analysis was performed using Joinpoint regression analysis to determine the annual percentage change (APC) for overall cases and each case group based on age, sex, and anatomical subsites. APC significance was assessed using a Monte Carlo permutation test. The projection of case numbers for the following 5 years (2021-2025) was estimated using linear/non-linear regression analysis and presented as a mathematical function. The significance of the trend slope was measured using an ANOVA test. Demographic and clinicopathological characteristics of OSCC were analyzed according to age and sex, and their comparative analysis was assessed using Chi-square and its alternatives. Results The incidence of OSCC in female patients and in the tongue and buccal mucosa showed a positive trend (APC 2.06%; 3.48%; 8.62%, respectively). Moreover, the incidence of OSCC overall, and in women with OSCC, is projected to increase significantly in the next 5 years following the quadratic model. The mean age of patients was 51.09 ± 14.36 years, with male patients being younger than female patients. The male-to-female ratio was 1.15, and 36.5% of these patients were categorized as young (≤45 years old). The tongue was the predominantly affected site. Prominent pathologic characteristics included well-differentiation, keratinization, and grade I of Bryne's (1992) cellular differentiation stage. Most patients presented with advanced staging, lymphovascular invasion, and uninvaded margins. Tumor sites and staging varied according to age, while age and tumor sites differed between sexes. Conclusion The rising incidence trends of OSCC among Indonesian patients, both in the past and projected future, are concerning and warrant attention. Further research into risk factors should be conducted as preventive measures.
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Affiliation(s)
- Nur Rahadiani
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Muhammad Habiburrahman
- Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Marini Stephanie
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Diah Rini Handjari
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ening Krisnuhoni
- Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Rachman A, Fiantoro ZH, Sutandyo N, Priantono D, Romadhon PZ, Jonlean R. Metabolic Profile and Negatively Association Between Insulin Resistance and Metastatic Incidence in Indonesian Primary Invasive Breast Cancer: A Cross-Sectional Study. Int J Gen Med 2023; 16:3257-3265. [PMID: 37546243 PMCID: PMC10404037 DOI: 10.2147/ijgm.s421558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Metastatic breast cancer was associated with high morbidity and mortality. Insulin resistance was hypothesized to be related to the incidence of advanced breast cancer. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Triglyceride/Glucose Index (TyG Index) are two metrics used to measure the degree of insulin resistance. This study aims to assess the relationship between the incidence of metastatic breast cancer and insulin resistance as reflected by both metrics. Material and Methods This study is a cross-sectional study involving 150 primary invasive breast cancer patients recruited from two hospitals of different sectors from August 2019 to April 2020. Patients with double cancer and autoimmune disorder were excluded from this study. Data obtained from the patients include age, body mass index (BMI), type 2 diabetes mellitus (T2DM) status and treatment, and low-density lipoprotein (LDL) cholesterol. The electronic medical records (EMR) was consulted to find histopathology examination result, cancer staging, and any missing data. The association between HOMA-IR and TyG with metastatic incidence was analyzed using either the Mann-Whitney test (for non-normally distributed data) or the independent-sample t-test (for normally distributed data). Results The mean of the TyG index is 8.60, and the median of HOMA-IR is 1.22. We found no significant correlation between both variables and the incidence of metastases. Conclusion Insulin resistance was not associated with metastatic breast cancer.
