[ABSTRAK
Pendahuluan: Timoma merupakan tumor mediastinum dengan kelompok lesi neoplastik yang heterogen sehingga penatalaksanaan dan prognosisnya berbedabeda. Penelitian ini ingin melihat angka tahan hidup timoma dan faktor-faktor yang mempengaruhinya. Metode penelitian. Penelitian ini menggunakan metode kohort retrospektifterhadap timoma di RSUP Persahabatan antara Januari 1997 sampai Desember 2012. Data diambil dari rekam medis. Analisis kesintasan menggunakan Kaplan- Meier sedangkan perbandingan survival menggunakan uji Log-Rank dan analisis multivariat dengan analis Regresi Cox. Hasil penelitian: Sebanyak 43 subjek penelitian dianalisis dan didapatkan 1-year survival rate sebesar 72,1%, 3-year survival rate 58,1% dan overall survival rate 55,8%. Histopatologi timoma menurut pembagian WHO masing-masing mempunyai 5-year survival rate sebesar 73,7% pada tipe A, 55,6% pada tipe AB, 100% pada tipe B1, 25% pada tipe B2 sedangkan tipe C semuanya meninggal pada bulan ke-23. Dengan uji perbandingan Log-Rank didapatkan perbedaanbermakna secara statistik antara tipe A-B2 (p 0,009), tipe A-C (p 0,001), tipe ABC (p 0,032) dan tipe B1-C (p 0,018). Stage timoma menurut pembagian Masaokamasing-masing mempunyai 5-year survival rate sebesar 100% pada stage I, 90% pada stage II,57,1% pada stage III, 26,7% pada stage IV A dan 20% pada stageIV B. Didapatkan perbedaan bermakna antara stage I-IV A (p 0,012), I-IV B (p 0,007), II-IV A (p 0,002) dan II-IV B (p 0,002). Tindakan pembedahan extendedthymo thymectomy (ETT) mempunyai 5-year survival rate sebesar 83,3%, debulking sebesar 27,3% dan tanpa pembedahan sebesar 42,9%. Didapatkan perbedaan bermakna antara ETT-debulkling (p 0,001) dan antara ETT-tidakdibedah (p 0,01). Tidak terdapat perbedaan angka tahan hidup timoma yang bermakna berdasarkan umur, jenis kelamin maupun ada tidaknya miastenia gravis. Analisis multivariat memperlihatkan faktor yang paling berpengaruh terhadap angka tahan hidup timoma adalah stage menurut Masaoka. Kesimpulan: Jenis histopatologi menurut WHO, stage menurut Masaoka dan tindakan pembedahan merupakan faktor yang mempengaruhi angka tahan hidup timoma. Faktor yang paling berpengaruh adalah stage menurut Masaoka.
ABSTRACT
Introduction: Thymoma is a mediastinal tumor with a heterogeneous group of neoplastic lesions, in such that it applied varies management and prognosis. Thisstudy wanted to see thymoma survival rate and the factors that influence it. Methods: This study used a retrospective cohort method to thymoma at Persahabatan Hospital between January 1997 and December 2012. Dataretrieved from medical records. Survival analysis using the Kaplan-Meier while survival comparisons using the Log-Rank test and multivariate analysis using theCox Regression analysis. Results: A total of 43 subjects were analyzed and found 1-year survival rate of72.1%, 3-year survival rate of 58.1% and overall survival rate of 55.8%. Histopathology division of thymoma according to the WHO each have 5-yearsurvival rate of 73.7% in type A, 55.6% in type AB, 100 % in type B1, 25% in type B2 while type C all died in month-23. Using the Log-Rank test comparisons foundstatistically significant differences between type A-B2 (p 0.009), type A-C (p 0.001), type AB-C (p 0.032) and type B1-C (p 0.018). Thymoma stage division according to Masaoka each has a 5-year survival rate of 100 % in stage I, 90% instage II, 57.1% in stage III, 26.7% in stage IV A and 20% in stage IV B. Obtained significant differences between stage I - IV A (p 0.012), the I - IV B (p 0.007), IIIV A (p 0.002) and II-IV B (p 0.002). Surgery extended thymo thymectomy (ETT) has a 5-year survival rate of 83.3%, 27.3% and debulking without surgery by 42.9%. Obtained significant differences between the ETT-debulkling (p 0.001) and between ETT-no surgery (p 0.01). There was no significant difference in survival rate of thymoma based on age, gender and the presence of myastheniagravis. Multivariate analysis showed that the most influential factors on the survival rate thymoma are stage divisions according to Masaoka. Conclusions: Histopathological type according to the WHO, stage divisions according to Masaoka and surgery are affecting factors of thymoma survival rate. The most dominant factor is the stage divisions according to Masaoka.;Introduction: Thymoma is a mediastinal tumor with a heterogeneous group of neoplastic lesions, in such that it applied varies management and prognosis. Thisstudy wanted to see thymoma survival rate and the factors that influence it. Methods: This study used a retrospective cohort method to thymoma at Persahabatan Hospital between January 1997 and December 2012. Dataretrieved from medical records. Survival analysis using the Kaplan-Meier while survival comparisons using the Log-Rank test and multivariate analysis using theCox Regression analysis. Results: A total of 43 subjects were analyzed and found 1-year survival rate of72.1%, 3-year survival rate of 58.1% and overall survival rate of 55.8%. Histopathology division of thymoma according to the WHO each have 5-yearsurvival rate of 73.7% in type A, 55.6% in type AB, 100 % in type B1, 25% in type B2 while type C all died in month-23. Using the Log-Rank test comparisons foundstatistically significant differences between type A-B2 (p 