Perbandingan Rentang Waktu Standar dan Tidak Standar pada Pasien Karsinoma Hepatoselular Post Transarterial Chemoembolization 2 Menggunakan vRECIST CT Scan Abdomen

Inri Suryani Batan, dr. Yana Supriatna, Ph.D, Sp.Rad(K)RI ; dr.Sri Retna Dwidanarti,Sp.Rad(K)Onk.Rad

2023 | Tesis-Spesialis | S2 Radiologi

Latar Belakang : Penyakit Hepatocellular Carcinoma (HCC) merupakan kanker yang disebabkan oleh tumbuhnya sel hepatosit secara abnormal. TACE telah menjadi standar perawatan dan modalitas pengobatan yang direkomendasikan oleh klasifikasi stadium B BCLC. TACE berulang memberikan manfaat bertahan hidup pada pasien. Evaluasi respon tumor yang digunakan adalah kriteria vRECIST. Perbandingan rentang waktu standar (<95hari>95 hari) pada hasil terapi post TACE 2 berdasarkan kriteria vRECIST berguna untuk menentukan prognosis pasien Karsinoma Hepatoselular.

Tujuan : Mengetahui adanya perbedaan hasil terapi post TACE 2 lebih baik pada rentang waktu standar dibandingkan dengan rentang waktu tidak standar berdasarkan penilaian respon terapi vRECIST menggunakan CT Scan Abdomen.

Bahan dan Metode : Penelitian ini merupakan penelitian observasional analitik, desain retrospektif cross sectional. Sampel adalah 44 pasien KHS dengan metode pengambilan secara consecutive non-random sampling yang menjalani TACE 1 dan TACE 2 di ruang Catheter lab Instalasi Radiologi RSUP dr. Sardjito dan pemeriksaan CT Scan abdomen setelah TACE 2 pada rentang waktu standar (<95>95 hari) pada Januari 2014 - Desember 2022.

Hasil : Dari 44 sampel penelitian, hasil uji interobserver pada 10 sampel didapatkan nilai Kappa sebesar 1,000. Hasil uji Mann Whitney didapatkan p=0,047 (p<0 p=0,021.>

Kesimpulan : Terdapat perbedaan yang bermakna menurut kriteria vRECIST pada evaluasi hasil respon terapi post TACE 2 kelompok rentang waktu standar (<95>95 hari) pada pasien Karsinoma Hepatoselular (p=0,047). Tidak terdapat hubungan karakteristik jenis kelamin, usia, lokasi, ascites, thrombus vena porta, bentuk nodul, jumlah nodul, ukuran nodul dengan kriteria vRECIST. Hasil analisis multivariate yaitu jarak TACE tidak standar berpengaruh signifikan terhadap hasil respon terapi (p=0,021) yang artinya memiliki derajat hasil respon terapi 2 tingkat lebih rendah dibandingkan jarak standar.

Background : Hepatocellular Carcinoma (HCC) is a cancer caused by the abnormal growth of hepatocyte cells. TACE has become the standard of care and treatment modality recommended by the BCLC stage B classification. Repeated TACE provides survival benefits in patients. The tumor response evaluation used was the vRECIST criteria. Comparison of standard (<95>95 days) time frames for post TACE 2 therapy results based on vRECIST criteria is useful for determining the prognosis of Hepatocellular Carcinoma patients.

Objective : To find out whether there is a difference in the results of post TACE 2 therapy, which is better in the standard time range than the non standard time range based on assessing the response to vRECIST therapy using a CT Scan of the Abdomen.

Materials and Methods : This research is an analytical observasional study with a cross sectional retrospective design. The sample was 44 KHS patients using a consecutive non random sampling method who underwent TACE 1 and TACE 2 in the Catheter lab rom at the Radiology Installation non standard time (>95 days) in January 2014-December 2022.

Results : Of the 44 research samples, the results of interobserver test on 10 samples obtained a Kappa value of 1,000. The results of the Mann Whitney test were p=0.047 (p<0 p=0.021.>

Conclusions: There is a significant difference according to the vRECIST criteria in the evaluation of post TACE therapy response results in 2 groups, the standard time range (<95>95 days) in Hepatocellular Carcinoma patients (p=0.047). There was no relationship between the characteristics of gender, age, location, ascites, portal vein thrombus, nodule shape, number of nodules, and nodule size with the vRECIST criteria. The results of the multivariate analysis are that the non standard TACE distance significantly affects the therapeutics response results (p=0.021), which means it has a degree of therapeutic response results that is 2 levels lower than the standard distance.

Kata Kunci : TACE, KHS, vRECIST, Rentang waktu, CT Scan Abdomen