FAKTOR - FAKTOR YANG MEMENGARUHI DISEASE FREE SURVIVAL 5 TAHUN PASIEN KANKER PAYUDARA DI RSUD RADEN MATTAHER JAMBI
DOI:
https://doi.org/10.31004/jkt.v6i2.38345Keywords:
disease free survival, DFS, kanker payudara, kohort retrospektifAbstract
Kanker payudara merupakan jenis kanker paling umum di dunia dan penyebab utama kematian global, dengan dua dari tiga pasien yang mengalami kekambuhan tidak bertahan hingga lima tahun. Penelitian ini bertujuan untuk menganalisis Disease Free Survival 5 tahun pada pasien kanker payudara berdasarkan aspek penderita dan klinis di RSUD Raden Mattaher Jambi. Penelitian ini menggunakan analisis data sekunder dari rekam medis pasien kanker payudara yang didiagnosis tahun 2017–2019 di RSUD Raden Mattaher Jambi, dengan desain kohort retrospektif. Sampel berjumlah 96 pasien dari populasi kohort dinamis (cohort dynamic). Analisis dilakukan dengan metode Kaplan-Meier dan uji log-rank menggunakan STATA 14, dengan nilai p < 0,05 dianggap signifikan. Probabilitas kesintasan bebas kekambuhan selama 5 tahun pada pasien kanker payudara di RSUD Raden Mattaher Jambi adalah 61,85%. Probabilitas kesintasan bebas kekambuhan lebih rendah pada pasien berusia < 40 tahun (41,30%), IMT ≥23 kg/m² (45,92%), stadium III (5,03%), grade buruk (30,25%), status nodal positif (23,86%), ukuran tumor >50 mm (10,70%), subtipe non-luminal (28,56%), invasi limfovaskular (27,08%), serta yang hanya menjalani pembedahan atau kemoterapi (33,33%). Terdapat perbedaan signifikan dalam rata-rata waktu kesintasan bebas kekambuhan berdasarkan usia, IMT, stadium, grade, status nodal, ukuran tumor, subtipe molekuler, invasi limfovaskular, dan jenis terapi (p<0,05). Meskipun telah menjalani pengobatan utama, pasien tetap berisiko mengalami kekambuhan. Oleh karena itu, diagnosis dini, kontrol rutin dan edukasi terkait gejala kekambuhan sangat diperlukan, serta rumah sakit perlu memastikan pemantauan dan perawatan yang tepat.References
American Cancer Society. (2022). Breast Cancer Facts & Figures 2022-2024. American Cancer Society.
Anders, C. K., Hsu, D. S., Broad Water, G., Acharya, C. R., & Foekens, J. A. (2008). Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol, 26(20). https://pubmed.ncbi.nlm.nih.gov/18612148/
Ashariati, A. (2019). Manajemen Kanker Payudara Komprehensif.
Ayuza, M., Harahap, W. A., Rustam, R., & Nindrea, R. D. (2020). Faktor yang Berpengaruh Terhadap Disease Free Survival dan Overall Survival pada Pasien Kanker Payudara Usia Muda di Kota Padang Tahun 2008 - 2018. Jurnal Kesehatan Andalas, 9.
Bauer, K. R., Brown, M., Cress, R. D., Parise, C. A., & Caggiano, V. (2007). Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: A population-based study from the California Cancer Registry. Cancer, 109(9), 1721–1728. https://doi.org/10.1002/cncr.22618
Bhardwaj, P., & Brown, K. A. (2021). Obese Adipose Tissue as a Driver of Breast Cancer Growth and Development: Update and Emerging Evidence. In Frontiers in Oncology (Vol. 11). Frontiers Media S.A. https://doi.org/10.3389/fonc.2021.638918
Botteri, E., Bagnardi, V., Rotmensz, N., Gentilini, O., Disalvatore, D., Bazolli, B., Luini, A., & Veronesi, U. (2009). Analysis of local regional recurrences in breast cancer after conservative surgery. Annals of Oncology, 21(4), 723–728. https://doi.org/10.1093/annonc/mdp386
Canadian Cancer Society. (n.d.). Grading Breast Cancer. Retrieved December 15, 2024, from https://cancer.ca/en/cancer-information/cancer-types/breast/grading
Chandradewi, M. R., Manuaba, I. B. T. W., & Adiputra, P. A. T. (2022). Faktor Yang Mempengaruhi Rekurensi Pada Pasien Kanker Payudara Pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah. Intisari Sains Medis, 13(3), 690–693. https://doi.org/10.15562/ism.v13i3.1544
Chung, M., Chang, H. R., Bland, K. I., & Wanebo, H. J. (1996). Younger women with breast carcinoma have a poorer prognosis than older women. Cancer, 77(1), 97–103. https://doi.org/10.1002/(SICI)1097-0142(19960101)77:1<97::AID-CNCR16>3.0.CO;2-3
Colleoni, M., Sun, Z., Price, K. N., Karlsson, P., Forbes, J. F., Thürlimann, B., Gianni, L., Castiglione, M., Gelber, R. D., Coates, A. S., & Goldhirsch, A. (2016). Annual hazard rates of recurrence for breast cancer during 24 years of follow-up: Results from the international breast cancer study group trials I to V. Journal of Clinical Oncology, 34(9), 927–935. https://doi.org/10.1200/JCO.2015.62.3504
Courtney, D., Davey, M. G., Moloney, B. M., Barry, M. K., Sweeney, K., McLaughlin, R. P., Malone, C. M., Lowery, A. J., & Kerin, M. J. (2022). Breast cancer recurrence: factors impacting occurrence and survival. Irish Journal of Medical Science, 191(6), 2501–2510. https://doi.org/10.1007/s11845-022-02926-x
Dahlan, M. S. (2014). Analisis Survival : Dasar-Dasar Teori dan Aplikasi Program Stata (2nd ed.). Sagung Seto.
