Search

A delay on diagnosing Gestational Trophoblastic Neoplasia (GTN) may cause increase of morbidity to the patient. The important things that OBGYN usually forgot is that GTN may develop not only from previous molar gestation (50-60%), but also from abortions or ectopic pregnancy (25-30%) and term or preterm deliveries (10-25%).1,2This can cause a delay on diagnosing that may increase the GTN score from low risk become high risk, such as this case, as follow.

Along with the development of cancer diagnosis and treatment, the life expectancy of women in reproductive age who suffer from cancer are also higher. Women with cancer still have the possibility to be pregnant and have a child during or after completion of therapy. Taking this into consideration, the guideline for contraception in special circumstances like this is needed. After reviewing the safety and effectiveness of contraceptive methods available for women with cancer, The Society of Family Planning urged not to use combination hormonal contraceptives (estrogen and progestin). Hormonal contraceptive use in cancer patients may increase the risk of venous thromboembolism (Level A). T380A IUD, which has a high effectiveness, reversible, long-term, and hormone-free contraception should be considered as the primary choice in patients with breast cancer (Level A). In women who received tamoxifen therapy, the use of IUD containing Levonorgestrel can be considered as a second choice (Level B) because it can decrease the proliferation endometrium. Women with anemia due to chemotherapy may be given contraceptive containing progestin (Level A). Women with osteopenia or osteoporosis after chemotherapy should avoid progestin contraceptive injection (Level A). Currently, there are no data to evaluate the risk of venous thromboembolism in progestin contraceptive use. Further information is also needed to determine the effect of the use of IUD that contains Levonorgestrel against breast cancer recurrence and the effect of hormonal contraceptives on breast cancer in women who received chest wall radiotherapy. Keywords: cancer, contraception, malignancy

Objective: To evaluate the pr eoperative endo metria l cancer risk as a guida nce to choose th e typ e of surg ical approach based on European Society for Medical Oncology guideline (200 9). Method: Cross-sectional study involved 73 endometrial cancer patients of Dr. Cipto Mangunkusumo Hospital, from january 200 6 to December 2012 whi ch obt ain ed from medical record. The inclusion criteria wer e endometr ial cancer pati ents with compl ete D&C, ultr asonographic, and postoperative histopathological rep orts. Endometrial cancer risk of recurren ce was classified acco rding to ESMO 2009 and final diagno sis and stage based on FIGO. Result: From 40 5 patients, only 73 patients had compl ete reports. Most of the them were postmenopaus al (54.8 %), non-nulliparity (79 .9%), and obese (49.5%) women.According to risk of recurren cestratification, low, intermediate and high risk were found in 12 patients, 27 patients, and 34 pati ents. Based on FIGO, there were 60.2% early and 39.8% advanced sta ge. In high risk gro up, rates of advan ced stage wer e prominent compar ed to othe r gro ups. There were 38.3% patients with postoper ativ e positive lymph nod es metastases. Conclusion: Most of th e endometrial cancer patients we re pr eoperatively diagnosed as high risk. The commones t stage after surgical examination were me. High risk of recurrence showed more positive lymph node compared to low or intermediat e risk. Result of preoperative histopathological and myometrial invasion compared to postoper ative results wer e showed to be inconsistent Pat ients with =1/2 myometrial invasion had more positive lymph nodes metastases. Endometrial cancer risks compared to FIGO stage showed the higher the risk, th e more advanced the stage were. Keywords: endometrial cancer, FIGO stage, high risk, histol ogical type, intermediate risk , low risk, lymph node.

Objective: To evaluate Risk of Malignancy Index (RMI) as a triage tool for ovarian cancer in Dr. Cipto Mangunkusumo Hospital. Method: This is a retrospective study conducted from January 2008-December 2012 in patients diagnosed with ovarian mass. Patients admitted for surgery due to ovarian masses were included to this study. RMI 3 score was calculated based on ultrasonography examination in Dr. Cipto Mangunkusumo Hospital, CA-125 test and menopausal status. Patients without final pathological report and incomplete data were excluded from study. Data were analysed using SPSS 20 to evaluate RMI result and final pathlogical report in benign and malignant case. Result: From 882 patients identified with ovarian masses from cancer registry, only 99 patients aged 17-70 y.o were included in this study. Most of the patients were nully-parity (28.3%), non-menopausal women (60.6%), normal body mass index (40.4%), and with stage IIIC ovarian cancer (33.3%). Ultrasonography examination showed that most of patients had solid mass and ascites (19.2%). Meanwhile, CA-125 showed that patients with