Abstract Objective: To evaluate the impact of pathogenic BRCA1/2 tumor mutation on advanced stage-high grade serous epithelial ovarian cancer (HGSOC) survival outcome. Methods: A total of 68 from 144 patients were diagnosed with FIGO 2014 stage IIB-IV HGSOC between January 1st 2015, until March 31st 2021, at Dr. Cipto Mangunkusumo National Central Referral Hospital, Persahabatan Central Referral Hospital, and MRCCC Central Referral Hospital Siloam Jakarta, underwent NGS tumor BRCA1/2 gene testing and were included in this cohort historical study. We compared patient’s overall survival outcomes to pathogenic BRCA1/2 tumor mutational status. The patient’s clinicopathological characteristic factors that might affect patient’s survival outcomes were also investigated. Results: In the group with pathogenic BRCA1/2 tumor mutation, the likelihood of dying was 86% ​​lower (adjusted RR 0.149; 95%CI 0.046-0.475; p-value=0.001), and the median survival was better (median 46 months; 95%CI 34.009-57.991; p value=0.001) than the group without pathogenic BRCA1/2 tumor mutations (median 23 months; 95%CI 15.657-30.343; p value=0.001). The multivariate analyses identified pathogenic BRCA1/2 tumor mutation as an independent favorable prognostic factor for survival outcome (adjusted RR 0.149; 95%CI 0.046-0.475; p-value=0.001).Conclusions: In advanced stage-HGSOC patients, the pathogenic BRCA1/2 tumor mutations group have a better prognosis with longer survival outcomes than those without pathogenic BRCA1/2 tumor mutations.

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN. Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017 Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072). Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN. Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta. Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017. Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072). Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB. Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.

Background: Morbidly adherent placenta is a condition which placenta adheres and invades deeply into the myometrium and, in some cases, until uterine serosa, thus contribute to peri-partum hemorrhage and significant maternal mortality. Purpose: To identify prevalence, clinical characteristics and their odds ratio to increasing se-verity of morbidly adherent placenta case in RSUP Persahabatan from 2015 to 2018 Methods: Cohort retrospective study Results: From 2015 to 2018, prevalence of morbidly adherent placenta was around 0.8%. The risk factors which contribute to increasing severity of morbidly adherent placenta were: age above 35 years (OR 1.6, 95% CI 0.41-6.24) and history of Caesarean section more than 2 times (OR 1.63, 95% CI 0.41-6.46). The presence of increasing severity of morbidly adherent placenta were related to volume of blood loss more than 1000 ml during surgery (OR 2.13, 95% CI 0.52-8.76). Conclusion: The prevalence of morbidly adherent placenta at Persahabatan General Hospital in 2015-2018 was 0.8%. Age, history of Caesarean section more than 2 times, volume of blood loss, and duration of surgery were not statistically associated with adherent placenta case.

Latar belakang: Plasenta perkreta merupakan salah satu kondisi mengancam nyawa yang membutuhkan tatalaksana secara multidisiplin. Angka kejadian plasenta perkreta semakin meningkat seiring dengan meningkatnya kejadian seksio sesarea. Diagnosis saat antenatal merupakan titik penting untuk mencegah morbiditas serta mortalitas pada ibu dan bayi. Ultrasonografi (USG) merupakan salah satu modalitas yang relatif lebih murah dan mudah, untuk penegakan diagnosis plasenta perkreta.Tujuan: Mengidentifikasi kriteria ultrasonografi yang optimal untuk diagnosis plasenta perkreta. Metode: Kami mengikuti 2 kasus, yang melakukan antenatal care (ANC). Kedua pasien kemudian dilakukan pemeriksaan USG sesuai dengan metode placenta accrete index (PAI). Temuan penilaian USG ini kemudian dibandingkan dengan temuan klinis intraoperatif dan gambaran histologi. Hasil: Dari dua kasus, kami tidak menemukan adanya lakuna Bizarre, melainkan ditemukan lapisan miometrium retroplasenta yang tipis disertai dengan hilangnya clear zone. Penemuan pada ultrasonografi ini sesuai dengan temuan intraoperatif dan gambaran histologi, dimana gambaran plasenta perkreta jelas terlihat.Kesimpulan: Berbeda dengan penilaian pada PAI, dimana adanya lakuna merupakan faktor prediksi terbesar terjadinya plasenta adhesiva, pada kedua kasus ini, lapisan miometrium retroplasenta yang tipis disertai clear zone yang menghilang, walau tidak ditemukan lakuna, cukup dapat menggambarkan plasenta perkreta.

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