Kelangsungan hidup dan faktor-faktor prognosis yang mempengaruhinya pada penderita karsinoma endometrium RS. Dr. Sardjito yang dirawat sejak 1 Januari 2003-31 Desember 2007

SARI, Dyah Mellydia Permata, dr. H. Heru Pradjatmo, M.Kes., SpOG(K)

2009 | Tesis | S2 PPDS I-Obstetri dan Ginekologi

Latar belakang: Karsinoma endometrium merupakan kanker utama urutan ke empat pada wanita. Diperkirakan sebanyak 40.100 penderita karsinoma endometrium dengan insidensi 17,7 sampai 26 setiap 100.000 penduduk, dan berakibat 6.800 kematian setiap tahunnya. Kelangsungan hidup penderita karsinoma endometrium dipengaruhi berbagai faktor. Di Indonesia belum ditemukan penelitian yang meneliti median survival penderita karsinoma endometrium dan faktor-faktor prognosis yang berpengaruh terhadap kelangsungan hidup. Tujuan penelitian: Mengetahui kelangsungan hidup penderita karsinoma endometrium yang dirawat di RS Dr. Sardjito dan faktor prognosis apakah yang berpengaruh terhadap kelangsungan hidup penderita karsinoma endometrium. Rancangan penelitian: Kohort restrospektif Bahan dan Cara penelitian: Dilakukan penelitian terhadap penderita karsinoma endometrium yang dirawat di RS Dr. Sardjito sejak 1 Januari 2003 sampai 31 Desember 2007. Subyek yang memenuhi kriteria inklusi diamati, dicatat yang meninggal maupun yang masih hidup. Penelitian diakhiri tanggal 31 Desember 2008. Kelangsungan hidup penderita dan perbedaan median survival antara masing-masing faktor yang diduga berpengaruh dianalisis dengan uji Log Rank dan disajikan berupa kurva Kaplan-Meier. Faktor-faktor prognostik yang berpengaruh pada kelangsungan hidup dianalisis dengan Cox proportional Hazard Model. Hasil: Terdapat 78 pasien karsinoma endometrium yang dirawat di RS. Dr. Sardjito antara 1 Januari 2003 sampai 31 Desember 2008. 60 kasus (77%) masih hidup sampai akhir penelitian. Median survival penderita karsinoma endometrium yang dirawat di RS. Dr. Sardjito adalah 40 bulan. Stadium klinis, stadium surgikal, jenis terapi secara statistik memiliki perbedaan yang bermakna dalam mempengaruhi median survival. Stadium klinis (p=0,008, p< 0,05), stadium surgikal (p=0,004, p<0,05), jenis terapi (p=0,001, p<0,05). Faktor prognosis yang berpengaruh terhadap kelangsungan hidup adalah stadium klinis (p=0,013, RR 3,519, 95%, CI 1,470-8,424) dan stadium surgikal (p=0,003, RR 9,000, 95% CI 1,209-66,971). Kesimpulan: Stadium klinis, stadium surgikal dan jenis terapi memiliki pengaruh terhadap median survival. Faktor prognosis yang berpengaruh terhadap kelangsungan hidup adalah stadium klinis dan stadium surgikal.

Background: Endometrial carcinoma is the fourth main cancer of woman in the world. There was 40.100 endometrial carcinoma patients in the world, with incidency 17,7 until 26 every 100.000 peoples in the population. There were several factors assessed the endometrial patients’s survival rate. There was no previous research in Indonesia about median survival rate and prognostic factors for endometrial patients. Objective: To find endometrial carcinoma survival rate and prognostic factors from Sardjito Hospital’s patients who admitted to the hospital . Study Design: Restrospectif cohort Methods: Patients who admitted to the Sardjito Hospital since 1 January 2003 until 31 December 2007 were observed. The patients who have match the inclusion criteria followed until 31 December 2008. At the end of observation, median survival rate and the prognostic factors for endometrial carcinoma patient were measured. Log Rank test applicated and Kaplan-Meier curves showed. Prognostic factors measured by Cox Proportional Hazard Model. Results: There were 78 endometrial carcinoma patients who admitted to the Sardjito Hospital between 1 January 2003 until 31 December 2007. 60 patient (77%) still alive until the end of observation. Median survival rate was 40 months. Clinical stage, surgical stage and therapy was statistically significant correlate with median survival rate. With Log rank test, clinical stage p=0,008(p<0,05), surgical stage p=0,004 (p<0,05), therapy p=0,001 (p<0,05). Prognostic factors that statistically significant correlate with survival were clinical stage (p=0,013,RR 3,519, 95% CI 1,470-8,424) and surgical stage (p=0,003,RR 9,000 95% CI 1,209-66,971). Conclusions: Clinical stage, surgical stage and therapy was statistically significant correlate with median survival rate. Prognostic factors that statistically significant correlate with survival were clinical stage and surgical stage.

Kata Kunci : Kelangsungan hidup,Karsinoma endometrium,survival, endometrial carcinoma