Evaluation Of The Effect Of Trastuzumab And Non-Trastuzumab Therapy On Overall Survival And Prognosis Of HER2-Positive Breast Cancer At Fatmawati Hospital Jakarta 2019-2024
DOI:
https://doi.org/10.63004/hrji.v4i5.1404Keywords:
kanker payudara, HER2-positif, Trastuzumab, terapi target, overall survival, Cox regressionAbstract
Pendahuluan: Kanker merupakan salah satu penyebab utama kematian di dunia, dan kanker payudara merupakan jenis yang paling sering ditemukan. Berdasarkan data GLOBOCAN 2022, terdapat 178.393 kasus kanker payudara secara global, termasuk 66.271 kasus (16,2%) di Indonesia. Subtipe HER2-positif diketahui lebih agresif dan memiliki prognosis yang lebih buruk. Tujuan: Untuk mengevaluasi pengaruh terapi trastuzumab dan non-trastuzumab terhadap kelangsungan hidup (overall survival/OS), mengidentifikasi faktor klinis yang memengaruhi hasil terapi, serta menilai pengaruhnya terhadap prognosis pasien kanker payudara HER2-positif di RSUP Fatmawati Jakarta periode 2019–2024. Metode: Kohort retrospektif dengan data sekunder dari rekam medis Kaplan–Meier, uji log-rank, dan model Cox proportional hazards. Hasil: Dari 178 pasien, sebanyak 31 (17,4%) mengalami event dan 147 (82,6%) tergolong censored. Terapi trastuzumab, terutama bila dikombinasikan dengan terapi hormonal, menunjukkan hasil terbaik dengan rerata OS 1.096 hari tanpa kejadian event, sedangkan kelompok tanpa terapi target memiliki angka kematian tertinggi (55%) dengan rerata OS 855 hari (p = 0,13). Ukuran tumor (p = 0,02) dan lokasi metastasis (p = 0,04) berpengaruh signifikan terhadap kelangsungan hidup. Kesimpulan: Kelompok risiko rendah, yang sebagian besar menerima trastuzumab, memiliki prognosis terbaik (4,4% kejadian), sedangkan kelompok risiko tinggi menunjukkan penurunan kelangsungan hidup signifikan (40% kejadian; log-rank p < 0,0001; C-index = 0,820).
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