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Karsinoma endometrium merupakan salah satu keganasan yang menyerang wanita dengan angka kesintasan yang relatif baik. Salah satu faktor yang diduga berperan dalam prognosis karsinoma endometrium antara lain adalah usia saat diagnosis. Penelitian ini bertujuan untuk melihat hubungan usia saat diagnosis dengan kesintasan hidup keseluruhan pasien 4 tahun karsinoma endometrium yang dirawat di RS Kanker Dharmais selama rentang tahun 2013–2019.
Studi ini merupakan kohort retrospektif yang menggunakan data sekunder berupa regsitri kanker berbasis rumah sakit dan sistem informasi RS di RSKD dengan subjek data pasien karsinoma endometrioid endometrium yang terdiagnosis dalam rentang 2013-2019. Sebanyak 220 pasien eligibel untuk dilakukan analisis terhadap variabel usia saat diagnosis, stadium, derajat keganasan, durasi menerima terapi, protokol terapi, kedalam invasi, adanya diabetes mellitus, hiperkolesterol, dan hipertensi. Analisis statistik digunakan untuk melihat hubungan masing-masing variabel terhadap kesintasan hidup, interaksi antar variabel, dan adanya perancu. Model akhir dibangun untuk melihat perbedaan kesintasan hidup pasien berdasarkan usia.
Probabilitas kesintasan hidup pada pasien karsinoma endometrium dirawat di RS Kanker Dharmais adalah 78,19%. Tidak terdapat perbedaan pada probabilitas kesintasan karsinoma endometrium pada kelompok usia ≥50 tahun (74,91%) dan
Endometrial endometrioid carcinoma is one of the malignancies that affect women with relatively excellent survival rates. One of the factors that play a role in the prognosis of endometrial carcinoma is the age at diagnosis. This study aims to examine the corellation between age at diagnosis and 4 years overall survival of endometrial carcinoma patients treated at Dharmais National Cancer Hospital from 2013 to 2019. This study was a retrospective cohort that utilized secondary data from the hospital-based cancer registry and the hospital information system at Dharmais National Cancer Hospital, involving subjects diagnosed with endometrioid endometrial carcinoma between 2013 and 2019. A total of 220 eligible patients were analyzed for variables such as age at diagnosis, stage, grade of malignancy, duration of treatment, treatment protocol, depth of invasion, presence of diabetes mellitus, hypercholesterolemia, and hypertension. Statistical analysis was used to assess the relationship between each variable and overall survival, interaction between variables, and confounding factors. A final model was constructed to examine the difference in survival among patients based on age at diagnosis. The survival probability for endometrial endometrioid carcinoma at Dharmais Cancer Hospital is 78.19%. There was no difference in the survival probability between the age groups ≥50 years (74.91%) and
CertDA Acute Lymphocytic Leukemia (ALL) masih menjadi penyebab utama kematian pada pasien kanker anak, dengan prognosis yang buruk. Pasien ALL yang didiagnosis pada masa bayi memiliki kelangsungan hidup terendah, diikuti oleh anak-anak yang didiagnosis antara usia 15 dan 19 tahun. Sedangkan pasien yang didiagnosis antara usia 1 dan 9 tahun memiliki peluang bertahan hidup tertinggi. Tujuan penelitian ini adalah untuk mengetahui probabilitas kesintasan secara keseluruhan maupun berdasarkan kelompok usia saat diagnosis serta hubungan antara usia saat diagnosis dengan kesintasan pasien ALL pada anak. Penelitian ini merupakan studi cohort retrospective dengan menggunakan data rekam medik pasien ALL anak di RS Fatmawati yang didiagnosis pada periode tanggal 1 Januari 2017-31 Desember 2022, kemudian dianalisa dengan menggunakan Cox Proportional Hazard. Hasil penelitian menunjukkan bahwa probabilitas kesintasan pasien ALL anak di RS Fatmawati secara keseluruhan sebesar 44,34%, probabilitas kesintasan anak yang saat diagnosis berusia 1-5 tahun lebih tinggi daripada pasien ALL anak yang saat diagnosis berusia > 5 tahun yaitu sebesar 49,87%. Secara statistik terdapat hubungan yang signifikan antara usia saat diagnosis dengan kesintasan pasien ALL pada anak, dimana pasien ALL anak yang usia saat didiagnosisnya > 5 tahun dan yang mempunyai efek samping selama pengobatan memiliki risiko kematian 2,74 kali lebih besar (HR: 2,74; 95%CI: 1,104 – 6,808, Pvalue: 0,03) dibandingkan dengan pasien ALL anak yang saat diagnosis berusia 1-5 tahun. Diharapkan dilakukan penerapan pola hidup sehat serta memberi edukasi tentang deteksi leukemia serta dilakukannya deteksi dini/skrining leukemia secara berjenjang untuk mengurangi risiko kematian pada pasien ALL anak.
