Hasil Pencarian  ::  Simpan CSV :: Kembali

"Ovarian cancer is one of the largest cause of death in women. It is often refered to as the silent killer because the symtoms remain unseen to the patient. The number of ovarian cancer cases varies in each country. For example, the rate of ovarian cancer in counties such as Asia and Africa lower rather than in most industrialized countries like Europe and North America, Rate of Epithelial ovarian cancer in women ages 45-49 was 16.4 cases per 100,000 people. The risk of being diagnosed increases with age. The risk more than doubles in women 60 and over with 40 cases per 100,000, and the highest rate at 61 cases to 100,000 is in the age group of women 80-84. Currently, informaiion regarding ovarian cancer in Indonesia is limited, but Dharmais Cancer Hospital found about 30 new cases of ovarian caricer every year. The purpose of this study is to determine the probability of serum albumin levels in the survivors of epithelial ovarian cancer at Dharmais Cancer Hospital in Jakarta in 1996-2004. Design study is retvospective cohort usirg secondary data epithelial ovarian cancer patients at Dharmais Cancer Hospital. The study uses observations of 48 patients from the time of their diagnotion until they are cured, their death or they lost to follow up. The data were analyzed using survival analysis. The resu!ts shows that overall probability five-year survival in patients with epithelial ovarian cancer at the Dharmais Cancer Hospital Jakarta in 1996-2004 is 26.2%. the probability of patients surviving five years on the serum albumin with > 3.6 mg / dl was 36.1% whichis higher than those of patients with serum albumin <3.6 mg / di at 15.7%. After controled by stage of the cancer, the ascites and hemoglobin levels of the patients with an albumin level of < 3.6 mg / dl had a risk of death 7.979 times higher than with an a!tumin fevel > 3.6 mg / dl. "

"Kanker Ovarium merupakan salah satu dari tiga keganasan kanker ginckologi yang paling sering ditemukan pada alat genitalia wanita selain kanker serviks dan kanker uterus. lnsidens rata-rata kanker ovarium diperkirakan 15 kasus baru per 100 ribu populasi wanita daiam setahunnya. Di AS kanker ovarium merupakan penyebab kematian kanker urutan kelima pada wanita setelah kanker paru, kanker payudara, kanker kolorektal dan kankcr pankreas, Sedangkan di Indonesia merupakan penyebab kematian kedua karena keganasan akibat kanker ginekologik pada wanita setelah kanker serviks. 70% dari penderita kanker ovarium diperkirakan akan meninggal dengan angka ketahanan hidup 3 tahun sebesar 54% dan 5 tahun sebesar 44%. Penilaian angka ketahanan hidup umumnya digunakan untuk mengevaluasi pengaruh faktor prognosis terhadap ketahanan hidup penderita. Analisis yang dapat digunakan untuk menghitung angka ketahanan hidup adalah dengan metode Life table dan Kaplan Meier, untuk menilai pengaruh faktor prognosis terhadap risiko kematian penderita kankcr ovarium epitelial digunakan dengan metode regresi Cox. Tujuan penelitian ini adalah untuk mengetahui pengaruh stadium kanker terhadap angka ketahanan hidup 3 tahun dan 5 tahun penderita kanker ovarium epitelial, dan penilaian pada variabel lain yaitu jenis histologi, derajat ditérensiasi sel, residual tumor, umur saat didiagnosa, asites, status perkawinan, keadaan umum setelah operasi, tingkat pendidikan, status pekerjaan, dan status pengobatan yang mempengaruhi hubungan antara stadium kanker dengan ketahanan hidup. Penelitian mempakan studi kohort retrospektif dengan menggunakan data sekunder dari rekam medik penderita kunker ovarium epitelial. Terdapat dua analisis ketahanan hidup yaitu ketahanan hidup 5 tahun untuk penderita yang didiagnosa dan menyelesaikan pengobatan pada 1993 sampai mei 2003 sebanyak 84 pendcrita dan 3 tahun untuk penderita yang didiagnosa dan menyelesaikan pengobatan pada i993 sampai mei 2005 sebanyak II6 penderita. Pengumpulan data melalui observasi rekam medik dan penelusuran melalui telepon. Hasil penelitian memperlihatkan secara keseluruhan angka ketahanan hidup 5 tahun sebesar 39% dan ketahanan hidup 3 tahun adalah 51%. Ada perbedaan yang bermakna secara statistik pada ketahanan hidup 3 tahun dan 5 tahun penderita dengan stadium awal (I-II) dengan stadium lanjut (III-IV) dcngan p=0,0007 dan p=0,0001. Angka ketahanan hidup 3 tahun pada stadium awal sebesar 83% dan stadium Ianjut sebesar 37%. Angka kctahanan hidup 5 tahun pada stadium awal sebesar 74% dan stadium Ianjut sebcsar 15%. Ada perbedaan bennakna pada probabilitas kctahanan hidup 3 tahun dan 5 tahun penderita kanker ovarium epiteiial dengan residual tumor < 2 cm dengan 2 2 cm dengan p=0,0003 dan p=0,0437. Risiko kematian 3 tahun penderita kankcr ovarium epitclia! dengan stadium lanjut 5 kali (95% Cl 1,76-14,22) dibandingkan stadium awal sebelum memperhitungkan variabel kovariat. Sctclah memperhitungkan variahcl derajat diferensiasi sel, residual tumor, umur saat didiagnosa, asites, dan status pengobatan risiko kernatian stadium lanjut scbcsar 5,09 kali (l,6\-|6,I0) dibanding stadium awal. Pada saat setelah mempcrhitungkan variabel jenis histologi dan status pengobatan risiko kematian nya adalah 4,47 kali (95% CI 1,50-13,37) dibanding stadium awal. Risiko kematian 5 tahun penderita kanker ovarium epitelial dcngan stadium Ianjut 5,84 kali (95% Cl 2,l8~i5,59) dibandingkan stadium awal sebelum memperhitungkan variabel kovariat. Setelah mempcrhitungkan variabel derajat diferensiasi sel, residual tumor, umur saat didiagnosa, asites, dan status penobatan risiko kematian stadium lanjut sebesar 4,02 kali (95% Cl 1,24-l2,99) dibanding stadium awal. Pada saat setelah memperhitungkan variabel jenis histologi dan status pengobatan risiko kematian nya adalah 4,68 kali (95% CI 1,53-l4,28) dibanding stadium awal.

