Status gizi sebagai faktor prognosis penderita karsinoma endometrium
Heru Pradjatmo(1*), Deyna Primavita Pahlevi(2)
(1) Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada/Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta
(2) Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada/Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta
(*) Corresponding Author
Abstract
Background: In Indonesia, endometrial cancer is the third gynaecologic cancer after cervical and ovarian cancers. Various factors affect the survival of the patients, however, which factors affect the survival of endometrial carcinoma patients in Dr. Sardjito Hospital remain unclear. A research is therefore needed in order to determine the survival and the prognostic factors.
Objective: To investigate the prognostic factors that affect the survival of endometrial carcinoma patients who had been admitted to Dr. Sardjito Hospital.
Method: The study design was retrospective cohort. The subjects were patients with endometrial carcinoma who were treated in Dr. Sardjito Hospital from 1st of January 2006 until 31st of December 2011. Kaplan-Meier analysis was performed to analyze several factors that influenced the survival of the patients. The differences of survival were analyzed with log rank test while the prognostic factors influencing the survival were analyzed using Cox regression.
Results: 68 endometrial carcinoma patients were recruited as the subjects for the study. The median survival of endometrial carcinoma patients 52 months for those on early stage and 17 months on advanced stage (p≤0.01). The prognostic factors affecting survival that has been found statistically and clinically significant was the stage of the disease (p=0.002; HR=6.175; 95% CI=1.1980 to 19.25). Meanwhile, the nutritional status of patients with low, normal, and high BMIs score showed increased survival rate as indicated by the HR values of 1; 0.768; and 0.311 respectively.
Conclusion: The prognostic factor that was clinically and statistically significant influenced the survival was the stage of the disease, while the nutritional status of patients was found clinically significant as the prognostic survival of the patients.
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American Cancer Society. Endometrial cancer statistics. [series online] 2012 [cited Maret 2013]. Available from: URL: http.//www.cancer.org
Farquar CM, Lethaby A, Shower M, Verry J, Baranyai J. An evaluation of risk factor for endometrial hyperplasia in premenopousal woman with abnormal menstrual bleeding. Am J Obstet Gynecol 1999;181(3):525-9.
Masciullo V, Amadio G, Russo DL, Raimondo I, Giordano A, Scambia G. Controversies in the management of endometrial cancer. Obstet Gynecol Int 2010; 2010: 638165.
Mueck AO, Seeger H, Rabe T. Hormonal contraception and risk of endometrial cancer: a systematic review. Endocr Relat Cancer 2010;17(4):R263-71.
Mauland KK, Trovik J, Wik E, Raeder MB, Njølstad TS, Stefansson IM, Oyan AM, Kalland KH, Bjørge T, Akslen LA, Salvesen HB. High BMI is significantly associated with positive progesterone receptor status and clinico-pathological markers for non-aggresive disease in endometrial cancer. Br J Cancer 2011;104(6):921-6.
Blake P, Swart AM, Orton J, Kitchener H, Whelan T, Lukka H, Eisenhauer E, Bacon M, Tu D, Parmar MK, Amos C, Murray C, Qian W. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis. Lancet 2009;373(9658):137-46.
Fader AN, Frasure HE, Gil KM, Berger NA, von Gruenigen VE. Quality of life in endometrial cancer survivors: what does obesity have to do with it? Obstet Gynecol Int 2011; 2011: 308609.
Hacker NF. Uterine cancer. In: Berek JS, Hacker NF. Practical gynecologic oncology. Fourth ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
Maggi R, Lissoni A, Spina F, Melpiagnano M, Zola P, Favalli G, Colombo A, Fossati R. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: result of a randomized trial. Br J Cancer 2006;95(3):266-71.
Disaia PJ, Creasman WT. Endometrial carcinoma in clinical gynecology oncology. Seventh ed. Toronto: Mosby year book inc; 2007.
Madison T, Schottenfeld D, James SA, Schwartz AG, Gruber SB. Endometrial cancer: socioeconomic status and racial/ethic differences in stage at diagnosis, treatment, and survival. Am J Public Health 2004;94(12):2104-11.
Sofyan A. Kanker endometrium. Prawirohardjo S. Buku acuan nasional onkologi ginekologi. Jakarta: Yayasan Bina Pustaka; 2006.
Studzinski Z, Branicka D. Initial estimation effect of body mass on survival of patient with endometrial carcinoma. Gynecol Pol 1999;70(2):81-7.
Badan Penelitian Pengembangan Kesehatan. Laporan hasil riset kesehatan dasar (Riskesdas) Indonesia – tahun 2007. Jakarta: Departemen Kesehatan Republik Indonesia; 2008.
Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet 2005;366(9484):491-505.
Sopiyudin D. Langkah-langkah membuat proposal penelitian bidang kedokteran dan kesehatan. Jakarta: Sagung Seto; 2009.
Bajracharya SR, Juan FY. Prognostic factors in endometrial cancer. J Institute of Medicine 2013;35(1):9-17.
Duong LM, Wilson RJ, Rhit CTR, Ajani UA, Singh SD, Eheman CR. Trends in endometrial cancer incidence rate in United State, 1999-2006. J Womens Health 2011;20(8):1157-63.
Lochen M, Lund E. Childbearing and mortality from cancer of the corpus uteri. Acta Obstet Gynecol Scand 1997;76(4):373-7.
Klip H, Burger CW, Kenemans P, van Leeuwen FE. Cancer risk associated with subfertility and ovulation induction: a review. Cancer Causes Control 2000;11(4):319-44.
Thigpen JT, Brady MF, Homesley HD. Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: a gynecologic oncology group study. J Clin Oncol 2004;22(19):3902-08.
Keys HM, Roberts JA, Brunetto Vl. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a gynecologic oncology group study. Gynecol Oncol 2004;92(3):744-51.
Aziz MF. Gynecological cancer in Indonesia. J Gynecol Oncol 2009;20(1):8-10.
Chi DS, Welshinger M, Venkatraman ES, Barakat RR. The role of surgical cytoreduction in stage IV endometrial carcinoma. Gynecol Oncol 1997;67(1):56-60.
Temkin SM, Pezzullo JC, Hellmann M, Lee YC, Abulafia O. Is body mass index an independent risk factor of survival among patients with endometrial cancer? Am J Clin Oncol 2007;30(1):8-14.
Munstedt K, Wagner M, Kullmer U, Hackethal A, Franke FE. Influence of body mass index on prognosis in gynecological malignancies. Cancer Causes Control 2008;19(9):909-16.
Jeong NH, Lee JM, Lee JK, Ki JW, Cho CH, Kim SM, Seo SS, Park CY, Kim KT, Lee J. Role of body mass index as a risk and prognostic factor of endometrioid uterine cancer in Korean women. Gynecol Oncol 2010;118(1):24-8.
Von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR. Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma: a gynecologic oncology group study. Cancer 2006;107(12):27860-91.
DOI: https://doi.org/10.22146/ijcn.18838
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