Tesis

Penegakan Diagnosis Tumor Otak Metastasis Akibat Kanker Paru dan Faktor yang Memengaruhi di RSUPN Cipto Mangunkusumo = Diagnosis of Metastatic Brain Tumors Due to Lung Cancer and Influencing Factors at Cipto Mangunkusumo General Hospital.

Latar belakang: Insidens metastasis otak lebih tinggi dibanding tumor primer otak dan berisiko menimbulkan kematian dengan penyebab terbanyak berasal dari kanker paru (36,5%) di RSUPN Cipto Mangunkusumo (RSCM). Keterlambatan diagnosis berisiko menyebabkan herniasi otak, sehingga terjadi kecacatan dan kematian. Dibutuhkan data mengenai durasi penegakan diagnosis di RSCM. Metode penelitian: Penelitian ini merupakan studi deskriptif analitik dengan rancangan kohort retrospktif untuk mengetahui kesesuaian antara durasi penegakan diagnosis tumor otak metastasis akibat kanker paru dengan pedoman praktik klinis (durasi ≤ 2 minggu). Subjek merupakan pasien rawat inap di RSCM pada Januari 2019 s/d Desember 2021. Hasil: Terdapat 12 subjek (30%) dapat ditegakkan dalam waktu ≤ 2 minggu dengan median durasi 18,5 hari (IQR (12-34 hari). Selain itu didapatkan durasi 7 hari (IQR 4-11 hari) untuk sampai didapatkannya massa di paru, durasi 8 hari (IQR 4.5-13 hari) sampai dilakukannya biopsi, dan 6 hari (IQR 3.5-7 hari) sampai keluarnya hasil patologi anatomi. Tidak terdapat hubungan yang bermakna secara statistik antara variabel yang dinilai dengan durasi penegakan diagnosis ≤ 2 minggu (14 hari). Kesimpulan: Hanya 30% subjek dengan durasi yang sesuai dengan panduan praktik klinis di RSCM. Dibutuhkan diseminasi hasil dan kolaborasi antar bagian agar penegakan diagnosis lebih cepat.
Kata kunci: Metastasis otak, Kanker paru, Penegakan diagnosis.


Background: Incidence of brain metastases is higher than primary brain tumors, with lung cancer as common etiology (36.5%) at Cipto Mangunkusumo General Hospital (RSCM). Delay in diagnosis can cause brain herniation, resulting in disability and death. Data is needed regarding the duration of diagnosis in RSCM. Method: This is a descriptive analytic study with a retrospective cohort design to determine the conformity between the duration of diagnosis of metastatic brain tumors due to lung cancer in daily clinical practice with clinical practice guidelines (duration 2 weeks). Subjects were inpatients at RSCM from January 2019 to December 2021. Results: There were 12 subjects (30%) who could be diagnosed within 2 weeks with a median duration of 18.5 days (IQR (12-34 days). Duration of 7 days (IQR 4-11 days) to obtain a lung mass, 8 days (IQR 4.5-13 days) until a biopsy was performed, and 6 days (IQR 3.5-7 days) until anatomic pathology results were released. There is no statistically significant relationship between the variables assessed and the duration of diagnosis 2 weeks. Conclusion: Only 30% of subjects with the duration matched the clinical practice guidelines at RSCM. Dissemination of results and collaboration between departments is needed to make diagnosis faster.
Keywords: Brain metastases, Lung cancer, Diagnosis.