Skripsi

Luaran Mortalitas Pasien Remaja Post Tindakan Amputasi Pada Kasus Osteosarkoma Ekstremitas Bawah di RSCM = Mortality Outcomes in Post-Amputation Adolescent Patients in Cases of Osteosarcoma of the Lower Extremities at RSCM.

Latar Belakang Osteosarkoma adalah tumor ganas pada tulang yang umumnya terjadi pada remaja. Penanganan osteosarkoma perlu melibatkan tim multidisiplin mulai dari penegakan diagnosis hingga tata laksana berupa kombinasi kemoterapi dan pembedahan (amputasi atau operasi penyelamatan tungkai/limb salvage surgery). Di Indonesia, kasus osteosarkoma sering terlambat ditangani sehingga berujung amputasi. Beberapa faktor mempengaruhi mortalitas pasien post amputasi tetapi efeknya terhadap mortalitas pasien osteosarkoma ekstremitas bawah usia remaja post amputasi masih dapat diteliti lebih lanjut. Metode Penelitian ini menggunakan desain potong lintang ini. Subjek penelitian berjumlah 57 pasien remaja post tindakan amputasi pada kasus osteosarkoma ekstremitas bawah di RSCM. Analisis dilakukan untuk mengetahui hubungan usia, onset, kemoterapi, metastasis, manipulasi pijat, dan lokasi tumor dengan luaran mortalitas pada subjek. Hasil Tingkat mortalitas 57 subjek sebesar 59,6%. Subjek berusia 14,56  2,51 dengan onset 24 (3 – 156). Terdapat 42 subjek yang dikemoterapi, 29 subjek yang bermetastasis, 47 subjek yang dipijat, dan 27 subjek dengan lokasi tumor pada femur distal. Kemoterapi (p = 0,002) dan metastasis (p = 0,002) berhubungan dengan luaran mortalitas. Namun, usia (p = 0,530), onset (p = 0,442), manipulasi pijat (p = 0,287) dan lokasi tumor (p = 0,780) tidak berhubungan. Metastasis (p = 0,008) merupakan faktor prognostik yang paling dominan. Kesimpulan Subjek penelitian ini mayoritas berusia 14 tahun dengan onset 24 minggu, bermetastasis, dipijat, lokasi tumor di distal femur, dan dikemoterapi. Kemoterapi dan metastasis berhubungan dengan luaran mortalitas, sementara usia, onset, manipulasi pijat, dan lokasi tumor tidak berhubungan. Metastasis merupakan faktor prognostik paling dominan.
Kata Kunci: osteosarkoma, mortalitas, amputasi, remaja


Introduction Osteosarcoma is a malignant bone tumor that commonly occurs in adolescents. The management of osteosarcoma requires a multidisciplinary team from diagnosis to treatment, which includes a combination of chemotherapy and surgery (amputation or limb salvage surgery). In Indonesia, osteosarcoma cases are often treated late, leading to amputation. Several factors influence post-amputation mortality, but their effects on mortality in adolescent patients with lower extremity osteosarcoma post-amputation still warrant further investigation. Method This study utilized a cross-sectional design. The subjects included 57 post-amputation adolescent patients for lower extremity osteosarcoma at RSCM. Analysis was conducted to determine the relationship between age, onset, chemotherapy, metastasis, massage manipulation, and tumor location with mortality outcomes in the subjects. Results The mortality rate of 57 subjects was 59.6%. The subjects had an average age of 14.56 ± 2.51 years, with an onset of 24 weeks (3 – 156 weeks). There were 42 subjects who received chemotherapy, 29 subjects who had metastasis, 47 subjects who underwent massage, and 27 subjects with tumor location in the distal femur. Chemotherapy (p = 0.002) and metastasis (p = 0.002) were associated with mortality outcomes. However, age (p = 0.530), onset (p = 0.442), massage manipulation (p = 0.287), and tumor location (p = 0.780) were not associated. Metastasis (p = 0.008) was the most dominant prognostic factor. Conclusion Most of the study subjects were 14 years old with an onset of 24 weeks, had metastasis, received massage, had tumor location in the distal femur, and received chemotherapy. Chemotherapy and metastasis were associated with mortality outcomes, while age, onset, massage manipulation, and tumor location were not associated. Metastasis is the most dominant prognostic factor.
Keywords: osteosarcoma, mortality, amputation, adolescent