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Mesotheliomas
have either spindle
cells or plump
rounded cells
forming gland-like
configurations, as
seen here at high
power
microscopically.
They are very
difficult to
diagnose
cytologically.
3
TNM staging
Multicenter, Jakarta
2007-2008
IIIA
IIB
IIA
IIIB
IB
IA
Staging,
nonsmall cell
lung cancer
IB IIA
IA
IIIA
IV
www.kankerparu.org
RS
Persahabatan
2004-2006
IIB
IV
IIIB
6
Scalpel: surgery
Beam: radiotherapy
Drugs: chemotherapy,
new targeted therapy
Combined/multimodality
7
NEJM 2004
Surgery
5(1,3%)
Chemoradioth/
(17.2%)
Chemoradio
Chemotherapy 35,26%
10,4%
Untreated 35,1%
Radioth/
No medical
Treatment
39(10,5%)
131(35,1%)
Surgery 1,42%
% Others 27,3%
Chemoth/)
95
( 25.5%)
Others
39(10,5%
)
RS Persahabatan
(n = 373)
Untreat ed 17,6%
targted th 0,9%
Radioth 7,3%/
Multicenter, Jakarta
WWW.KANKERPARU.ORG
Survival rate
Stg IA&IIA
0.75
p=0,0000
0.50
Stg IB
0.25
Stg IIIB
0.00
0
Lama hidup
(bulan)
Stg IIB
20
Stg IV Stage
40
Stg IIIA
IB
Stage IIB
Stage IIIB
60
80
Stage
Stage
Stage
Stage
IASurvival
IIA
IIIA
IV
10
time
0.75
p=0,0002
0.50
0.25
0.00
0
Resection+
adjuvant
Lama hidup
(bulan)
20
Neoadjuvant+resection
40
60
Adjuvan
Resection only
Pembedahan saja
NotTanpa
resected
pembedahan
Neoadjuvan
80
12
15
Laki2 58 thn,
17
Not responding to an
adequate treatment
within 1-2 weeks
should be evaluated for the
possibility of lung ca ncer
18
Beware!
persistent pain
in the shoulder and/or arm
20
Male, 44 yrs
Persistent pain
on rgt shoulder,
treated as tb for
>2 months,
not improved.
Biopsy: adeno
carcinoma
23/5/2008
After chemothrp I
& radiotherapy 10x
110608
After chemothrp II
& radiotherapy
20x
21
230308
080508
Before therapy
Male, 44 yrs
Persistent pain
on rgt shoulder,
treated as tb for
>2 months,
not improved.
Biopsy: adeno
carcinoma
23/5/2008
After chemothrp I
& radiotherapy 10x
110608
After chemothrp II
& radiotherapy
20x
22
Beware!
Netter FH, et al
What We Need
to Be Aware of
frequently neglected
symptoms & signs
24
Netter FH, et
al
igns
Severe
headache or signs of stroke
may indicate
cerebral metastasis from lung cancer
Chest x-ray film must be made
before brain surgery.
Lung cancer is often found after extirpat-ion of brain lesion
suspected for tumor.
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REPUBLIKA
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29
Lung cancer:
Diagnosis, treatment,
prevention
Anwar Jusuf
Departmnt of Respiratory Medicine
Fac. of Me dicine, UI
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