Tesis

Faktor Prognostik Respons Tumor Karsinoma Sel Hati Sesuai Modified Response Evaluation Criteria in Solid Tumors Pasca Terapi Konvensional Trans Arterial Chemoembolization Pertama (Penelitian Pendahuluan) = Tumor Responses Prognostic Factors of Hepatocellular Carcinoma Using Modified Response Evaluation Criteria in Solid Tumors After the First Conventional Trans Arterial Chemoembolization (Preliminary Study).

Latar belakang: Berbagai faktor yang mempengaruhi respon tumor pasca TACE pada karsinoma sel hati berukuran besar serta tingginya permintaan TACE membuat perlunya dibuat model prediksi tercapainya responder pasca tindakan konvensional TACE yang pertama kali. Metode: Dari Januari 2014 hingga Januari 2020 terdapat 36 pasien KSH diterapi konvensional TACE dan memiliki imaging sebelum serta sesudah tindakan. Delapan faktor prediktor pada pasien dievaluasi dengan keluaran akhir adalah responder (complete response atau partial response) dan non-responder (stable disease atau progressive disease) sesuai mRECIST. Faktor yang mempengaruhi respons tumor dianalisis menggunakan analisis multivariat regresi logistik. Hasil: Setelah terapi konvensional TACE, hanya 42% pasien masuk kategori responder. Tidak ada pasien Child Pugh B yang menjadi responder. Pada analisis multivariat pada kelompok pasien Child Pugh A, diameter terbesar lesi 5-10 cm (OR 8,78; 95% CI 1,73– 44,55; P 0,009) dan kapsul tumor (OR 3,93; 95% CI 0,78–19,72; P 0,09) merupakan faktor prediktor independen untuk responder pasca TACE pertama. Kesimpulan: Faktor prediktor respons tumor pasca konvensional TACE pertama pada pasien Child-Pugh A adalah diameter terbesar tumor 5-10 cm dan kapsul tumor. Kemungkinan responder adalah sebesar 58,18% jika hanya memiliki faktor diameter 510 cm; 38,46% jika hanya memiliki kapsul dan 84,55% jika tumor berdiameter 5-10 cm dan berkapsul.
Kata kunci: faktor prognostik, karsinoma sel hati, TACE.


Background: Various factors affect post-TACE tumor response in large hepatocellular carcinoma as well as the high demand for TACE procedure, make the need to make a predictive model of achieving responders after the first conventional TACE. Methods: From January 2014 to January 2020, there were 36 HCC patients treated with conventional TACE who had imaging before and after the procedure. Eight predictor factors were evaluated with the final status as responders (complete response or partial response) and non-responder (stable disease or progressive disease) according to mRECIST criteria. Factors that affect tumor response were analyzed using multivariate analysis of logistical regression. Results: After conventional TACE, only 42% of patients fall into the category of responders. None of the Child Pugh B patients were responders. In multivariate analysis of the Child Pugh A patient group, the largest diameter of lesions (5-10 cm) (OR 8,78; 95% CI 1,73–44,55; P 0,009) and tumor capsules (OR 3,93; 95% CI 0,78–19,72; P 0,09) is an independent predictor factor after the first TACE. Conclusions: The predictor factors after the first conventional TACE in Child-Pugh A patients are the diameter of tumors 5-10 cm and the tumor capsules. The probability of responders is 58.18% if it only has a diameter factor of 5-10 cm; 38.46% if only have capsules and 84.55% if the tumor is 5-10 cm in diameter and tumor capsules.
Keywords: hepatocellular carcinoma, prognostic factors, TACE.