Publications by authors named "Susanna H Hutajulu"

Insulinoma, the most common functional pancreatic neuroendocrine tumor, is a rare and typically benign tumor. However, excessive insulin secretion can result in life-threatening hypoglycemia, which is often misdiagnosed due to its nonspecific early symptoms, leading to a delayed diagnosis. Rigorous evaluation is required once insulinoma is suspected since the tumor might also be challenging to detect through imaging techniques.

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Background: Cancer cachexia in breast cancer (BC) patients is not commonly reported, particularly in Indonesia. This study assessed the prevalence of cachexia in local patients with BC receiving chemotherapy, and the associated factors.

Methods: This cross-sectional study included 160 BC patients who started chemotherapy between July 2018 and June 2022.

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Background: Chemotherapy has a substantial role in decreasing the risk of recurrence and mortality in breast cancer (BC) in a dose-dependent manner where a low relative dose intensity (RDI) is associated with unfavorable outcomes. Several baseline clinicopathological factors, including pro-inflammatory biomarkers, were found to be significant determinants of low RDI. This study aimed to explore the occurrence of low RDI and its influencing factors in women with BC.

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Article Synopsis
  • Chemotherapy-induced peripheral neuropathy (CIPN) negatively impacts the quality of life for breast cancer patients, leading to a study that aimed to develop a prediction model using the classification and regression tree (CART) algorithm.
  • The research involved 170 breast cancer patients and used a patient-reported assessment to identify CIPN occurrences, ultimately finding that high C-reactive protein (CRP) levels, BMI, and marital status are key predictors of CIPN.
  • The CART model achieved an accuracy of 65.9% and highlighted the importance of CRP levels and neutrophil-to-lymphocyte ratios in predicting CIPN, suggesting this model could be useful for developing individualized patient care strategies in the future.
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Objectives: To assess the feasibility, acceptability, and preliminary effectiveness of implementing a home-based aerobic and resistance exercise for patients with breast cancer receiving endocrine treatment in Indonesia.

Methods: This is a mixed methods study with concurrent design consisting of quantitative single-arm pre-post intervention and qualitative study. We recruited patients with breast cancer ( = 36) receiving endocrine treatment and assigned 12 weeks of home-based pedometer-driven walking and resistance exercises using therapeutic bands.

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Background: Early colorectal cancer (CRC) symptom recognition and prompt diagnosis are crucial for the identification of cases in the earliest stage and for improving survival. This study investigates the incidence of presentation and diagnosis delays, their contributing determinants and their impact on the cancer stage at diagnosis.

Methods: This cross-sectional study recruited 227 CRC patients between November 2022 and October 2023.

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Article Synopsis
  • This study examines early-onset colorectal cancer (EOCRC) in Indonesia, finding that EOCRC patients mostly have higher education, are single, and tend to be underweight compared to those with average-onset colorectal cancer (AOCRC).
  • Despite these differences, the overall survival rates for EOCRC (34.2%) and AOCRC (36.9%) are relatively similar.
  • The research emphasizes the need for further studies to explore risk factors and social determinants affecting EOCRC, which is becoming a significant public health concern.
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Background: In Indonesia incidence of colorectal cancer (CRC) remains high. Information about early symptoms that can offer clinicians insights for timely diagnosis, prompt referral and quick treatment decisions is very limited. This study aims to examine the pattern of CRC early symptoms and its association with tumor laterality, age at onset, metastatic status, and symptom-to-treatment initiation (STI) duration and delay.

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Article Synopsis
  • In Indonesia, early-onset colorectal cancer (EOCRC) occurs more frequently in those under 50, potentially linked to a higher incidence of Lynch syndrome (LS) among CRC patients.
  • A study at Dr. Sardjito General Hospital examined 244 samples for mutations in KRAS and PIK3CA, finding significant associations between these mutations, microsatellite instability (MSI) status, and Lynch syndrome.
  • Results indicated that KRAS mutations correlate with right-sided colorectal cancer and higher histology grades, while PIK3CA mutations link to female patients and lower tumor-infiltrating lymphocyte levels; however, neither mutation significantly impacted overall survival.
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Objectives: Colon and rectal cancer are associated with different risk factors and prognostic. However, this discrepancy has not been widely explored in the local population. This study aimed to investigate the site-specific likelihood of colorectal cancer (CRC) incidence in the Yogyakarta province, Indonesia.

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Background: Chemotherapy-induced neutropenia (CIN) is a substantial side effect in chemotherapy of breast cancer patients. Administration of granulocyte colony stimulating factor (G-CSF) that may reduce CIN occurrence is not commonly available to many local cases.

Objectives: To investigate the occurrence of grade 4 CIN and the influencing factors in breast cancer patients not receiving G-CSF prophylaxis.

