Perbandingan antara klasifikasi Jepang dan sistem TNM dalam menentukan stadium keganasan sigmoid dan rektum di RSCM-RSF (laporan pendahuluan) = Comparison of Japanese classification with the tnm system in determining stage classification of sigmoid and rectal cancer patients at Cipto Mangunkusumo Hospital Fatmawati Hospital (preliminary study)
Yusak Kristianto;
Agi Satria Putranto, examiner; Wangge, Grace, supervisor
(Fakultas Kedokteran Universitas Indonesia, 2015)
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[ABSTRAK Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification] |
 SP-Yusak Kristianto.pdf :: Unduh
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| No. Panggil : | SP-PDF |
| Entri utama-Nama orang : | |
| Entri tambahan-Nama orang : | |
| Entri tambahan-Nama badan : | |
| Subjek : | |
| Penerbitan : | [Place of publication not identified]: Fakultas Kedokteran Universitas Indonesia, 2015 |
| Program Studi : |
| Bahasa : | ind |
| Sumber Pengatalogan : | LibUI ind rda |
| Tipe Konten : | text |
| Tipe Media : | computer |
| Tipe Carrier : | online resource |
| Deskripsi Fisik : | xi, 37 pages : illustration + appendix |
| Naskah Ringkas : | |
| Lembaga Pemilik : | Universitas Indonesia |
| Lokasi : | Perpustakaan UI, Lantai 3 |
| No. Panggil | No. Barkod | Ketersediaan |
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| SP-PDF | 16-17-593477321 | TERSEDIA |
| Ulasan: |
| Tidak ada ulasan pada koleksi ini: 20417251 |