CertDA Acute Lymphocytic Leukemia (ALL) remains the main cause of death in pediatric cancer patients, with a poor prognosis. ALL patients diagnosed in infancy had the lowest survival, followed by children diagnosed between the ages of 15 and 19 years. Meanwhile, patients diagnosed between the ages of 1 and 9 years have the highest chance of survival. This study aims to determine the overall probability of survival based on age group at diagnosis and the relationship between age at diagnosis and survival of ALL patients in children. This research is a retrospective cohort study using medical record data from pediatric ALL patients diagnosed in the period 1 January 2017-31 December 2022 at Fatmawati Hospital which was then analyzed using Cox Proportional Hazard. The results of the study showed that the overall probability of survival for pediatric ALL patients at Fatmawati Hospital was 44.34%, the probability of survival for children aged 1-5 years at diagnosis was higher than those > 5 years at diagnosis, namely 49.87%. Statistically there is a significant relationship between age at diagnosis and survival of childhood ALL patients, where pediatric ALL patients who were aged > 5 years at diagnosis and who had side effects during treatment had a 2.74 times greater risk of death (HR: 2.74; 95%CI: 1.104 – 6.808, pvalue=0,03) compared with pediatric ALL patients aged 1-5 years at diagnosis. It is hoped that healthy lifestyle will be implemented and education will be provided about leukemia detection as well as early detection/leukemia screening in stages to reduce the risk of death in pediatric ALL patients.
Kata Kunci: Kanker payudara, kesintasan hidup, stadium kanker, RSCM
Based on GLOBOCAN data of 2012, the highest incidence of cancer in Indonesia is breast cancer. Currently there are still many deaths caused by breast cancer. The survival of breast cancer survivors depends on several factors that are very important to know, including the stage of cancer. This study aims to determine the effect of stage of cancer, age, education, occupation, marriage, health insurance status, family history, type of therapy and distance of residence to survival of breast cancer survivors. The study design used a retrospective cohort method. Samples in this study were 135 breast cancer patients who were first diagnosed with breast cancer from January 2007 to June 2012 at RS Cipto Mangunkusumo. Data analysis using SPSS program and Kaplan Meier method and related factors were analyzed with Cox regression. The results of bivariable analysis showed that the stage of cancer had a significant relationship to survival of breast cancer (p value = 0,000; HR 19,227 (95% CI 1,395-265,101)). While in the analysis of mutivariabel the relationship of stage to life survival is not significant (p value = 0,102) after controlled by education variable, work, therapy type and interaction of cancer stage with education of patient. The survival of breast cancer survivors in early stage of breast cancer was higher (94.1%) than those in advanced stage (70.1%). Patients with advanced stage 11 times higher risk than the early stage (HR = 10,923; 95% CI 0.623-191,417). So needed awareness and efforts to early detection of breast cancer to further improve survival of breast cancer patients.
Keywords: Breast cancer, life survival, cancer stage, RSCM
Kanker payudara merupakan kanker yang paling banyak diderita oleh wanita di dunia, khususnya di Indonesia. Pengobatan yang lama dan berat memiliki dampak psikologis yang berpengaruh terhadap kualitas hidup pasien. Dukungan sosial penting untuk kualitas hidup pasien kanker payudara. Penelitian ini bertujuan untuk menganalisis pengaruh dukungan sosial terhadap kualitas hidup pasien kanker payudara di Rumah Sakit Kanker Dharmais. Penelitian ini menggunakan pendekatan kuantitatif dengan desain studi longitudinal dan kualitatif dengan case study. Sampel penelitian ini adalah pasien kanker payudara yang berobat dan tercatat pada di RS Kanker Dharmais periode bulan Agustus-Desember 2023 yang memenuhi syarat kriteria inklusi dan eksklusi penelitian sebanyak 190 pasien. Pengukuran kualitas hidup dengan kuesioner EORTC QLQ 30 dan BR-23 Pengukuran dukungan sosial dengan kuesioner Multidimensional Scale of Perceived Social Support (MSPSS). Pengumpulan data kualitatif dengan kelompok focus group discussion (FGD) dan wawancara mendalam. Analisis data menggunakan analisis regresi logistik untuk pengukuran