Tesis

A Qualitative Analysis of Radical Cystectomy Refusal in Patients with Muscle-Invasive Bladder Cancer = Analisis Kualitatif Penolakan Tindakan Radikal Sistektomi pada Pasien Muscle-Invasive Bladder Cancer.

Introduction: This study aimed to describe the reasons behind patient’s radical cystectomy refusal for bladder cancer Methods: This study was conducted at Adam Malik General Hospital between July 2014 and August 2020 were recruited in this study. A family conference or interview was taken to explain the risk and benefit of the surgery and get the approval or rejection (and refusal reason) of the procedure. The bivariate analysis assessed all dependent variables’ significance as a predictor of radical cystectomy refusal. Significant variables will be included in the multivariate regression analysis. Results: A total of 51 newly diagnosed bladder cancer patients indicated for radical cystectomy were included in this study, with an average of 51.73±8.73 years old; 34 (66.67%) of those were aged < 55 years old. There were 42 male patients (82.4%) in this study. 15 (29.4%) patients refused the radical cystectomy. 81.25% of early-stage patients agreed to undergo radical cystectomy. The prevalence ratio of stage III–IV patients refused to undergo radical cystectomy was 1.544 (95% CI, 0.977–2.440). Only six patients (35.3%) aged ≥55 years agreed to the procedure, with a prevalence ratio of patients ≥ 55 years of age to refuse to the procedure of 2.500 (95% CI, 1.298–4.814). Conclusion: Age ≥ 55 years, low education level, and stage III-IV were the determining factors in the rejection of radical cystectomy. The odds ratios for refusal were 2.500 (95% CI, 1.298–4.814), 3.588 (95% CI, 1.708–7.537), and 1.544 (95% CI, 0.977–2.440) for ages ≥ 55 years, low education level, and stages III-IV, respectively.
Keyword: Bladder cancer, refusal, cystectomy



Pendahuluan dan tujuan: Penelitian ini bertujuan untuk mendeskripsikan alasan pasien di balik penolakan radikal sistektomi pada kanker kandung kemih Metode: Penelitian ini dilakukan di Rumah Sakit Umum Adam Malik dalam rentang periode Juli 2014 hingga Agustus 2020. Family meeting ataupun wawancara dilakukan untuk menjelaskan risiko dan manfaat dari operasi dan mendapatkan persetujuan atau penolakan (dan alasan penolakan) dari prosedur tersebut. Analisis bivariat menilai signifikansi semua variabel dependen sebagai prediktor penolakan radikal sistektomi. Variabel yang signifikan akan dimasukkan dalam analisis regresi multivariat. Hasil: Sebanyak 51 pasien kanker kandung kemih yang baru terdiagnosis dan diindikasikan untuk radikal sistektomi diikutsertakan dalam penelitian ini, dengan ratarata usia 51,73±8,73 tahun; 34 (66,67%) diantaranya berusia < 55 tahun. Ada 42 pasien laki-laki (82,4%) dalam penelitian ini. 15 (29,4%) pasien menolak radikal sistektomi. 81,25% pasien stadium awal setuju untuk menjalani radikal sistektomi. Rasio prevalensi pasien stadium III-IV yang menolak menjalani radikal sistektomi adalah 1,544 (95% CI, 0,977-2,440). Hanya enam pasien (35,3%) berusia ≥ 55 tahun yang menyetujui prosedur, dengan rasio prevalensi pasien berusia ≥ 55 tahun yang menolak prosedur sebesar 2.500 (95% CI, 1.298–4.814). Kesimpulan: Usia ≥ 55 tahun, tingkat pendidikan rendah, dan stadium III-IV menjadi faktor penentu penolakan radikal sistektomi. Odds rasio penolakan adalah 2.500 (95% CI, 1.298–4.814), 3.588 (95% CI, 1.708–7.537), dan 1.544 (95% CI, 0.977–2.440) masing-masing untuk usia ≥ 55 tahun, tingkat pendidikan rendah, dan tahap III-IV.
Kata kunci: Kanker Buli, penolakan, sistektomi