Devita, V. T., Hellman, S., Rosenberg, S. A., Lippincott, W., & Publishers, W. (2001). Principles and Practice of Oncology (11th ed.). Lippincot-Raven.
Eveline, K., Purwanto, H., & Lestari, P. (2017). Faktor Klinis dan Histopatologi serta Hubungannya dengan Kekambuhan Pasca-operasi pada Pasien Kanker Payudara di RSUD Dr. Soetomo. Indonesian Journal of Cancer, 11(2).
Gnerlich, J. L., Deshpande, A. D., Jeffe, D. B., Sweet, A., White, N., & Margenthaler, J. A. (2009). Elevated Breast Cancer Mortality in Women Younger than Age 40 Years Compared with Older Women Is Attributed to Poorer Survival in Early-Stage Disease. Journal of the American College of Surgeons, 208(3), 341–347. https://doi.org/10.1016/j.jamcollsurg.2008.12.001
Gusmana, A. I. (2024). Analisis Survival Pasien Kanker Payudara pada Wanita di RSUD Raden Mattaher Jambi Tahun 2017-2019.
Ithimakin, S., Luengwatthanakit, N., & Wongkraisri, C. (2023). Follow-Up Strategies and Detection of Recurrent Breast Cancer in the Modern Era. Asian Pacific Journal of Cancer Prevention, 24(4), 1359–1366. https://doi.org/10.31557/APJCP.2023.24.4.1359
Keegan, T. H. M., DeRouen, M. C., Press, D. J., Kurian, A. W., & Clarke, C. A. (2012). Occurrence of breast cancer subtypes in adolescent and young adult women. Breast Cancer Research, 14(2). https://doi.org/10.1186/bcr3156
Kim, S. W., Chun, M., Han, S., Jung, Y. S., Choi, J. H., Kang, S. Y., Yim, H., & Kang, S. H. (2017). Young age is associated with increased locoregional recurrence in node-positive breast cancer with luminal subtypes. Cancer Research and Treatment, 49(2), 484–493. https://doi.org/10.4143/crt.2016.246
Koca, B., Yildirim, M., & Kuru, B. (2022). Prognostic Factors Affecting Disease-Free Survival in Triple-Negative Breast Cancer and Impact of Ki-67. Indian Journal of Surgery, 84, 708–713. https://doi.org/10.1007/s12262-021-03066-9
L, W., & MD, D. (1997). Tumor-related prognostic factors for breast cancer. CA: A Cancer Journal for Clinicians, 47(1), 28–51.
Lafourcade, A., His, M., Baglietto, L., Boutron-Ruault, M. C., Dossus, L., & Rondeau, V. (2018). Factors associated with breast cancer recurrences or mortality and dynamic prediction of death using history of cancer recurrences: The French E3N cohort. BMC Cancer, 18(1). https://doi.org/10.1186/s12885-018-4076-4
Lee, S. J., Go, J., Ahn, B. S., Ahn, J. H., Kim, J. Y., Park, H. S., Kim, S. Il, Park, B. W., & Park, S. (2023). Lymphovascular invasion is an independent prognostic factor in breast cancer irrespective of axillary node metastasis and molecular subtypes. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1269971
Lin, H. U. I., Zhang, F. A. N., Wang, L., & Zeng, D. E. (2019). Use of clinical nomograms for predicting survival outcomes in young women with breast cancer. Oncology Letters, 17(2), 1505–1516. https://doi.org/10.3892/ol.2018.9772
National Cancer Institute. (n.d.). Disease Free Survival. NCI Dictionary of Cancer Terms. Retrieved July 14, 2024, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/disease-free-survival
Pagani, O., Price, K. N., Gelber, R. D., Castiglione-Gertsch, M., Holmberg, S. B., Lindtner, J., Thürlimann, B., Collins, J., Fey, M. F., Coates, A. S., & Goldhirsch, A. (2009). Patterns of recurrence of early breast cancer according to estrogen receptor status: A therapeutic target for a quarter of a century. Breast Cancer Research and Treatment, 117(2), 319–324. https://doi.org/10.1007/s10549-008-0282-0
Pan, L., Han, Y., Sun, X., Liu, J., & Gang, H. (2010). FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: A meta-analysis. Journal of Cancer Research and Clinical Oncology, 136(7), 1007–1022. https://doi.org/10.1007/s00432-009-0746-6
Purwanto, H., Handojo, D., Haryono, S., & Harahap, W. (2015). Panduan Penatalaksanaan Kanker Payudara.
