Introductions: Epithelial ovarian cancer accounts for 90% of all ovarian malignancies. More than 70% of patients will experience a relapse even after receiving operative therapy and chemotherapy. There are several prognostic factors that influence the recurrence of ovarian cancer. In Indonesia, especially at Dr. Kariadi Hospital, Semarang, the data as mentioned above is still very limited.objective: Knowing the disease-free survival rate, optimizing surgery and factors related to the incidence of recurrence in epithelial ovarian cancer patients at Dr. Kariadi Hospital SemarangMethods: This study is a retrospective cohort study with survival analysis. Data were collected through medical records, with the study population are patients with a diagnosis of epithelial ovarian cancer who were treated at Dr. Kariadi Hospital Semarang in period January 2018-December 2019. Furthermore, patients who had been remission were observed for signs of disease recurrence for 2 years period.Results: There were 361 patients with epithelial ovarian cancer who underwent primary treatment at Dr. Kariadi Hospital, Semarang in  2018-2019. Furthermore, there were observations of recurrence in 148 patients who achieved remission. Of these 76 patients (51.4%) experienced recurrence, while 72 patients not relapse. From 148 epithelial ovarian cancer patients who underwent cytoreduction surgery at Dr. Kariadi Hospital, Semarang, 113 patients (76.4%) achieved optimal operation with a residu less than 2 cm, while 35 patients (23.6%) were not optimal with a residu more than 2 cm. FIGO stage (HR 2.44) and tumor residu (HR 2.15) were shown to be significant factors associated with the recurrence of epithelial ovarian cancer.Conclusion: Overall disease-free survival in epithelial ovarian cancer at Dr. Kariadi Semarang were 74.8% (6 months), 57.1% (1 year), 42.5% (18 months), and 37.4% (2 years). Tumor residual factors and FIGO stage were shown to be significant prognostic factors influencing the recurrence of epithelial ovarian cancer.

Objectives: To determine the factors that may be used as the prognostic parameter for the therapeutic efficacy of neoadjuvant chemotherapy, which can be used to revising the management of early stage cervical cancer patients with large lesions. Methods: This was a retrospective cohort study. The study was conducted in the Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia. The subjects were 15 cervical cancer stage IB2 and IIA patients with lesions’ size of > 4 cm, who would be treated with neoadjuvant chemotherapy, consisted of cisplatin 50 mg/m2, vincristine 2 mg/m2 and bleomycin 15 mg regiment. The patients’ response would be evaluated after completing 3 series of chemotherapy. Data was retrieved from medical records and cervical biopsy paraffin blocks and examined histopathologically using IHC staining to see expression of caspase-3 with histoscore assessment score. Data was analyzed by univariate, bivariate analysis. Results: Response to PVB neoadjuvant chemotherapy was found in 5 out of 15 patients. None of the clinicopathology variables can be used to predict response to therapy. Expression of caspase-3 as a marker of apoptosis, can not predict the response of the therapy before administrating neoadjuvant chemotherapy either. There is a significant difference between the levels of caspase-3 in epidermoid carcinoma with adenocarcinoma, with p value of 0.02 (RR 6;95% CI 1.69-21.26). Conclusion: Clinicopathologic factors and the expression of caspase-3 before getting chemotherapy neoadjuvant can not predict the succeed of the therapy. [Indones J Obstet Gynecol 2013; 1-3: 156-60] Keywords: caspase -3, clinicopathologic, early-stage cervical cancer lession in large, neoadjuvant chemotherapy response to therapy

No abstract

Karsinoma ovarium merupakan keganasan ginekologi terbanyak kedua yang terjadi pada kehamilan. Dilaporkan terjadi 1:10.000 sampai 1:25.000 kehamilan. Histopatologi karsinoma ovarium jenis epitelial lebih jarang terjadi dibandingkan germ cell tumor1,2. Kehamilan tidak mempengaruhi prognosis karsinoma ovarium, akan tetapi komplikasi yang mungkin terjadi adalah torsi tumor, ruptur dan meningkatkan kemungkinan terjadinya persalinan prematur16. Tulisan ini melaporkan seorang wanita, 31 tahun, primigravida, hamil 34 minggu, dengan pembesaran abdomen melebihi usia kehamilan, peningkatan kadar Ca-125 darah dan massa solid ovarium sinistra disertai ascites pada pemeriksaan ultrasonografi. Pemeriksaan histopatologi jaringan tumor ovarium, uterus dan omentum menunjukkan diagnosis low grade serous carcinoma ovarii bilateral dengan infiltrasi hingga tuba dan omentum. Pemeriksaan rutin kehamilan dengan ultrasonografi penting dilakukan untuk skrining adanya neoplasma ovarium yang menyertai kehamilan. Penatalaksanaan hamil dengan  tumor padat ovarium tergantung dari usia kehamilan. Menurut algoritme dilakukan operasi pengangkatan massa dan dilakukan frozen section (FS) untuk mengetahui sifat tumor jinak atau ganas pada usia kehamilan 18-22 minggu dan dilanjutkan dengan operasi lanjutan setelah kelahiran bayi16. Pada kasus ini dengan mempertimbangkan kehamilan ini merupakan kehamilan pertama dengan tidak adanya keluhan dan secara prinsip tidak adanya perubahan anatomi untuk dapat dilakukan operasi complete surgical staging saat bayi dilahirkan pada usia kehamilan 34 minggu, maka dari hasil rapat medis diambil keputusan untuk dilakukan operasi complete surgical staging bersamaan setelah sectio caesaria. Prosedur operasi ini tidak mudah dilakukan dan banyak dihindari, tetapi dengan kehati-hatian dan identifikasi struktur anatomi yang baik, maka operasi berjalan lancar.

Background: Premature rupture of membranes (PROM) is a rupture of amniotic sac before delivery. PROM is associated with an increased incidence of preterm labor and infection. The use of prophylactic antibiotic may reduce the risks of infection. High-sensitivity C-reactive protein (hs-CRP) is an acute-phase reactant protein that is associated with PROM. How much effect of prophylactic antibiotic to hs-CRP level remains unclear.Objective: To compare the reduction in hs-CRP levels in premature rupture of membranes before and after given ampicillin or cefazolin.Methods: The design of this study was true experimental design (pre and post-test) conducted at Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara from September 2019 to January 2020. Study samples are pregnant women with premature rupture of membranes that came to the Emergency Department and Maternity Ward Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara. Samples were divided into two groups, a group treated with ampicillin and the other with cefazolin therapy. All samples were subjected to a hs-CRP examination. Statistical analysis was performed by Mann-Whitney and Wilcoxon.Results: There are no significant differences in the age variable (28.8 ± 6.54 vs 29.1 ± 5.93), gestational age (36.3 ± 2.55 vs 36.3 ± 2.90), and parity (2,2 ± 0.99 vs 2.47 ± 1.19) in the ampicillin and cefazolin groups (p> 0.05). In this study, 37.1% patients have a history of PROM while 62.9%. had no history of PROM. Reduction in hs-CRP levels after administration of ampicillin and cefazolin was significant (4.4 ± 2.65 mg/L vs 6.3 ± 4.43 mg/L, respectively, p = 0.03). The difference in the decrease in hs-CRP levels before and after given ampicillin and cefazolin was significant (p = 0.0001). Conclusion: There is a decrease in hs-CRP levels after the administration of ampicillin or cefazolin in PROM, whereas cefazolin induced higher reduction in hs-CRP levels. Ampicillin can still be used as a first-line prophylactic antibiotic in primary healthcare facilities.