HUBUNGAN KADAR CA-125 PRAOPERATIF TERHADAP PROGNOSIS SURVIVAL PENDERITA KANKER OVARIUM EPITELIAL DI RSUP DR. SARDJITO
HERLINA PRAJATMO, Dr. dr. H. Heru Pradjatmo, M.Kes, SpOG(K)
2014 | Tesis | SP Ilmu Kebidanan dan Penyakit KandunganLatar belakang: Kadar CA-125 meningkat pada 50% pasien stadium I penyakit, 90% stadium II, 92% stadium III, 94% stadium IV penyakit kanker ovarium. Kadar CA-125 bukan penanda diagnostik untuk mendeteksi kanker ovarium, tetapi merupakan penanda tumor yang bermanfaat untuk memonitor perjalanan penyakit dan sebagai penanda prognostik. Tujuan: Untuk mengetahui apakah kadar CA-125 sebelum operasi penderita kanker ovarium di RSUP Dr. Sardjito juga merupakan faktor yang berhubungan dengan prognosis survival penderitanya. Rancangan penelitian: Penelitian ini menggunakan rancangan kohort retrospektif. Tempat penelitian: RSUP Dr. Sardjito Yogyakarta. Hasil: Sebanyak 71 penderita kanker ovarium yang disertakan dalam penelitian ini sesuai dengan kriteria inklusi dan eksklusi. Subyek dibagi menjadi 2 kelompok yaitu kelompok kadar CA-125 rendah (≤35 U/ml) sebanyak 18 subyek dan kelompok kadar CA-125 tinggi (>35 U/ml) sebanyak 53 subyek. Dari analisis bivariat dengan survival analisis (Cox’s Regression) secara independen didapatkan stadium penyakit (p=0,005; HR 4,827; IK 95% 1,623-14,355) dan residu tumor (p=0,029; HR 2,605; IK 95% 1,101-6,161) merupakan faktor prognosis survival dari penderita EOC (Epithelial Ovarian Cancer). Dari analisis multivariat dengan survival analisis (Cox’s Regression) didapatkan faktor yang berpengaruh terhadap survival penderita EOC di RSUP Dr. Sardjito baik secara statistik dan secara klinis adalah kadar CA-125 dengan (p=0,031; HR 4,131; IK 95% 1,143-14,933), dan menarche dengan (p=0,003; HR 4,989; IK 95% 1,736- 14,342). Kesimpulan: Kadar CA-125 berpengaruh terhadap survival penderita kanker ovarium epitelial di RSUP Dr. Sardjito. Selain kadar CA-125, terdapat faktor-faktor lain yang berpengaruh terhadap survival penderita kanker ovarium epitelial yaitu stadium kanker ovarium, residu operasi, dan umur menarche. Kata kunci: Kadar CA-125, EOC, prognosis, survival.
Background: CA-125 level increases in 50% of patients with stage I, 90% of patients with stage II, 92% of patients with stage III and 94% of patients with stage IV ovarian cancer. CA-125 level were not a diagnostic tool to detect ovarian cancer, however it was useful to monitor the progressive of disease and as a prognostic marker. Objectives: The aim of this study is to prove whether CA-125 level before surgery in ovarian cancer patients at Dr. Sardjito Hospital as well as a factor that correlates to the survival prognosis of those patients. Method: This research used cohort retrospective study at Dr. Sardjito Hospital Yogyakarta. Results: As much as 71 ovarian cancer patients which had been included in this research with inclusion and exclusion criteria. Subjects were divided into two groups. One group was for patients with low CA-125 level (≤35 U/ml) as much as 18 subjects and another group was for patients with high CA-125 level (>35 U/ml) as much as 53 subjects. The result of a bivariate analysis with an independent survival analysis (Cox’s Regression) was the stage of disease (p=0.005, HR 4.827, CI 95% 1.623 – 14.355) and residual tumour (p=0.029, HR 2.605, CI 95% 1.101 – 6.161) were a survival prognosis factor. Multivariate analysis with a survival analysis (Cox’s Regression) shows CA-125 level (p=0.031, HR 4.131, CI 95% 1.143 – 14.933) and menarche (p=0.003, HR 4.989, CI 95% 1.736 – 14.342) were significantly related with survival prognosis in EOC (Epithelial Ovarian Cancer) patients at Dr. Sardjito Hospital. Conclusion: CA-125 level affects the survival rate of epithelial ovarian cancer patients in Dr. Sardjito Hospital. Besides the level of CA-125, there are other factors that affect the survival rate of epithelial ovarian cancer patients which is the stage of cancer, residual operation and age of menarche. Keywords: CA-125 level, EOC, prognosis, survival
Kata Kunci : CA-125 level, EOC, prognosis, survival;
