Faktor Klinis dan Histopatologi serta Hubungannya dengan Kekambuhan Pascaoperasi pada Pasien Kanker Payudara di RSUD Dr. Soetomo, Januari–Juni 2015

Abstract

ABSTRACT Breast cancer recurrence occurs because of factors such as surgical problem and clinicopathological features. The present study aimed to assess the relation between clinicopathological factors to breast cancer recurrence. Cross sectional design was used to take medical documents of all patients who visited Out Patient Department Soetomo Hospital from January 2015 to June 2015. A total of 228 patients were identified. The rates of breast cancer recurrence were 30%, most of recurrence occurred in first 5 years and the peak was in the first year. There were significant correlations between breast cancer recurrence and the factors observed below: tumor size [p=0.01,PR(95% CI)=1.621(1.086-2.421)]; nodal status 1-3 and ≥ 4 ≥ 4 [respectively p=0.014,PR(95%CI)=1.281(1.030-2.593) ; p=0.011,PR(95%CI) =1.289(1.038-1.601)]; tumor location [p=0.00,PR(95%CI)=2.422(1.576-3.721)]; hospital where the operation performed [p=0.03,PR(95%CI)=1.207(1.026-1.421)]; adjuvant therapy [p=0.00,PR(95%CI)= 4.371(2.231- 8.566)]. However there were no correlations of breast cancer recurrence and age, clinical stage or type of surgery. Conclusion, there are significant correlations between breast cancer recurrence and clinicopathological factors, such as tumor size, nodal status, tumor location, hospital where the operation performed and adjuvant therapy ABSTRAKKekambuhan kanker payudara terjadi karena beberapa faktor, di antaranya faktor klinis dan histopatologis. Penelitian ini bertujuan untuk mengetahui hubungan faktor klinis dan histopatologi terhadap kekambuhan. Penelitian ini menggunakan desain cross sectional dengan mengambil data dari rekam medis pasien yang berkunjung ke Unit Rawat Jalan RSUD Dr. Soetomo periode Januari- Agustus 2015. Sebanyak 228 pasien diidentifikasi. Tingkat kekambuhan kanker payudarasebsar 30%, sebagian besar kekambuhan terjadi dalam 5 tahun pertama, dan puncaknya adalah pada tahun pertama. Ada hubungan yang signifikan antara kekambuhan kanker payudara dengan faktor-faktor yang diamati: ukuran tumor [p=0,01, PR (95%CI) =1,621 (1.086-2.421)]; status nodal 1-3 and ≥ 4 ≥ 4 [masing-masing p=0,014,,PR(95%CI) = 1.281(1.030-2.593); p=0,011, PR (95%CI) = 1.289(1.038-1.601)]; letak tumor [p=0,00, PR(95%CI) = 2.422(1.576-3.721)]; rumah sakit tempat operasi dilaksanakan[p=0,03, PR,(95%CI)=1.207(1.026-1.421)]; terapi adjuvant [p=0,00, PR(95%CI)= 4.371(2.231-8.566)]. Namun, tidak ada korelasi antara kekambuhan kanker payudara dengan usia, stadium klinis, dan jenis operasi. Kesimpulan, terdapat hubungan yang signifikan antara kekambuhan kanker payudara dengan ukuran tumor, status nodal, lokasi tumor, rumah sakit di mana operasi dilaksanakan, dan terapi adjuvant.