PERBEDAAN KUANTITAS WASHOUT KARSINOMA HEPATOSELULER SEBAGAI PREDIKTOR RESPON TERAPI POST TACE

Arif Budiman, dr. Yana Supriatna, Ph.D Sp.Rad (K) RI.; dr. Sudarmanta, Sp. Rad (K) RI.

2024 | Tesis-Spesialis | S2 Radiologi

Latar Belakang : Kuantitas washout lesi KHS sebelum terapi dapat memprediksi prognosis jangka pendek post terapi, studi sebelumnya menyebutkan kuantifikasi washout lesi pada fase delayed menjadi prediktor yang baik, rumus kuantifikasi terbaik dan nilai cuttoff washout di indonesia belum pernah diteliti sebelumnya.

Tujuan : Menilai perbedaan kuantitas washout sebelum terapi pada KHS yang berespon dan tidak berespon terhadap TACE, sehingga dapat menjadi prediktor respon terapi.

Metode : Penelitian retrospektif ini menggunakan rancangan cross sectional, sumber data sekunder CT Scan Abdomen Multifase yang memenuhi kriteria inklusi dan ekslusi dijadikan subyek penelitian ialah 49 sampel. Subyek penelitian yang telah menjalani TACE tahap pertama, dikelompokan menjadi lesi respon (+) dan respon (-) sesuai kriteria mRECIST, selanjutnya diukur kuantitas washout sebelum terapi dan dibandingkan nilainya. Data kemudian dianalisis dengan uji Mann Withney, ditentukan kurva ROC dan AUC serta cutoff point dari data tersebut.

Hasil : Terdapat perbedaan kuantitas washout antara kelompok respon (+) dan respon (-), nilai p<0>cutoff 120,5, ? 120,5 pada respon (+) dan < 120>

Kesimpulan : Perbedaan kuantitas washout DPAR lesi KHS dapat memprediksi prognosis post TACE awal, respon terapi partial-complete response memiliki nilai washout lebih besar sama dengan nilai cutoff 120,5 sedangkan pasien dengan progresive-stable disease akan cenderung memiliki nilai washout dibawah cutoff.

Kata Kunci : Kuantitas washout, KHS, prediktor, terapi TACE

Background : The quantity of washout lesions in KHS before therapy can predict short-term prognosis after therapy. Previous studies have indicated that the quantification of washout lesions in the delayed phase is a good predictor. The best quantification formula and the cutoff value for washout in Indonesia have not been studied before.

Objective : Assessing the difference in washout quantity before therapy in KHS that responds and does not respond to TACE, so that it can serve as a predictor of therapy response

Method : This retrospective study uses a cross-sectional design. The secondary data source consists of multi-phase abdominal CT scans that meet the inclusion and exclusion criteria, with 49 samples included as research subjects. The subjects who have undergone the first stage of TACE are classified into response (+) and response (-) lesions according to the mRECIST criteria. The washout quantity before therapy is then measured and compared. The data is analyzed using the Mann-Whitney test, and the ROC curve and AUC are determined, along with the cutoff point from the data.

Results : There is a difference in washout quantity between the response (+) and response (-) groups, with a p-value of <0>

Conclusion : The difference in DPAR washout quantity of KHS lesions can predict prognosis post-initial TACE. Patients with partial-complete therapy response tend to have washout values equal to or greater than the cutoff of 120.5, while patients with progressive-stable disease are likely to have washout values below the cutoff.

Keywords : Washout quantity, HCC, predictor, TACE

Kata Kunci : Kuantitas washout, KHS, prediktor, terapi TACE