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Affiliation(s)
- Andhika Rachman
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Siloam MRCCC Semanggi Hospital, Jakarta, Indonesia
| | - Zaenal Hakiki Fiantoro
- Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Dimas Priantono
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Pradana Zaky Romadhon
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Airlangga University, Surabaya, Indonesia
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Tufail M, Wu C. Cancer Statistics in Pakistan From 1994 to 2021: Data From Cancer Registry. JCO Clin Cancer Inform 2023; 7:e2200142. [PMID: 37450777 DOI: 10.1200/cci.22.00142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/08/2023] [Accepted: 05/19/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE Pakistan has been systematically collecting cancer data since 1994 through cancer registries. METHODS This article presents a comprehensive analysis of cancer statistics in Pakistan from 1994 to 2021, including incidence and patterns. RESULTS The total number of patients with malignant neoplasm was 111,941, and the number of patients registered was 109,863. Most patients were from Punjab (67.6%) and Khyber Pakhtunkhwa (20.2%). Breast cancer (22.2%), colorectum cancer (5.6%), leukemia (5.3%), lip and oral cavity cancer, and non-Hodgkin lymphoma (5.1%) were the top five prevalent cancers in all age groups and sexes. Breast (24.2%), colorectum (6.2%), lip and oral cavity (5.8%), non-Hodgkin lymphoma (4.4%), and prostate cancers (4.0%) were most common in adults in both sexes. In both sexes, the most common cancers among children were Hodgkin lymphoma (20.1%), acute lymphoblastic leukemia (19.8%), non-Hodgkin lymphoma (11.6%), osteosarcoma (7.0%), and retinoblastoma (6.2%). Breast (45.9%), ovary and uterine adnexa (4.9%), lip and oral cavity (4.2%), cervix uteri (4.0%), and colorectum cancers (3.9%) were most common in adult females. In adult males, colorectum cancer (8.7%), prostate cancer (8.5%), lip and oral cavity cancer (7.6%), non-Hodgkin lymphoma (6.4%), and liver and intrahepatic bile duct cancers were the top five most common malignancies. CONCLUSION It has been found that breast cancer, colorectum cancer, prostate cancer, leukemia, and bone cancer rates are among the highest in Pakistan. This information may be useful in assessing the effectiveness of future intervention strategies.
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Affiliation(s)
- Muhammad Tufail
- Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Changxin Wu
- Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
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12
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Wiranata JA, Puspitaningtyas H, Hutajulu SH, Fachiroh J, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Temporal and spatial analyses of colorectal cancer incidence in Yogyakarta, Indonesia: a cross-sectional study. GEOSPATIAL HEALTH 2023; 18. [PMID: 37246534 DOI: 10.4081/gh.2023.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/26/2023] [Indexed: 05/30/2023]
Abstract
We aimed to explore the district-level temporal dynamics and sub-district level geographical variations of colorectal cancer (CRC) incidence in the Special Region of Yogyakarta Province. We performed a cross-sectional study using data from the Yogyakarta population-based cancer registry (PBCR) comprised of 1,593 CRC cases diagnosed in 2008-2019. The age-standardized rates (ASRs) were determined using 2014 population data. The temporal trend and geographical distribution of cases were analysed using joinpoint regression and Moran's I statistics. During 2008-2019, CRC incidence increased by 13.44% annually. Joinpoints were identified in 2014 and 2017, which were also the periods when annual percentage change (APC) was the highest throughout the observation periods (18.84). Significant APC changes were observed in all districts, with the highest in Kota Yogyakarta (15.57). The ASR of CRC incidence per 100,000 person- years was 7.03 in Sleman, 9.20 in Kota Yogyakarta, and 7.07 in Bantul district. We found a regional variation of CRC ASR with a concentrated pattern of hotspots in the central sub-districts of the catchment areas and a significant positive spatial autocorrelation of CRC incidence rates in the province (I=0.581, p<0.001). The analysis identified four high-high clusters sub-districts in the central catchment areas. This is the first Indonesian study reported from PBCR data, showing an increased annual CRC incidence during an extensive observation period in the Yogyakarta region. A heterogeneous distribution map of CRC incidence is included. These findings may serve as basis for CRC screening implementation and healthcare services improvement.
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Affiliation(s)
- Juan Adrian Wiranata
- Academic Hospital; Master Program in Clinical Epidemiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Herindita Puspitaningtyas
- Doctorate Program of Health and Medical Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
| | - Jajah Fachiroh
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Nungki Anggorowati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta.
| | - Guardian Yoki Sanjaya
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai.
