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Karakteristik klinikopatologi dan analisis kesintasan 1 tahun tumor mediastinum = Clynicopathology characteristic and 1 year survival of mediastinal tumor

Latar Belakang. Tumor mediastinum merupakan lesi yang sering dijumpai dan terakadang membawa permasalahan diagnostik dan terapi yang kompleks. Tumor dapat berasal dari organ mediastinum atau jaringan sekitarnya, tetapi paling sering muncul dari timus, limfatik, neurogenik, germinal atau jaringan mesenchymal. Tujuan. Menganalisa karakteristik klinikopatologi, gambaran klinis, jenis tindakan operasi dan hasil histopatologi, dan mengidentifikasi analisis kesintasan selama 1 tahun. Metode. Studi cross sectional dengan kohort retrospektif berbasis analisis berdasarkan rekam medis terhadap 80 pasien dengan tumor mediastinum yang dilakukan operasi dan terdaftar di RSUP Persahabatan antara 2007-2011. Pasien yang tidak didapatkan diagnosa pasti berdasarkan histopatologi di eksklusi. Hasil. Antara bulan Januari 2007 dan September 2011, 80 pasien tumor mediastinum menjalani prosedur pembedahan. Usia antara 4 tahun - 68 tahun, dengan insiden tertinggi dalam dekade kedua dan ketiga kehidupan. Laki-laki sebanyak 39 (48.8%) dan perempuan sebanyak 41 (51,3%). Tumor di mediastinum anterosuperior sebanyak 75 (93.8%), mediastinum media sebanyak 4 (5,0%), dan mediastinum posterior 1 (1.3%). Myasthenia gravis didapati pada 31.6% kasus. Reseksi komplit pada 45% pasien. Secara Histopathologi, 28 (35%) pasien dengan timik tumor, limfoma 12 (15%), tumor sel germinal pada 23 (28.8%), tumor neurogenik 3 (3,8%), tumor tiroid 4 (5%), dan tumor jenis lain 10 (12,5%). Tingkat kelangsungan hidup 1 tahun adalah 77.5%. Kesimpulan. Tumor mediastinum jinak lebih sering terjadi daripada ganas dengan timoma yang terbanyak ditemukan. Reseksi komplit memiliki peran yang penting untuk menentukan angka kelangsungan hidup jangka panjang. Sternotomi merupakan pendekatan yang paling sering dilakukan pada tumor mediastinum, dan dianjurkan untuk melakukan diagnosis preoperatif berupa biopsi. Torakotomi biopsi sering dilakukan untuk tindakan diagnostik.
Kata kunci. Mediastinum, Klinikopatologi, Kesintasan


Background. Mediastinal tumor are relatively common lesions that sometimes pose an interesting diagnostic and therapeutic problem. They can originate from any mediastinal organ or tissue but most commonly arise from thymic, lymphatic, neurogenic, germinal or mesenchymal tissues. Objective. The aim of this study was to analyze clinicopathology, clinical features, operative and histopathological findings, and identify 1 year survival analysis. Methods. A cross sectional study with analysis retrospective cohort study of the medical records of 80 patients with mediastinal tumors who underwent surgical treatment registered at our institute between 2007-2011 was performed. Those with uncertain histopatologic diagnosis was excluded. Results. Between January 2007 and September 2011, 80 patients underwent surgical treatment of a mediastinal mass. Ages ranged from 4 years to 68 years, with peak incidence in the second and third decade of life. The male was 39 (48.8%) and female was 41 (51.3%). The anterosuperior mediastinum was involved in 75 patients (93.8%), middle mediastinum in 4 (5.0%), and posterior mediastinum in 1 (1.3%). Myasthenia gravis was present in 31.6% of cases. Complete resection was possible in 45% of patients. Histopathologically, 28 (35%) patients had thymic pathology, 12 (15%) had lymphoma, 23 (28.8%) had germ cell tumors, 3 (3.8%) had neurogenic tumors, 4 (5%) had thyroid tumors, and 10 (12.5%) had other tumors. The 1 year survival rate was 77.5%. Conclusion. Benign mediastinal lesions are more common than malignant lesions with thymoma being the most commonly diagnosed mediastinal lesion. Complete resection is important to achieve satisfactory long-term survival. A median sternotomy is an excellent approach, and a preoperative diagnosis by biopsy is desirable. Diagnosis may require invasive procedures like thoracotomy.
Key word. Mediastinum, Clynicopathology, Survival