Tesis

Ketahanan Hidup Pasien yang Dilakukan Sistektomi Parsial Lebih Baik Daripada yang Dilakukan Radioterapi = Survival of Patients with Bladder Cancer Who Had Partial Cystectomy is Better than Those Who Had Radiotherapy.

Objektif Untuk mengevaluasi ketahanan hidup pasien kanker kandung kemih invasif ke otot yang dilakukan terapi operasi maupun radioterapi di Rumah Sakit Sardjito.

Bahan dan cara Dari tahun 2004-2010, dilakukan pendataan pasien dengan kanker kandung kemih invasif ke otot yang dilakukan tindakan sistektomi maupun radioterapi di RS Sardjito . Data yang dipelajari adalah usia saat diagnosis, jenis kelamin, status TNM, gambaran histopatologi, grading histopatologi, jenis tindakan operasi dan status pada saat follow up. Dievaluasi ketahanan hidup dari masing-masing pasien hingga 5 tahun pasca tindakan. Dilakukan analisa bivariat untuk menilai hubungan ketahanan hidup dengan status T, N, M, grading histopatologi, stadium klinis dan jenis penatalaksanaan. Digunakan kurva Kaplan Meier untuk menilai gambaran ketahanan hidup pasien kanker kandung kemih invasi ke otot.

Hasil Ada 37 Pasien dengan Tumor Buli yang terdiri dari perempuan 3 orang (8.1%) dan laki-laki 34 orang (91.9%). Lima orang dilakukan Radikal Sistektomi, empat orang dilakukan parsial sistektomi dan 28 pasien dilakukan TUR-BT dan Radioterapi. Tidak dijumpai hubungan bermakna antara ketahanan hidup pasien kanker kandung kemih invasif ke otot dengan jenis kelamin, usia, stadium, staging T, N, M, grading histopatologi maupun jenis penatalaksanaan (p>0.05). Berdasarkan kurva Kaplan Meier diketahui ketahanan hidup lebih baik pada stadium I, Staging T1, N0, M0 dan grading histopatologi G1. Sedangkan berdasarkan jenis tindakan, pasien yang dilakukan parsial sistektomi memiliki angka ketahanan hidup lebih baik daripada hanya dilakukan TUR-BT dan Radioterapi. Kesimpulan Tindakan operasi parsial sistektomi memiliki angka ketahanan hidup lebih baik daripada TUR-BT dan Radioterapi.
Kata Kunci : Ketahanan hidup, kanker kandung kemih, invasif ke otot


Objectives To evaluate survival analysis of muscle invasive bladder cancer who had radical cytectomy, partial cystectomy nor radiotherapy at Sardjito Hospital.

Methods From year 2004 until 2010, we collected patients with muscle invasive bladder cancer who had radical cystectomy, partial cystectomy and radiotherapy at Sardjito Hospital. The clinical factors that studied were age, sex, the TNM staging, clinical staging, histopathology findings, histopathology grading, therapy and survival status. We evaluate their survival up to five year after the therapy. Correlation between survival status with the TNM staging, clinical staging, histopathology grading and the therapy were analyzed using Fisher Exact Test. The Kaplan Meier survival analysis was used to calculate survival.

Result There are 37 patients of muscle invasive bladder cancer which conist of 3 female (8.1%) and 34 male (91.9%). 5 Patients had radical cytectomy, 4 patients had partial cystectomy, and 28 patients had TUR-BT and Radiotherapy. There are no correlation between survival status with age, sex, TNM staging, clinical staging, histopathology grading and the therapy (P>0.05). Based on Kaplan Meier survival analysis, their survival were better on stadium I, T1, N0, M0 staging and G1 histopathology grading. While according to the therapy, patients who had partial cystectomy were having better survival rather than patients who had TUR-BT and Radiotherapy.

Conclusion Patients who had partial cystectomy had better survival rather than those who had TUR-BT and Radiotherapy.
Keyword : Survival analysis, muscle invasive, bladder cancer