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Objective: This study aims to characterize patient-reported chemotherapy-induced toxicity in patients with breast cancer, determine its association with treatment regimens and patient characteristics, identify toxicity symptom clusters within a specific chemotherapy timeframe and analyze the correlation between symptom clusters within and between the timeframe to understand the changes and influences across chemotherapy.

Methods: Forty-six patient-reported toxicities during neoadjuvant/adjuvant chemotherapy for breast cancer were evaluated using adapted CTCAE version 4.0.

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Background: Nasopharyngeal carcinoma (NPC) is the most prevalent geographically-specific head and neck cancer. Its incidence was high in the Asian population, especially in certain parts such as Southern China and South East Asia. Most patients with NPC are presented with intermediate-stage or locally advanced disease requiring chemoradiation as the primary treatment of choice.

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Nasopharyngeal cancer (NPC) cases are often diagnosed in advanced stages. The complexity of clinical management for advanced-stage NPC requires thorough communication and shared decisions between medical professionals and allied teams. Incorporating a multidisciplinary team meeting (MDTM) for newly diagnosed NPC patients was chosen to facilitate collaboration and communication between physicians.

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BACKGROUND Cerebral ischemia and hemorrhages were reported to be the main complications of polycythemia vera (PV). The relationship between PV and increased risk of the cerebrovascular events has been established. Some patients with secondary polycythemia have thromboembolic events comparable to those of PV.

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Introduction Triple assessment, consisting of clinical breast examination, breast imaging, and fine-needle aspiration biopsy (FNAB), is the gold standard for breast lump diagnosis to avoid diagnostic errors. However, current diagnostic practices for breast lump cases in Indonesia are widely variable and evidence for triple assessment implementation is lacking. We aimed to explore the implementation of diagnostic assessments in breast lump cases, its influencing factors, and its association with diagnostic error.

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Introduction Chemotherapy-induced nausea and vomiting (CINV) is a common and debilitating adverse effect of breast cancer chemotherapy. The incidence of CINV in the first cycle of chemotherapy is essential, as it sets the tone for anticipatory CINV and the overall patients' treatment experience. We aimed to investigate the risk factors of first cycle CINV in breast cancer patients and to develop a classification and regression tree (CART) model to predict its occurrence.

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Background: The utilization of a multidisciplinary team (MDT) strategy is a beneficial approach in integrating the knowledge and proficiencies of various fields to produce thorough and advantageous cancer treatment plans for patients. Nevertheless, MDT has yet to be widely adopted in Indonesia. In this study, the authors examined an early form of MDT in Indonesia that does not involve dedicated meetings, referred as independent multidisciplinary work (IMW).

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Adrenal insufficiency in systemic lupus erythematosus is rarely detected, especially in male patients. Nevertheless, such coexistence can occur, and screening for systemic lupus erythematosus should be considered in primary adrenal insufficiency with symptoms of systemic multiorgan involvement. We report a 22-year-old Asian man, initially diagnosed with bicytopenia, developed severe unintentional weight loss, skin and mucosal hyperpigmentation, along with persistent fatigue.

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Article Synopsis
  • - The study aimed to assess the prognostic role of vimentin in triple negative breast cancer (TNBC) patients, focusing on how it relates to chemotherapy types and p53 mutant expression.
  • - Researchers analyzed data from 72 TNBC patients over 48 months, finding that vimentin expression was linked to better overall survival, particularly in those receiving non-platinum-based chemotherapy and those with p53 mutations.
  • - The results suggested that while vimentin was generally associated with improved survival rates, its significance varied based on the chemotherapy regimen and the presence of p53 mutations.
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Article Synopsis
  • * Common symptoms included vaginal dryness (45.9%), decreased libido (45.2%), and dyspareunia (13.3%), with symptoms worsening during chemotherapy and lasting up to six months post-treatment.
  • * Factors like longer chemotherapy duration and certain characteristics of the spouse and patient (age, weight) were linked to higher risks of specific sexual dysfunctions.
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Background: Breast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia.

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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.

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Malaria is known to be a significant risk factor and also a potential complicating factor during the treatment of lymphoid malignancy. There has not been a reported case of malaria reactivation that occurred weeks after cytotoxic chemotherapy completion, especially in non-endemic regions. Our patient was a 47-year-old man with a history of repeated falciparum malaria infection experiencing 2 months of progressive unilateral nasal blockage and recurrent anterior epistaxis, which was diagnosed as diffuse large B-cell lymphoma (DLBCL) through pathological examination.

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BACKGROUND Chemotherapy based on 5-fluorouracil (5-FU) is a well-established treatment for solid cancers, including metastatic or advanced colon cancer. Despite its efficacy, 5-FU can cause rare but serious adverse events such as acute neurotoxicity, which presents as symptoms similar to stroke. CASE REPORT We report the case of a patient who was diagnosed with stage IV colorectal cancer and who underwent chemotherapy with a high dose of 5-FU as part of the FOLFIRI (Folinic Acid, Fluorouracil, Irinotecan) treatment plan.

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