Analisis Ketahanan Hidup Tumor Testis Sel Germinal di RS Sardjito Periode 2007-2013

Abstract

Objective: To know survival of germ cell testicle tumor at Sardjito hospital who had chemotherapy or radiotherapy and its factor which influenced their survivalMethod: From year 2007 until 2013, we collected patients with germ cell testicle tumor at Sardjito hospital who had chemotherapy or radiotherapy. The clinical factor that studied were age, histopathology findings, the TNMS staging, clinical staging, therapy and survival status. We evaluate their survival up to five years after therapy. Correlation between survival status with age, histopathology findings, the TNMS staging, clinical staging,therapy and prognosis were analyzed using Fisher Exact Test. The Kaplan Meier survival analysis was used to calculate survival of germ cell testicle tumor. Result: There are 23 patient of germ cell testicle tumor whom 21 patients had chemotherapy and 2 patients had radiotherapy. There are no correlation between survival status with age, histopathology findings, the TNMS staging, clinical staging, therapy and prognosis (p>0.05). Based on Kaplan Meier survival analysis, their survival were better on age < 30 years old (p=0.534), seminoma type (p=0.860), had chemotherapy (p=0.599), T3 (p=0.031), Nx (p=0.394), Mx (p=0.781), 51 staging (p=0.623) dan 3rdstadium (p=0.732). Based on risk classification, survival of seminoma with intermediate prognosis were better than seminoma with good prognosis (p=0.631) whereas survival of non seminoma with good prognosis were higher than non seminoma with intermediate or poor prognosis (p=0.014). Conclusion: Germ cell testicle tumor at Sardjito hospital had dominant of seminoma type and had already developed into advanced staged with chemoterapy as therapy. Survival of germ cell testicle tumor were lower than other country. T3 staging and non seminoma with good prognosis could be prognostic factor of germ cell testicle tumor at Sardjito hospital.ABSTRAKObjektif: Untuk mengetahui gambaran ketahanan hidup pasien tumor testis jenis sel germinal di RS Sardjito yang dilakukan kemoterapi maupun radioterapi serta faktor-faktor yang mempengaruhi ketahanan hidup tumor testis jenis sel germinal Bahan dan cara: Dari tahun 2007-2013, dilakukan pendataan pasien dengan tumor testis jenis sel germinal di RS Sardjito baik yang dilakukan kemoterapi maupun radioterapi. Data yang dipelajari adalah usia, jenis histopatologi, stadium T, N, M, S, stadium klinis dan status ketahanan hidup. Dilakukan evaluasi ketahanan hidup hingga 5 tahun post terapi. Dilakukan analisa bivariat menggunakan tes Fisher untuk menilai hubungan antara ketahanan hidup dengan faktor-faktor seperti usia, jenis histopatologi, stadium T, N, M, S, stadium klinis, jenis terapi dan prognosis. Digunakan kurva Kaplan Meier untuk menilai gambaran ketahanan hidup pasien tumor testis sel germinal. Hasil: Ada 23 pasien tumor testis jenis sel germinal di RS Sardjito periode 2007-2013 dimana 21 pasien mendapatkan kemoterapi dan 2 pasien mendapatkan radioterapi. Tidak dijumpai hubungan bermakna antara ketahanan hidup pasien tumor buli jenis sel germinal dengan usia, jenis histopatologi, stadium T, N, M, S, stadium klinis dan prognosis(p>0.05). Berdasarkan kurva Kaplan Meier diketahui ketahanan hidup tumor testis sel germinal lebih baik pada usia < 30 tahun (p=0.534), jenis non seminoma (p=0.860), stadium T3 (p=0.031), Nx (p=0.394), Mx (p=0.781), S1 (p=0.623) dan stadium 3 (p=0.732). Berdasarkan klasifikasi resiko, ketahanan hidup tumor testis jenis seminoma dengan prognosis sedang lebih baik dibandingkan tumor testis jenis seminoma dengan prognosis baik (p=0.631) sedangkan ketahanan hidup jenis non seminoma dengan prognosis baik lebih tinggi dibandingkan tumor testis jenis non seminoma dengan prognosis sedang dan buruk (p=0.014). Kesimpulan: Tumor testis sel germinal di RS Sardjito mayoritas jenis seminoma dan sudah dalam stadium lanjut dengan kemoterapi sebagai sarana terapi. Angka ketahanan hidup tumor testis jenis sel germinallebih rendah dibandingkan negara lain. Stadium T3 dan grup non seminoma prognosis baik dapat dijadikan faktor prognostik ketahanan hidup tumor testis sel germinal di RS Sardjito.