OVERALL SURVIVAL RATE PENDERITA GESTATIONAL TROPHOBLASTIC NEOPLASIA YANG DIRAWAT DI RSUP DR. SARDJITO

RUDI HELMANSYAH, DR. dr. Heru Pradjatmo M.Kes. SpOG(K), dr.Ahsanudin Attamimi, SpOG(K).

2017 | Tesis-Spesialis | SP Ilmu Kebidanan dan Penyakit Kandungan

Latar belakang: Gestational trophoblastic neoplasia meliputi mola invasif, koriokarsinoma dan PSTT termasuk variannya yang jarang terjadi epithelioid trophoblastic tumor (ETT). Istilah ini telah diterapkan secara kolektif untuk 3 kondisi terakhir, bersifat progresif, invasif, metastasis, dan menyebabkan kematian jika tidak ditangani. Kebanyakan pasien dengan GTN berhasil diterapi sempurna dengan tetap mempertahankan fungsi reproduksinya. Gestasional tropoblastik neoplasia sangat sensitif dengan kemoterapi bahkan pada pasien stadium lanjut. Dilaporkan overall survival 5 tahun pasien dengan GTN risiko rendah 100%, GTN risiko tinggi 75-90%, dengan metastase hepar 27 %, metastase otak 70% dan metastase keduanya sekitar 10%. Tujuan: penelitian ini bertujuan untuk melihat persentase overall survival rate serta menilai apakah terdapat hubungan antara nilai skoring WHO, stadium FIGO dan BMI terhadap survival rate penderita GTN di RSUP dr. Sardjito. Metode: Penelitian ini merupakan kohort retrospektif dengan melihat rekam medis dan melakukan pengamatan baik melalui telepon ataupun kunjungan rumah. Subyek penelitian adalah pasien yang terdiagnosis GTN risiko tinggi dan GTN risiko rendah yang dirawat di RSUP Dr. Sardjito. Kelangsungan hidup penderita GTN dan faktor prognostik yang mempengaruhi dianalisis dengan uji Log Rank dan disajikan berupa kurva Kaplan-meier. Hasil: Subyek penelitian 60 penderita GTN yang terbagi menjadi 30 penderita GTN risiko tinggi dan 30 penderita GTN risiko rendah. Overall survival rate 5 tahun pasien GTN di RSUP Dr. Sardjito adalah sebesar 93,3%, survival rate GTN risiko rendah 100% dan risiko tinggi 86,7% p=0,042 (p>0,05) yang berarti ada perbedaan bermakna. Faktor prognostik tidak berpengaruh bermakna secara statistik terhadap survival rate penderita GTN. Kesimpulan: Survival rate GTN risiko rendah lebih baik daripada GTN risiko tinggi. Faktor prognostik tidak berpengaruh terhadap survival rate penderita GTN.

Background: Gestational tropoblastic neoplasia includes invasive mole, choriocarcinoma and PSTT including its rare epithelioid trophoblastic tumor (ETT) variant. This term has been applied collectively to the last 3 conditions, progressive, invasive, metastatic, and causes death if left untreated. Most patients with GTN successfully treated perfectly while maintaining their reproductive function. Gestational tropoblastic neoplasia is very sensitive to chemotherapy even in advanced stage patients. Reported overall 5 years survival of patients with GTN low risk 100%, high risk GTN 75-90%, 27% with hepatic metastases, 70% with brain metastases and about 10% with both metastases Objective: This study aims to see the percentage of overall survival rate and to assess whether there is a correlation between WHO score, FIGO stage and BMI to survival rate of GTN patients in RSUP dr. Sardjito. Methods: This study is a retrospective cohort by viewing medical records and making observations either by telephone or home visits. The subjects of the study were patients diagnosed with high-risk GTN and low-risk GTN treated in Dr. Sardjito. The survival of GTN patient and prognostic factors that influence is analyzed by Rank Log test and presented in the form of Kaplan-meier curve. Result: The study subjects were 60 GTN sufferers divided into 30 high-risk GTN patients and 30 low-risk GTN patients. Overall survival rate 5 years of GTN patients in RSUP Dr. Sardjito was 93.3%, survival rate GTN low risk 100% and high risk 86.7% p = 0.042 (p> 0.05) which mean there is significant difference. Prognostic factors did not significantly influence the survival rate of GTN patients. Conclusions: Low-risk GTN Survival rates are better than high-risk GTN. Prognostic factors have no effect on survival rate of GTN patients.

Kata Kunci : Overall survival rate, gestational trophoblastic neoplasia, faktor prognosis, stadium, histopatologi, Overall survival rate, gestational trophoblastic neoplasia, prognostic factor, stage, grade histopathology