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Prihantono, Rusli R, Christeven R, Faruk M. Cancer Incidence and Mortality in a Tertiary Hospital in Indonesia: An 18-Year Data Review. Ethiop J Health Sci 2023; 33:515-522. [PMID: 37576162 PMCID: PMC10416343 DOI: 10.4314/ejhs.v33i3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/06/2023] [Indexed: 08/15/2023] Open
Abstract
Background Every population, regardless of wealth or social development, faces the major health issue of cancer. Cancer incidence and mortality differ by region and period. Thus, this study aimed to determine the characteristics, incidence, and mortality of various cancers at Dr. Wahidin Sudirohusodo Hospital, a referral center hospital in Makassar, Indonesia. Methods This study employed a descriptive research design using secondary data recorded at Dr. Wahidin Sudirohusodo Hospital in Makassar, Indonesia, between January 2002 and December 2019. Results We classified the 7824 cancer patients in our study into solid and non-solid cancer groups. The incidence of solid cancer (79.3%) was higher than that of non-solid cancer (20.7%), causing 1063 deaths, or 61.7%, of all cancer-related deaths. There were 6083 (77.7%) cases of cancer survival. The cancers with the highest incidence were breast cancer (1008 cases [12.9%]), leukemia (683 cases [8.7%]), and cervical cancer (631 cases [8.1%]). Breast, cervical, and ovarian cancers were the most frequent cancers in female patients. Leukemia was the most frequent cancer in male patients, followed by colorectal and liver cancers. Conclusions A region-based statistical record of cancer incidence and mortality is vital and useful to prioritizing cancer treatment at a given time.
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Affiliation(s)
- Prihantono
- Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Reski Rusli
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Robert Christeven
- Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
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Widjaja SS, Rusdiana R, Jayalie VF, Amelia R. What Contributes to Palliative Care Practice in Cancer Patients in Indonesia. Med Arch 2022; 76:464-468. [PMID: 36937612 PMCID: PMC10019868 DOI: 10.5455/medarh.2022.76.464-468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 12/26/2022] Open
Abstract
Background Palliative care has an important role in cancer treatment. It has been established in Indonesia for years, however, palliative care does not give significant improvements which may due to the numerous components of palliative care. Objective This research aims to identify factors affecting palliative care in Indonesia. Methods This article is a literature review which was conducted through a systematic search from four online databases: Cochrane, Pubmed, Embase, EbscoHOST. The search revealed 45 studies then selected using PRISMA 2020 algoritm, leaving 8 studies to be analyzed. The factors affecting palliative care in Indonesia were then grouped into three points of view: the patients and caregiver; healthcare provider, further divided into healthcare personnel and system; as well as healthcare system. By knowing these factors it is expected that we can achieve optimal implementation palliative care in Indonesia, especially in cancer patient. Results The factors influencing palliative care in Indonesia can be grouped into patients, healthcare provider and healthcare system. Conclusion Palliative care improvement in Indonesia can be enhanced to achieve optimal implementation in cancer treatment.
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Affiliation(s)
- Sry Suryani Widjaja
- Biochemistry Department, Medical Faculty Universitas Sumatera Utara, Medan, Indonesia
| | - Rusdiana Rusdiana
- Biochemistry Department, Medical Faculty Universitas Sumatera Utara, Medan, Indonesia
| | | | - Rina Amelia
- Community Health Department, Medical Faculty Universitas Sumatera Utara, Medan, Indonesia
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Hasim H, Mantik YA, Husnawati H, Priosoeryanto BP, Puspita R. Antiproliferative Potency of God’s Crown Fruit (Phaleria macrocarpa) Extract Against Breast Cancer Cell. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i4.2822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Breast cancer is a sickness caused by abnormal cell growth in the breast. Mahkota Dewa fruit or god’s crown fruit products (Phaleria macrocarpa) contain flavonoids, alkaloids, polyphenols, and tannins associated with active compounds. This work directs to influence the potency of P. macrocarpa fruit as an antiproliferative agent against breast cancer cells (MCF-7 cells). The antiproliferative potency of P. macrocarpa fruit was proved by extracting and fractionating P. macrocarpa fruit using maceration. The cytotoxicity of extracts and fractions was determined using Brine Shrimp Lethality Test (BSLT). The antiproliferative potency against MCF-7 cells was tested using the hemacytometer approach. This work demonstrates the crude ethanol extract, n-hexane fraction, ethyl acetate fraction, and water fraction. The LC50 values in crude ethanol extract, n-hexane fraction, ethyl acetate fraction, and water fraction were 13.72 ppm, 147.55 ppm, 405.81 ppm, and 149. 07 ppm severally. Phaleria macrocarpa fruit has shown antiproliferation potency against MCF-7 cells. The maximum part of crude ethanol extract antiproliferative potency (56 ppm) effectively suppressed MCF-7 cell growth by 70. 9% while doxorubicin (100 ppm) by 46. 92%. This work confirms that crude ethanol extract of P. macrocarpa fruit interacts synergistically as an antiproliferative compound against MCF-7 cells.
