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All Journal Medical Journal of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) Indonesian Journal of Rheumatology Journal of Stem Cell Research and Tissue Engineering The New Ropanasuri Journal of Surgery JOURNAL LA MEDIHEALTICO eJournal Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Journal Medical Informatics Technology
Murdani Abdullah
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo General National Hospital
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Journal : Jurnal Penyakit Dalam Indonesia

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Kesintasan Pasien Karsinoma Hepatoselular: Sebuah Studi Komprehensif tentang Pengaruh Awitan Dini versus Lambat dan Faktor Determinannya Achmad, Ibrahim; Jasirwan, Chyntia Olivia Maurine; Rajabto, Wulyo; Abdullah, Murdani; Nababan, Saut Horas H.; Nasution, Sally Aman; Koesnoe, Sukamto; Sari, Nina Kemala
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. The prognosis for patients with Hepatocellular Carcinoma (HCC) is generally poor because most cases are diagnosed at an advanced stage. Several studies indicate that HCC is more prevalent and has a worse prognosis among younger individuals. This study aims to identify and compare the variations in survival rates between early and late-onset HCC patients at Cipto Mangunkusumo Hospital and investigate the factors that impact survival outcomes in both groups. Methods. Retrospective cohort study of HCC patients registered in HCC registry 2015-2022. Survival was visualized using Kaplan-Meier curves. Prognostic factor variables in the Cox Proportional Hazard Regression analysis by backward method in the final model became independent prognostic factors for overall survival. Results. There were 896 subjects. Patients with early onset had a median survival of 2.0 months (95% CI 1.0-2.9), while late-onset patients had a median survival of 4.0 months (95% CI 3.4-4.5) (p=0.021). During the observation period, the incidence of death in early onset was found to be higher compared to late onset (92.9% vs. 87.7%, p 0.032). In the multivariate analysis for early onset, hypertension comorbidity and lack of hepatitis treatment were prognostic factors increasing the risk of death with [HR 3.7 (95% CI: 1.0-12.7)] and [HR 2.4 (95% CI: 0.9-6.2)] (p=0.053). In the multivariate analysis for late onset, prognostic factors increasing the risk of death include AFP levels ≥200 ng/mL [HR 1.2 (95% CI: 1.0-1.5)], liver cirrhosis [HR 1.2 (95% CI: 1.0-1.3)], AJCC stage 4 as the most advanced stage [HR 4.5 (95% CI: 2.2-8.9)], supportive therapy [HR 5.2 (95% CI: 3.9-6.8)], and palliative therapy [HR 1.6 [95% CI: 1.2-2.2)]. Conclusion. The median survival of early-onset HCC patients is lower compared to late-onset ones because the majority are not given curative treatment. Independent prognostic factors in early-onset are hypertension and hepatitis treatment, while in late-onset AFP levels, liver cirrhosis, AJCC stage, and therapy are given.
Co-Authors A.A. Ketut Agung Cahyawan W Aan Santi Abdul A. Rani Abdul Aziz Rani Abdullah, Arman Adel Achmad Fauzi Achmad, Ibrahim Adang Bachtiar Adeputri Tanesha Idhayu Adiningsih Srilestari Aditya Rachman, Aditya Adityo Susilo, Adityo Adli, Mizanul Afifah Is Afistianto, Muhammad Fikri Ahmad Soefyani Ahmar Abyadh Aida Lydia, Aida Akmal Taher Alexander, Reinaldo Ali Djumhana Ali Imron Yusuf Amanda P Utari, Amanda P Amanda Pitarini Utari Anastasia Yoveline Andri Sanityoso Ari F Syam Ari F. Syam Ari Fahrial Syam Ari Wijayanti Ariadi Humardani Arleni Bustami Arman A Abdullah Arnelis Arnelis Artati Murwaningrum, Artati Ascobat, Purwantyastuti Asysyifa, Nisrina Aziz Rani Azzaki Abubakar, Azzaki Birry Karim Bisuk, Batara Bona Adhista Budhi Setianto Budi Tan Oto Budiman Bela Budiman Budiman Budimutiar, Felix C Martin Rumende Ceva W. Pitoyo Chairul R Nasution Chatarina Umbul Wahyuni Chudahman Manan Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Chyntia Olivia MJ Cleopas Martin Rumende Cosphiadi Irawan Czeresna