---

Ovaries cancer is one of three kind of gynecologncal cancers that mostly found on women genitalia, beside cervical and uterus cancers. the average incidence of the ovaries cancer is estimated around 15 new cases of l00 thousand women per year. ln the US, the ovaries cancer is the tifth of cause death by cancer on women. after lung, breast, colorectal and pancreatic cancers. Meanwhile, in lndonesia, ovaries cancer is causing death number two for gynecological cancer in women, after cervical cancer. Seventy percents of patients with ovaries cancer is estimated will bc death with the survival rate for 3 years is 54% and tbr 5 years is 44% respectively.

The assessment on survival rate is usually use for evaluating the effect of prognosis factors on the patients survivorship. Analysis that can he use for calculating the survival rate is Life Table and Kaplan Meier methods, and to assess the eflect of prognosis factors to death risk of patients with epithelial ovaries cancer is using the Cox Regression.

The aim ofthe study is to tind out the effect of cancer stadium on the survival rate at 3 and 5 years of patients with epithelial ovaries cancer, and assessments toward variables that influenced the correlation between cancer stadium and survival, namely: histology types, degree of cells differentiation, tumor residual, age of diagnosed, peritoneal fluid accumulation (ascites), marital status, post-surgery general condition, education, occupation, and medication received.

The study applies a retrospective cohort design, using a secondary data on medical records of patients with epithelial ovaries cancer. There two analyses of survival, the 5 years on survival ol' patients diagnosed and finished the medication from |993 until May 2003, account for 84 patients, and the 3 years on survival of patient diagnosed and complete medication from 1993 to May 2005, comprise 116 patients. Data are collected through the observation on medical records and searched by phone.

The study revealed that in overall, the suwi val rate of 3 years and 5 years are 5 l% and 39%. It is also found a statistically significant on 3 years and 5 years of survival of patients at beginning stadium (l-ll) and advance stadium (lil-IV) with P-value on 0.0007 and 0.000l. While the survival rate of 3 years at beginning stadium is 83% and at advance stadium is 37%, the survival rate of 5 years at beginning stadium is 74% and at advance stadium is 15%. A significant probability on survival of 3 and 5 years is found between tumor residual less than 2 cm and 3 2 cm, with P-value 0.0003 and O.437. Three years death risk of patients with epithelial ovaries cancer at advance stadium is 5 times (95% Cl; 1.76-14.22) compare to those at beginning stadium, before adjusted by its covariate variables. Alter adjusted with variables of cells differentiation, tumor residual, age of diagnosed, ascites, and medication status, then the death risk at advance stadium is 5.09 times (95% Cl: l.6l-l6.l0) compare to beginning stadium.

When adjusted with variables of histology types and medication status, thc death risk at advance stadium is lower to 4.47 times (95% Cl: 1.50-l3.37) compare to beginning stadium. Of 5 years death risk for patients with epithelial ovaries cancer at advance stadium is 5.84 times (95% Cl: 2.l8-l5.59) compare to beginning stadium, before adjusted with its covariate variables. After adjusted with variables of cells diliercntiation, tumor residual, age of diagnosed, ascites, and medication status, then the death risk at advance stadium is lower to 4.02 times (95% CI: 1.24-l2_99) compare to beginning stadium, but the death risk is increase again when adjusted with variables of histology types and medication status, to 4.68 times (95% Cl: 1.53-l4.28) compare to beginning stadium."