Tesis

Faktor yang Memengaruhi Invasi Tiroid pada Kanker Laring Stadium Lanjut yang menjalani Laringektomi Total di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo = Factors Influencing Thyroid Invasion in Advanced Stage Laryngeal Cancer Undergoing Total Laryngectomy at Dr. Cipto Mangunkusumo National General Hospital.

Latar belakang: Invasi tiroid pada kanker laring stadium lanjut yang menjalani laringektomi total bervariasi pada berbagai studi dan belum ada konsensus indikasi tiroidektomi, sehingga risiko overtreatment tinggi. Tujuan: Menentukan frekuensi serta faktor yang memengaruhi invasi tiroid pada pasien karsinoma laring stadium lanjut di RSCM. Metode: Studi cross sectional menggunakan data pasien laringektomi total dengan tiroidektomi periode 2020–2025. Analisis bivariat dilanjutkan regresi logistik multivariat untuk model prediksi. Hasil: Frekuensi invasi tiroid pada studi ini adalah 18%. Faktor yang signifikan memengaruhi invasi kelenjar tiroid adalah interval diagnosis-terapi, interval trakeostomi-laringektomi, staging T, invasi kartilago tiroid, dan invasi tiroid radiologi. Dilanjutkan pada analisis multivariat didapatkan dua variabel bermakna yaitu interval trakeostomi >2 bulan, dan invasi tiroid berdasarkan radiologi. Kesimpulan: Interval trakeostomi-laringektomi dan invasi tiroid radiologi adalah prediktor kuat invasi kelenjar tiroid, membantu menentukan indikasi tiroidektomi untuk mencegah overtreatment.
Kata kunci: karsinoma laring, laringektomi, invasi tiroid


Background: Thyroid invasion in advanced stage laryngeal cancer undergoing total laryngectomy varies across studies. There is no consensus on indications for thyroidectomy, leading to a high risk of overtreatment Objective: To determine the frequency as well as factors influencing thyroid invasion in patients with advanced laryngeal carcinoma at RSCM. Methods: This was a cross-sectional study using data from patients who underwent total laryngectomy with thyroidectomy between 2020 and 2025. Bivariate analyses were followed by multivariate logistic regression. Results: The frequency of thyroid invasion was 18%. Significant factors associated with thyroid invasion included diagnosis-to-treatment interval, tracheostomy-tolaryngectomy interval, T staging, thyroid cartilage invasion, and radiologic thyroid invasion. Multivariate analysis shows two significant factors including tracheostomy interval >2 months and thyroid invasion based on radiology. Conclusion: The tracheostomy-laryngectomy interval and radiologic thyroid invasion are strong predictors of thyroid invasion, supporting more precise indications for thyroidectomy to avoid overtreatment.
Keywords: laryngeal carcinoma, laryngectomy, thyroid invasion.