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Maryam D, Wu LM, Su YC, Hsu MT, Harianto S. The journey of embracing life: Mothers' perspectives of living with their children with retinoblastoma. J Pediatr Nurs 2022; 66:e46-e53. [PMID: 35718669 DOI: 10.1016/j.pedn.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to explore the experience and views of mothers with children who have been diagnosed with retinoblastoma. DESIGN AND METHODS A descriptive qualitative study was conducted in the period of 2019-2021. Interviews were conducted with 21 mothers of children diagnosed with retinoblastoma in Indonesia. Data were collected by semi-structured interviews and examined by content analysis. RESULTS Mothers evolved from a sense of unacceptability to accepting challenges and gaining inner strength. Three themes were identified: 1) physical and psychological suffering, 2) awareness of changes and demands, and 3) keep moving forward. Mothers developed positive adaptive mechanisms for coping with the problems associated with having a child with retinoblastoma. Psychological adjustment and religious beliefs were key elements in their journeys toward embracing life in the moment. CONCLUSION Findings illuminated psychological adaptation and coping strategies of mothers with seriously ill children and highlighted how difficulties and cultural norms shaped the adaptative process. Religion and health beliefs played varied and important roles in helping mothers to manage their stress and enhance their coping strategies. PRACTICE IMPLICATIONS Our findings revealed that it is important to routinely assess social support, traditional health beliefs, and spirituality on mothers, facilitate mentoring to help mothers find their inner strengths, and develop intervention programs designed to promote psychological adjustment without delaying treatment.
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Affiliation(s)
- Dewi Maryam
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC, and Dr Soetomo Hospital, Surabaya, Indonesia.
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, and Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
| | - Yi-Ching Su
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Min-Tao Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Susilo Harianto
- Faculty of Nursing, Airlangga University, Surabaya Indonesia, Faculty of Vocational, Airlangga Indonesia, Mulyorejo, Surabaya 60115, Indonesia.
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Winarto H, Habiburrahman M, Siregar TP, Nuryanto KH. Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review. Radiol Case Rep 2022; 17:2680-2688. [PMID: 35663819 PMCID: PMC9160413 DOI: 10.1016/j.radcr.2022.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
The degree of myometrial invasion (MI) is crucial in the preoperative diagnosis of endometrial cancer (EC) using MRI in terms of therapeutic and prognostic implications. However, several pitfalls should be kept in mind when using this modality. We report a case of EC on a 64-year-old woman, identified preoperatively without MI based on ultrasonography and MRI, implying a low risk of lymph node metastasis; surprisingly, the uterine incision showed the lesion had invaded <50% of the myometrium. Thus, a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy were performed, and histopathologic analysis confirmed that the EC was on stage IA (cancer is in the endometrium only or less than halfway through the myometrium). In our case, thinning myometrium and uterine atrophy due to aging, multiple leiomyomas, previous curettage, and blood clots were all pitfalls for MRI in detecting MI. By detecting tiny or isointense tumors and depicting distinct vascularity of the malignancy in postmenopausal women, functional MRI techniques such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) can help reduce pitfalls when assessing MI. Clinicians can employ DWI preoperatively, which is more reliable and superior to DCE-MRI in determining tumor areas without contrast injection and perform a postoperative histopathological examination to confirm MI in EC.
