Tesis

Karakteristik, Penatalaksanaan Dan Kesintasan Tumor Ganas Sel Germinal Ovarium di RSCM Tahun 2011 – 2013 = Characteristics, Management, and Survival Rate of Ovarian Germ Cell Tumor in Cipto Mangunkusumo National General Hospital from 2011 to 2013.

Latar Belakang : Tumor ganas sel germinal ovarium jarang terjadi, hanya 5% dari keganasan ovarium. Terjadi pada remaja dan dewasa muda, dimana 65% kasus ditemukan pada stadium I. Disgerminoma merupakan jenis Histopatologi yang tersering, dengan kesintasan mencapai 100%. Pada non disgerminoma kesintasan mencapai 85%. Di Indonesia, khususnya RSCM belum ada laporan terbaru mengenai tumor ganas sel germinal ovarium. Tujuan : Mengetahui sebaran meliputi karateristik, penatalaksanaan dan kesintasan 3 tahun pasien tumor ganas sel germinal ovarium di RSCM tahun 2011 – 2013. Metode : Penelitian ini menggunakan studi potong lintang dengan mengambil data sekunder dari rekam medis dan mewawancarai pasien atau keluarga pasien via telepon atau kunjugan rumah. Hasil : Pada penelitian ini, dari 24 subjek penelitian, 54,2% ditemukan pada usia 20-40 tahun dan 58,3% subjek belum menikah. Sebanyak 83,3% datang dengan keluhan perut membesar. Secara histopatologi didapatkan jenis disgeminoma, tumor sel germinal campuran, sinus endodermal (yolk sac) dan teratoma imatur dengan proporsi masing-masing 50%, 25%, 16,7% dan 8,3%, sebagian besar kasus (50%) ditemukan pada stadium I. Conservative surgical staging dan kemoterapi adjuvan tatalaksana pilihan. Terdapat 2 subjek jenis disgerminoma yang diberikan dengan kemoterapi neoadjuvan (regimen Bleomycin, Etoposide, Cisplatin dan cyclophosmide-cisplatin) memberikan respon yang baik. Kesintasan ≥ 3 tahun pada jenis disgerminoma mencapai 83,3%, pada tumor sel germinal campuran 100% dan pada teratoma imatur mencapai 50%. Kesimpulan : Pada tumor ganas sel germinal ovarium conservative surgical staging diikuti kemoterapi lengkap merupakan pilihan terapi dengan kesintasan ≥ 3 tahun mencapai > 70%.
Kata kunci : Tumor sel germinal ovarium, disgerminoma, tumor ovarium non epithelial, kesintasan


Background: Malignant ovarian germ cell tumor is a rare event, occurring in 5% of total ovarian malignancy. This type of malignancy affects young adult and 65% cases is detected in stage I. Dysgerminoma is the most common histopathology finding with survival rate of 100%. In non-dysgerminoma type, survival type reaches 85%. In Indonesia, especially in Cipto Mangunkusumo Hospital Jakarta, there is no recent report on malignant ovarian germ cell tumor. Aim: To determine prevalence of malignant ovarian germ cell tumor in term of characteristics, management, and 3-year survival rate in Cipto Mangunkusumo Hospital Jakarta from 2011 to 2013. Methods: This is a cross-sectional study. Secondary data was collected from medical record as well as interviewing patients through phone call or home visit. Results: We collected data from 24 subjects. As many as 54.2% subjects were between 20 to 40 year old and 58.3% was single. Around 83.3% of total subjects came with chief complaint of abdominal enlargement. Histopathology finding confirmed dysgerminoma in 50% subjects, mixed ovarian germ cell tumor in 25%, endodermal sinus tumor or yolk sac tumor in 16.7%, and immature teratoma in 8.3%. Half of the cases were found in stage I. The main therapy was conservative surgical staging and adjuvant chemotherapy. In 2 subjects with dysgerminoma, neoadjuvant chemotherapy (Bleomycin, Etoposide, Cisplatin, and cyclophosmide-cisplatin regimen) resulted in good response. The 3-year survival rate was 83.3% in dysgerminoma, 100% in mixed ovarian germ cell tumor, and 50% in immature teratoma. Conclusion: In malignant ovarian germ cell tumor, conservative surgical staging followed by complete course of chemotherapy is the treatment of choice with 3-year survival rate exceeding 70%.
Keywords: Ovarian germ cell tumor, dysgerminoma, non-epithelial ovarian tumor, survival