data berulang pada data kategorik dengan General Estimation of Equotion (GEE). Dukungan sosial mempengaruhi kualitas hidup pasien kanker payudara sebesar 3,9 kali (OR=3,9; 95% CI: 3,3-4,6) setelah dikontrol faktor umur dan stadium kanker payudara. Sumber dukungan yang paling berpengaruh yaitu dukungan keluarga (OR=5,2 CI 95% 2,8-7,6) dan tenaga kesehatan (OR=2,0 CI 95% 1,3-3,1). Bentuk dukungan sosial yang paling berpengaruh yaitu dukungan emosional (OR=5,3 CI 95% 3,0-9,0), nyata (OR=3,6 CI 95% 2,5-5,2), dan informasi (OR=2,4 CI 95% 1,4-4,3). Pengaruh dukungan sosial terhadap kualitas hidup berdasarkan waktu terdapat penurunan seiring berjalannya waktu. Diharapkan untuk peningkatan dukungan sosial dari keluarga, tanaga Kesehatan dalam bentuk dukungan emosianal, nyata dan informasi. Rumah Sakit Kanker Dharmais juga diharapkan untuk mengoptimalkan program paliatif dan NAPAK sebagai bentuk dukungan sosial terhadap pasien kanker payudara. Kata Kunci : Kualitas Hidup, Dukungan Sosial, Pasien Kanker Payudara
Breast cancer is the most common type of cancer affecting women worldwide, particularly in Indonesia. The lengthy and intensive treatment process often has psychological impacts that affect patients' quality of life. Social support plays a crucial role in improving the quality of life of breast cancer patients. This study aims to analyze the effect of social support on the quality of life of breast cancer patients at Dharmais Cancer Hospital. A mixed-methods design was used, combining a quantitative longitudinal approach with a qualitative case study. The sample consisted of 190 breast cancer patients who were treated and registered at Dharmais Cancer Hospital between August and December 2023, and who met the study's inclusion and exclusion criteria. Quality of life was measured using the EORTC QLQ-C30 and BR-23 questionnaires, while social support was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Qualitative data were collected through focus group discussions (FGDs) and in-depth interviews. Data were analyzed using logistic regression for repeated measurements, employing the Generalized Estimating Equation (GEE) method for categorical data. The results showed that social support significantly influenced the quality of life of breast cancer patients, increasing the odds by 3.9 times (OR = 3.9; 95% CI: 3.3–4.6) after controlling for age and cancer stage. The most influential sources of support were family (OR = 5.2; 95% CI: 2.8–7.6) and healthcare workers (OR = 2.0; 95% CI: 1.3–3.1). The most impactful forms of support were emotional (OR = 5.3; 95% CI: 3.0–9.0), tangible (OR = 3.6; 95% CI: 2.5–5.2), and informational support (OR = 2.4; 95% CI: 1.4–4.3). However, the effect of social support on quality of life was found to decrease over time. It is therefore recommended to enhance social supports particularly from family and healthcare professionals through emotional, tangible, and informational forms. Dharmais Cancer Hospital is also expected to optimize its palliative care and NAPAK programs as a structured form of social support for breast cancer patients. Keywords: Quality of Life, Social Support, Breast Cancer Patients
In 2022, Indonesia ranked fourth globally in the number of breast cancer deaths. One of the contributing factors to the high mortality rate is comorbidity. This study aims to examine the association between comorbidities and three-year survival of breast cancer patients in Indonesia. A retrospective cohort design was used, involving 896 samples from the 2018–2023 BPJS Kesehatan General Sample Data. Survival curves and probabilities were estimated using the Kaplan-Meier method, while associations were analyzed using the log-rank test and Hazard Ratios (HR) via Cox regression. The study found that the cumulative survival probability (CSP) at 36 months for the overall sample was 49.9%, with a median survival time of 35,34 months. Breast cancer patients with comorbidities and other comorbid conditions had a higher risk of death within three years (comorbidity CSP = 43.7%; HR = 1.38; 95% CI = 1.01–1.89, other comorbidities CSP = 42.4%; HR = 1.43; 95% CI = 1.01–2.04). No significant differences in survival were found based on metabolic disorders including diabetes, hypertension, cardiovascular disease, age at diagnosis, marital status, socioeconomic status, or place of residence. Breast cancer survival in Indonesia remains low, particularly among patients with comorbidities.