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Anwar SL, Cahyono R, Suwardjo S, Hardiyanto H. Extrathyroidal extension and cervical node infiltration are associated with recurrences and shorter recurrence-free survival in differentiated thyroid cancer: a cohort study. Thyroid Res 2022; 15:13. [PMID: 35883150 PMCID: PMC9327162 DOI: 10.1186/s13044-022-00131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Differentiated thyroid cancer has excellent overall survival. However, around 20% of patients experience recurrent diseases after a certain time of follow-up. Therefore, identification of risk factors for recurrence is necessary to adjust treatment and surveillance planning. Methods A retrospective study was conducted of 312 patients with differentiated thyroid cancer who received surgery with and without adjuvant treatment. Clinical and pathological risk factors were analyzed for recurrences. Results After median follow-up of 57 months, 109 of 312 patients (34.9%) developed recurrences. Extrathyroidal extension and positive cervical nodes were significantly associated with recurrences (OR = 2.449, 95%CI:1.260–4.760, P = 0.008 and OR = 3.511, 95%CI:1.860–6.626, P < 0.001; respectively). Lympho-vascular invasion (LVI) and tumor multifocality were also associated with increased risk of recurrence (OR = 2.577, 95%CI:1.380–4.812, P = 0.003 and OR = 1.602, 95%CI:1.001–2.495, P = 0.050; respectively). Using multivariable regression, only older age and tumor infiltration to the lymph nodes were significantly associated with recurrences (OR = 2.227, 95%CI:1.037–4.782, P = 0.040 and OR = 2.966, 95%CI:1.470–5.986, P = 0.002; respectively). In addition, T4, cervical lymph node infiltration, older age, and LVI were associated with shorter recurrence-free survival. Conclusion Recurrence rates in our study population are relatively high. Extrathyroidal extension, positive neck lymph node, and older age were associated with recurrence risks of well differentiated thyroid cancers.
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Affiliation(s)
- Sumadi Lukman Anwar
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia.
| | - Roby Cahyono
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
| | - Suwardjo Suwardjo
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
| | - Herjuna Hardiyanto
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
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Melyda, Gondhowiardjo S, Jackson LJ, Oppong R. Planning human resources and facilities to achieve Sustainable Development Goals: a decision-analytical modelling approach to predict cancer control requirements in Indonesia. BMJ Open 2022; 12:e059555. [PMID: 35534085 PMCID: PMC9086632 DOI: 10.1136/bmjopen-2021-059555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives Indonesia aims to achieve universal health coverage (UHC) and Sustainable Development Goals (SDGs), including SDG 3 target 4, which focuses on cancer control, by 2030. This study aimed to forecast the human resources for health (HRH) and facilities required for cancer control in Indonesia over an 11-year period to support these goals. Design A two-stage Markov model was developed to forecast the demand side of facilities and HRH requirements for cancer control in Indonesia over an 11-year period. Setting Data sources used include the Indonesia Health Profile Report (2019), the Indonesian Radiation Oncology Society Database and National Cancer Control Committee documents (2019). Methods The study involved modelling the current availability of HRH and healthcare facilities in Indonesia and predicting future requirements. The gap between the current and the required HRH and facilities related to oncology, and the costs associated with meeting these requirements, were analysed. Results Results indicate the need to increase the number of healthcare facilities and HRH to achieve SDG targets. However, UHC for cancer care still may not be achieved, as eastern Indonesia is predicted to have no tertiary hospital until 2030. The forecast shows that Indonesia had a median of only 39% of the HRH requirements in 2019. Closing the HRH gap requires around a 47.6% increase in salary expenditure. Conclusion This study demonstrates the application of decision-analytical modelling approach to planning HRH and facilities in the context of a low-to-middle-income country. Scaling up oncology services in Indonesia to attain the SDG targets will require expansion of the number and capability of healthcare facilities and HRH. This work allows an in-depth understanding of the resources needed to achieve UHC and SDGs and could be utilised in other disease areas and contexts.
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Affiliation(s)
- Melyda
- Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.,Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Soehartati Gondhowiardjo
- Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Louise J Jackson
- Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Raymond Oppong
- Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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