Heriawan Soejono Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Dante Saksono Harbuwono Dasril Nizam Deddy Gunawanjati Dewantoro, Okto Dharmeizar Dharmeizar Dharmika Djojoningrat Diah Rini Handjari Diani Kartini Diany N Taher Diding Heri Prasetyo Djumhana A Dolly Dolven Kansera Dono Antono Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri E. Mujaddid Edy Rizal Wahyudi Ekowati Rahajeng Ellen Susanti Elli Arsita Em Yunir, Em Ening Krisnuhoni Eric Daniel Tenda Evy Yunihastuti Fauzi Ahmad Muda Fiastuti Witjaksono Fransiska Hardi Fumiaki Kitahara Gaol, Donnie Lumban Giri Aji, Giri Guntur Darmawan Haloho, Raja Mangatur Harini Oktadiana, Harini Harmani Kalim Harry Isbagio Haryana, Sofia M Haryanto Surya Hasan Maulahela, Hasan Hasan Mihardja Hayatun Nufus Hazim, Ahmad Herdiman T Pohan Herdiman T. Pohan Heri Wibowo Hiroyuki Otsuka Hotmen Sijabat I. D.N. Wibawa Ibrahim Basir Ibrahim Basyir Idrus Alwi Ifransyah Fuadi, Ifransyah Ika Prasetya Wijaya Ikhwan Rinaldi Ilum Anam, Ilum Indra Marki Inge Sutanto Ingrid S. Surono Irfan Maulani Iris Rengganis Irsan Hasan Irwin Tedja Iskandar, Rizka Puteri Ivo Novita Sah Bandar Jacobus Albertus Jamhari Jamhari Jane Estherina Jeffri Gunawan Jeffry Beta Tenggara Jimmy Posangi Jonlean, Reganedgary Joseph JY Sung Judo Prihartono Julwan Pribadi Jumhana Atmakusuma Jusman, Sri W Kahar Kusumawidjaja, Kahar Kaka Renaldi Katharina Setyawati Kemalasari, Indira Kemalasari, Indira Khie Chen Khomimah Khomimah, Khomimah Kuntjoro Harimurti Laras Budiyani, Laras Liem, Isabella Kurna Liem, Isabella Kurnia Lies Luthariana Lili Indrawati Lusiani Rusdi, Lusiani M Purnomo Isnaeni M Usman SM Maharani, Shabrina Mansur, M. Tasrif Marcellus Simadibrata Marcellus Simadibrata K Marthino Robinson Maruhum B.H. Marbun Masayuki A Fujino Masayuki A. Fujino Masdalina Pane Maulana Suryamin, Maulana Meriza, Tanggo Minarma Siagian Moch Ikhsan Mokoagow Mochamad Iqbal Hassarief Putra, Mochamad Iqbal Hassarief Mohammad Adi Firmansyah Mondrowinduro, Prionggo Muhadi Muhadi, Muhadi Muhammad Artisto Adi Yussac MUHAMMAD SYAFIQ Muhammad Yamin Muhammad Yamin Lubis, Muhammad Yamin Mulia Mulia Mustikarani, Dewi Mutiara, Rizka Muzellina, Virly Nanda Nababan, Saut Horas H. Nana Supriana Nanda N. Muhammad, Nanda N. Nata Pratama Novie Rahmawati Zirta Nully Juariah M Nur Rasyid Nur Riviati, Nur Nury Dyah, Nury Oktarina, Caroline Pambudi, Joko Rilo Pamela Abineno Pamela Abineno Damaledo Pangarapen Tarigan Pangestu Adi Parhusip, Santi Sumihar Rumondang Pattiiha, Arief Paulus Kusnanto Paulus Simadibrata Pawitan , Jeanne Adiwinata Pradipta, Saraswati Primariadewi Rustamadji Purwantyastuti Purwantyastuti Purwita W Laksmi, Purwita W Purwoko, Reza Yuridian Rabbinu Rangga Pribadi Raden Nur Ista Rahmad Mulyadi, Rahmad Ralph Girson Rambe, Dirga S. Ratu Ratih Kusumayanti Raymond R. Tjandrawinata Riahdo Saragih Rianto Setiabudy Rino A Gani Rino Alvani Gani Rio Zakaria Risa Ismadewi, Risa Rizki Yaruntradhani Rozaliyan, Anna Rudi Putranto Rumagesan, Djahalia Rumende, Cleopas M. Ryan Ranitya Sabarudin, Adang Saleha Sungkar Salius Silih Sally Aman Nasution, Sally Aman Sari, Nina Kemala Sarwono Waspadji Sedijono Sedijono Seri Mei Maya Ulina Simadibrata, Daniel Martin Simanjuntak, Tiroy Sari Bumi Sirowanto Inneke Siti Setiati Soleha, Winna Sonar S. Panigoro Sri Wahdini Starry H. Rampengan Steven Sumantri Sudirman Katu, Sudirman Sugita, Peter Suhardjono Suhardjono Suharko Soebardi Suhendro Suhendro Suhendro Suwarto, Suhendro Sukamto Koesnoe Sumariyono Sumariyono Surono, Ingrid S Suryantini Suryantini Susanto, Liana W SUWIJIYO PRAMONO Suzana Ndraha Suzanna Immanuel Syari, Lucky Novita Tadashi Sato Tandan, Manu Tandarto, Kevin Telly Kamelia Tito Ardi Tjahjadi Robert Tedjasaputra Toman L Toruan Tonny Loho TR Fitriyani, TR Tri Juli Edi T Ummi Ulfah Madina, Ummi Ulfah Ummu Habibah, Ummu Velma Herwanto Vera Yuwono Wijaya, Anthony Eka Wirasmi Marwoto Wismandari Wisnu Wulandari, Yohannessa Wulyo Rajabto Yoga, Vesri Yohana Sitompul, Yohana Yonathan, I Wayan Murna Yuichiro Kojima Yundari, Yundari Yustar Mulyadi Zubairi Djoerban