PROGNOSIS dan PREDIKTIF pada KANKER April 6, 2017 PROGNOSIS dan PREDIKTIF pada KANKER dr. Daan Khambri, SpB(K)Onk, M.Kes Subbagian Bedah Onkologi, Bagian Bedah FK-UNAND / RSUP Dr.M.Djamil Daan Khambri, Stase Nuclear Medicine

Curiculum Vitae Lahir di DUMAI, tanggal 6 Mei 1967 Dr. H. Daan Khambri, SpB (K) Onk, M.Kes Dokter Spesialis Bedah Konsultan Bedah Onkologi / HNB (Bedah Tumor) Lahir di DUMAI, tanggal 6 Mei 1967 Pendidikan : SD, SMP, SMA di DUMAI s/d Th 1985. S1 – Dokter Umum (FK-UNAND Padang, 1991). Sp1 – Spesialis Bedah (FK-UNAND Padang, 2003). S2 – Magister Kesehatan (FK-UNPAD Bandung, 2007). Sp2 – Konsultan Bedah Onkologi (FK-UNPAD Bandung, 2007). Pekerjaan :- Staf Subbagian Bedah Onkologi, Bagian Bedah FK-UNAND / RSUP Dr.M.Djamil Organisasi Profesi : IDI, IKABI, PABI, PERABOI, POI Riwayat Pekerjaan : 1992-95 PUSKESMAS Rantau Pandan Bungo Tebo JAMBI. 1995-96 PUSKESMAS SALIMPAUNG Tanah Datar SUMBAR. 2003-04 RSUD SUNGAI DAREH Kab. DHARMASRAYA. 2007- RSUP Dr.M.Djamil / FK-UNAND Padang. Padang, 2011 Curiculum Vitae 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker BUKU RUJUKAN Bradley KT. CAP Cancer Committee. Prognostic and Predictive Factors in Breast Cancer. Newspath. Sept 1. 2007. UICC, International Union Against Cancer. Prognostic Factors in Cancer. 3rd Ed. 2006. Gede Sukardja. Onkologi Klinik. Edisi 2. 2000. 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker CARA TERAPI KANKER SURGERY RADIATION THERAPY CHEMOTHERAPY HORMONAL THERAPY MOLECULAR-TARGET THERAPY 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Combination Therapy : MULTIMODALITAS 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker prognostic factor Definisi : a measurable variable that correlates with the natural history of the disease 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker prognostic factor Faktor yang dapat dipakai untuk meramalkan perjalanan penyakit kanker 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker PROGNOSTIC FACTOR PENDERITA TUMOR TERAPI 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker PENDERITA Umur Kelamin Suku Bangsa Genetik Status Umum Status Penampilan Imunitas Co-Morbiditas Gizi Sosial Ekonomi 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker TUMOR Topografi/Jenis Kanker Morfologi/Patologi Derajat Keganasan Stadium Luas Ekstensi Tumor Lokasi dan luas meta Reseptor Hormon Petanda Tumor Multisentris Radio/Khemo sensitivitas 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker TERAPI Jenis terapi Lengkap / tidak Radikalitas operasi Respon terhadap terapi Fasilitas Keahlian Dokter Kerjasama tim multidisiplin 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker Predictive Factor Definisi : is associated with response to a given therapy. 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker Predictive Factor Faktor prediksi adalah sesuatu yang berpengaruh secara spesifik terhadap jenis pengobatan tertentu 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Prognostic Factors in Breast Cancer Age Tumor size Axillary node status Histological tumor type Pathologic grade Hormonal receptor HER-2/neu 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker April 6, 2017 BREAST CANCER Stage I T1 N0 M0 T1a: T  0.5 cm T1b: 0.5 cm < T  1 cm T1c: 1 cm < T  2 cm T1 T  2 cm 35. Breast Cancer: Stage I Stage I disease T1 N0 M0 is common. T1 tumors are 2 cm in dimension. T1a tumors are 0.5 cm. T1b tumors are >0.5 cm, but 1 cm in greatest dimension. T1c tumors are 1 cm, but no more than 2 cm in greatest dimension. This early breast cancer is often diagnosed on screening mammograms. N0 = no regional lymph node metastasis M0 = no distant metastasis 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker Daan Khambri, Stase Nuclear Medicine

Daan K, Blok 2.1 Prognosis & Prediktif Kanker April 6, 2017 BREAST CANCER Stage IV Any T any N M1 40. Breast Cancer: Stage IV Stage IV, or metastatic, breast cancer is a lethal disease. The most common sites of metastases are soft tissue (skin or draining lymph nodes), bone, and viscera (eg, liver, lung). M1 = distant metastasis (including metastases to ipsilateral supraclavicular, cervical, or contralateral internal mammary lymph nodes) 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker Daan Khambri, Stase Nuclear Medicine

Daan K, Blok 2.1 Prognosis & Prediktif Kanker RESEPTOR HORMON Estrogen reseptor (ER) Progesteron Reseptor (PR) Epidermoid growth factor reseptor (EGFR) / Her2 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker JENIS RESEPTOR Reseptor hormon positif Reseptor hormon negatif Reseptor hormon menentukan sensitivitas kanker terhadap hormon 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker

Daan K, Blok 2.1 Prognosis & Prediktif Kanker 06/04/2017 Daan K, Blok 2.1 Prognosis & Prediktif Kanker