Ramli, M. (2015). Update Breast Cancer Management Diagnostic and Treatment. Majalah Kedokteran Andalas, 38(1). http://jurnalmka.fk.unand.ac.id
Safarudin, Prihartono, A, N., & Gautama, W. (2016). Pengaruh Indeks Massa Tubuh terhadap Disease-Free Survival Lima Tahun Pasien Kanker Payudara di Rumah Sakit Kanker “Dharmais” Jakarta. ARTIKEL PENELITIAN Indonesian Journal of Cancer, 10(1).
Saphner, T., Tormey, D. C., & Gray, R. (1996). Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol, 14(10). https://pubmed.ncbi.nlm.nih.gov/8874335/
Sestak, I., Dowsett, M., Zabaglo, L., Lopez-Knowles, E., Ferree, S., Cowens, J. W., & Cuzick, J. (2013). Factors predicting late recurrence for estrogen receptor-positive breast cancer. Journal of the National Cancer Institute, 105(19), 1504–1511. https://doi.org/10.1093/jnci/djt244
Singh, A. S., Bhardwaj, B. S., & Goswani, B. C. (2022). Disease Free Survival in Locally Advanced Breast Cancer: An Analysis of Clinical and Pathological Factors. Asian Pacific Journal of Cancer Care, 7(1).
Sleightholm, R., Neilsen, B. K., Elkhatib, S., Flores, L., Dukkipati, S., Zhao, R., Choudhury, S., Gardner, B., Carmichael, J., Smith, L., Bennion, N., Wahl, A., & Baine, M. (2021). Percentage of Hormone Receptor Positivity in Breast Cancer Provides Prognostic Value: A Single-Institute Study. Journal of Clinical Medicine Research, 13(1), 9–19. https://doi.org/10.14740/jocmr4398
Soerjomataram, I., Louwman, M. W. J., Ribot, J. G., Roukema, J. A., & Coebergh, J. W. W. (2008). An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Research and Treatment, 107(3), 309–330. https://doi.org/10.1007/s10549-007-9556-1
Tanggo, V. V. C. (2016). Gradasi Hispatologi Sebagai Prediktor Kejadian Kekambuhan pada Kanker Payudara.
Tonyali, O., Coskun, U., Sener, N., Inanc, M., Akman, T., Ulas, A., Yazilitas, D., Bal, O., Kucukoner, M., Yildirim Ozdemir, N., Demirci, U., Gunaydin, Y., Yildiz, R., Karaca, H., Unal, O. U., Gumus, M., Benekli, M., & Buyukberber, S. (2014). Prognostic factors for recurrence-free survival in patients with HER2-positive early-stage breast cancer treated with adjuvant trastuzumab. Onkologie(Czech Republic), 36(10), 554–558. https://doi.org/10.1159/000355156
Trisal, V. (2023). What is cancer recurrence? City of Hope.
Ture, M., Tokatli, F., & Kurt, I. (2009). Using Kaplan-Meier analysis together with decision tree methods (C&RT, CHAID, QUEST, C4.5 and ID3) in determining recurrence-free survival of breast cancer patients. Expert Systems with Applications, 36(2 PART 1), 2017–2026. https://doi.org/10.1016/j.eswa.2007.12.002
Turkoz, F. P., Solak, M., Petekkaya, I., Keskin, O., Kertmen, N., Sarici, F., Arik, Z., Babacan, T., Ozisik, Y., Altundag, K., & Altundag, K. (2013). The prognostic impact of obesity on molecular subtypes of breast cancer in premenopausal women. JBUON, 18(2), 335–341.
Vandenbroucke, J. P., & Pearce, N. (2012). Incidence rates in dynamic populations. International Journal of Epidemiology, 41(5), 1472–1479. https://doi.org/10.1093/ije/dys142
Wangchinda, P., & Ithimakin, S. (2016). Factors that predict recurrence later than 5 years after initial treatment in operable breast cancer. World Journal of Surgical Oncology, 14(1). https://doi.org/10.1186/s12957-016-0988-0
WHO. (2024, March 13). Breast Cancer. World Health Organization.
Yap, R. V., Marquez, D. Lou, & De La Serna, F. M. (2023). Young Filipino breast cancer patients have worse survival outcomes. Ecancermedicalscience, 17. https://doi.org/10.3332/ecancer.2023.1639
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