ABSTRAK Nama : Nuraini Oktaviani Program Studi : Epidemiologi Judul : Analisis Kesintasan 5 Tahun Pasien Kanker Payudara Stadium Lanjut Lokal Berdasarkan Kemoterapi Neoadjuvan di Rumah Sakit Cipto Mangunkusumo Tahun 2011-2016 Latar belakang: Salah satu modalitas terapi yang digunakan untuk meningkatkan angka kesintasan hidup pasien kanker payudara adalah dengan pemberian kemoterapi neoadjuvan. Pada umumnya kemoterapi neoajuvan kanker payudara stadium lanjut lokal di RSCM menggunakan regimen doxorubicin based. Namun belum ada penelitian lebih lanjut mengenai perbandingan kesintasan hidup lima tahun pasien kanker payudara lanjut lokal yang mendapatkan kemoterapi neoadjuvan doxorubicin based dengan non-doxorubicin based di RSCM. Tujuan: Mengetahui angka kesintasan hidup lima tahun penderita kanker payudara stadium lanjut lokal yang diberikan kemoterapi neoadjuvan doxorubicin based dan non-doxorubicin based di RSCM tahun 2011 – 2016. Metode: Sebanyak 236 pasien kanker payudara stadium lanjut lokal yang mendapatkan kemoterapi neoadjuvan di RSCM tahun 2011-2016 menjadi sampel dalam penelitian ini. Analisis data dilakukan dengan metode Kapplan Meier, uji Log Rank dan Cox Regreession. Hasil penelitian: Angka kesintasan hidup lima tahun pasien kanker payudara stadium lanjut lokal yang diberi kemoterapi neoadjuvan doxorubicin based sebesar 37% dan non-doxorubicin based sebesar 48,9%. Pasien kanker payudara stadium lanjut lokal yang mendapatkan kemoterapi neoadjuvan doxorubicin based memiliki probabilitas 1,38 kali lebih cepat terjadinya kematian (95% CI 0,946 – 2,026) setelah dikontrol dengan variabel invasi pembuluh limfatik, respon klinis, stadium, radiasi, jenis histopatologi, grade, dan status menopause. Invasi pembuluh limfatik merupakan variabel dengan hazard ratio terbesar yaitu 4,74 (95% CI 3,213 – 7,284). Kesimpulan: Kemoterapi neoadjuvan non-doxorubicin based menunjukkan kesintasan hidup yang lebih tinggi dibandingkan kemoterapi neoadjuvan doxorubicin based. Kata kunci : doxorubicin based, non-doxorubicin based, kanker payudara, kemoterapi neoadjuvan
ABSTRACT Name : Nuraini Oktaviani Study Program : Epidemiologi : Survival Rate 5-years Breast Cancer Locally Advanced Based on Chemotherapy Neoadjuvan in Hospital Cipto Mangunkusumo 2011-2016 Background : One of the therapeutic modalities used to increase survival rates of breast cancer patients with neoadjuvan chemotherapy. In general, neoajuvan chemotherapy for locally advanced breast cancer at RSCM used a doxorubicinbased regimen. But there has been no further study on the survival comparison of five years of locally advanced breast cancer patients who are neoadjuvan chemotherapy doxorubicin based or non-doxorubicin based at RSCM. Title Objectives: This study is conducted for determine 5-years survival rate of locally advanced breast cancer who were given neoadjuvan chemotherapy doxorubicin based and non-doxorubicin based at RSCM in 2011 - 2016. Methods: A total of 236 patients with locally advanced stage breast cancer who received neoadjuvan chemotherapy at RSCM in 2011-2016 were sampled in the study. Data analysis was perfomed by Kapplan Meier method, Log Rank and Cox Regreession analysis. Results: 5-years survival rate of locally advanced breast cancer patients given neoadjuvan doxorubicin based chemotherapy is 37% and non-doxorubicin based is 48.9%. Locally advanced breast cancer patients receiving neoadjuvan doxorubicin based chemotherapy had a 1.38 times faster probability of death (95% CI 0.946 - 2.026) after controlled by invasive variation of lymphatic vein, clinical response, stage, radiation, histopathology, grade, And menopausal status. Invasion of lymphatic vessels is the variable with the largest hazard ratio of 4.74 (95% CI 3,213 - 7,284). Conclusions: Neoadjuvan chemotherapy non-doxorubicin based showed a higher survival than doxorubicin-based for locally advanced breast cancer. Keywords: doxorubicin based, non-doxorubicin based, breast cancer, neoadjuvan chemotherapy
Central venous catheter (CVC) are used extensively in patient with neoplastic disease, and primary bloodstream infection related to CVC (BSI-CVC) increasing morbidity, prolonged hospital stays including operational costs and treatment. Cross-sectional study with all hospitalized patient with an underlying cancer using CVC in periods 2011-2012 to describe primary bloodstream infections related to CVC at “Dharmais” National Cancer Centre year 2011-2012. 119 patients were selected from inclusion and exclusion criteria were eligible for this study. Univariate analysis shows clinical sepsis (18.5%), colonization (47.9%), bacteremia (14.3%) and cumulative incidence of BSI-CVC (13.3%). Most frequent of BSI-CVC are patient with hematology malignancies (78.4%) and higher proportion are patients in the immunocompromised-care (90%) in patients with average of hospital stays are more than 30 days. 45% Gram-negative bacteria’s are responsible to BSI-CVC. Behavior of nursing care against cancer patients with CVC, management support and surveillance data needed to bloodstream infection control and prevention.