0.009), type A-C (p 0.001), type AB-C (p 0.032) and type B1-C (p 0.018). Thymoma stage division according to Masaoka each has a 5-year survival rate of 100 % in stage I, 90% instage II, 57.1% in stage III, 26.7% in stage IV A and 20% in stage IV B. Obtained significant differences between stage I - IV A (p 0.012), the I - IV B (p 0.007), IIIV A (p 0.002) and II-IV B (p 0.002). Surgery extended thymo thymectomy (ETT) has a 5-year survival rate of 83.3%, 27.3% and debulking without surgery by 42.9%. Obtained significant differences between the ETT-debulkling (p 0.001) and between ETT-no surgery (p 0.01). There was no significant difference in survival rate of thymoma based on age, gender and the presence of myastheniagravis. Multivariate analysis showed that the most influential factors on the survival rate thymoma are stage divisions according to Masaoka. Conclusions: Histopathological type according to the WHO, stage divisions according to Masaoka and surgery are affecting factors of thymoma survival rate. The most dominant factor is the stage divisions according to Masaoka.;Introduction: Thymoma is a mediastinal tumor with a heterogeneous group of neoplastic lesions, in such that it applied varies management and prognosis. Thisstudy wanted to see thymoma survival rate and the factors that influence it. Methods: This study used a retrospective cohort method to thymoma at Persahabatan Hospital between January 1997 and December 2012. Dataretrieved from medical records. Survival analysis using the Kaplan-Meier while survival comparisons using the Log-Rank test and multivariate analysis using theCox Regression analysis. Results: A total of 43 subjects were analyzed and found 1-year survival rate of72.1%, 3-year survival rate of 58.1% and overall survival rate of 55.8%. Histopathology division of thymoma according to the WHO each have 5-yearsurvival rate of 73.7% in type A, 55.6% in type AB, 100 % in type B1, 25% in type B2 while type C all died in month-23. Using the Log-Rank test comparisons foundstatistically significant differences between type A-B2 (p 0.009), type A-C (p 0.001), type AB-C (p 0.032) and type B1-C (p 0.018). Thymoma stage division according to Masaoka each has a 5-year survival rate of 100 % in stage I, 90% instage II, 57.1% in stage III, 26.7% in stage IV A and 20% in stage IV B. Obtained significant differences between stage I - IV A (p 0.012), the I - IV B (p 0.007), IIIV A (p 0.002) and II-IV B (p 0.002). Surgery extended thymo thymectomy (ETT) has a 5-year survival rate of 83.3%, 27.3% and debulking without surgery by 42.9%. Obtained significant differences between the ETT-debulkling (p 0.001) and between ETT-no surgery (p 0.01). There was no significant difference in survival rate of thymoma based on age, gender and the presence of myastheniagravis. Multivariate analysis showed that the most influential factors on the survival rate thymoma are stage divisions according to Masaoka. Conclusions: Histopathological type according to the WHO, stage divisions according to Masaoka and surgery are affecting factors of thymoma survival rate. The most dominant factor is the stage divisions according to Masaoka., Introduction: Thymoma is a mediastinal tumor with a heterogeneous group of neoplastic lesions, in such that it applied varies management and prognosis. Thisstudy wanted to see thymoma survival rate and the factors that influence it. Methods: This study used a retrospective cohort method to thymoma at Persahabatan Hospital between January 1997 and December 2012. Dataretrieved from medical records. Survival analysis using the Kaplan-Meier while survival comparisons using the Log-Rank test and multivariate analysis using theCox Regression analysis. Results: A total of 43 subjects were analyzed and found 1-year survival rate of72.1%, 3-year survival rate of 58.1% and overall survival rate of 55.8%. Histopathology division of thymoma according to the WHO each have 5-yearsurvival rate of 73.7% in type A, 55.6% in type AB, 100 % in type B1, 25% in type B2 while type C all died in month-23. Using the Log-Rank test comparisons foundstatistically significant differences between type A-B2 (p 0.009), type A-C (p 0.001), type AB-C (p 0.032) and type B1-C (p 0.018). Thymoma stage division according to Masaoka each has a 5-year survival rate of 100 % in stage I, 90% instage II, 57.1% in stage III, 26.7% in stage IV A and 20% in stage IV B. Obtained significant differences between stage I - IV A (p 0.012), the I - IV B (p 0.007), IIIV A (p 0.002) and II-IV B (p 0.002). Surgery extended thymo thymectomy (ETT) has a 5-year survival rate of 83.3%, 27.3% and debulking without surgery by 42.9%. Obtained significant differences between the ETT-debulkling (p 0.001) and between ETT-no surgery (p 0.01). There was no significant difference in survival rate of thymoma based on age, gender and the presence of myastheniagravis. Multivariate analysis showed that the most influential factors on the survival rate thymoma are stage divisions according to Masaoka. Conclusions: Histopathological type according to the WHO, stage divisions according to Masaoka and surgery are affecting factors of thymoma survival rate. The most dominant factor is the stage divisions according to Masaoka.] |
T-Husnun Nisa Ratna Ningrum.pdf :: Unduh