Faktor Yang Berpengaruh Terhadap Kesintasan Kanker Kolorektal di Rs.Dr. Soetomo
Downloads
Kanker Kolorektal (KKR) merupakan salah satu penyebab mortalitas tinggi, dengan berbagai faktor prognostik yang memengaruhi kesintasan pasien. Analisis kesintasan penting untuk meningkatkan kualitas pelayanan terapeutik. Penelitian ini bertujuan untuk mengetahui tingkat kesintasan 12, 36, dan 60 bulan serta menganalisis faktor prognostik yang memengaruhi kesintasan pasien KKR di RSUD Dr. Soetomo (RSDS) Surabaya. Metode yang digunakan adalah analitik observasional retrospektif (cross-sectional) terhadap rekam medis 681 pasien KKR yang didiagnosis periode 2012–2017. Data dianalisis secara statistik dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan bahwa kesintasan 12 bulan dipengaruhi secara signifikan oleh peningkatan CEA (HR 1,641) dan Ca19-9 (HR 2,167), jenis kelamin laki-laki (HR 1,747), serta diabetes tidak terkontrol (HR 3,096), sementara merokok berhubungan dengan peningkatan kesintasan. Pada kesintasan 36 bulan, faktor yang menurunkan kesintasan meliputi peningkatan CEA (HR 2,095), Ca19-9 (HR 2,743), BMI <18,5 (HR 4,9), serta stadium 3 (HR 11,6) dan 4 (HR 11,9). Sementara itu, pada kesintasan 60 bulan, hanya stadium 3 yang secara signifikan menurunkan kesintasan (HR 11,5). Implikasi dari penelitian ini adalah identifikasi faktor prognostik spesifik berdasarkan lokasi tumor dan waktu kesintasan dapat menjadi dasar klinis dalam penyusunan strategi pemantauan dan penatalaksanaan pasien KKR yang lebih personal dan efektif, khususnya dalam konteks sumber daya terbatas.
Adila, A., & Mustika, S. E. (2023). Hubungan usia dan jenis kelamin terhadap kejadian kanker kolorektal. Jurnal Kedokteran STM (Sains Dan Teknologi Medik), 6(1), 53–59.
American Cancer Society. (2017). Colorectal cancer facts & figures 2017–2019. American Cancer Society. https://doi.org/10.1016/S0140-6736(13)61649-9
Astuti, N. S. A., Rafli, R., & Zeffira, L. (2019). Profil dan kesintasan penderita kanker kolorektal di RSUP Dr. M. Djamil Padang. Health and Medical Journal, 1(1), 45–49.
Chen, W., Tan, X.-P., Ye, J.-W., Liu, Q., Zeng, Q., Wang, L., & Wang, J.-P. (2014). Effect of bowel obstruction on stage IV colorectal cancer. Molecular and Clinical Oncology, 2(2), 308–312. https://doi.org/10.3892/mco.2014.240
Cho, S., Shin, A., & Park, S. K. (2015). Alcohol drinking, cigarette smoking, and risk of colorectal cancer in the Korean multi-center cancer cohort. Cancer Research and Treatment, 20(2), 147–152.
Colibaseanu, D., Shahjehan, F., Cochuyt, J., Li, Z., Merchea, A., & Kasi, P. M. (2018). Body mass index and long-term outcomes in patients with colorectal cancer. Journal of Clinical Oncology, 36(15_suppl), e15631. https://doi.org/10.1200/JCO.2018.36.15_suppl.e15631
Daniel, C. R., Shu, X., Ye, Y., Gu, J., Raju, G. S., Kopetz, S., & Wu, X. (2016). Severe obesity prior to diagnosis limits survival in colorectal cancer patients evaluated at a large cancer centre. British Journal of Cancer, 114(1), 103–109. https://doi.org/10.1038/bjc.2015.424
Li, J., Liu, J., Gao, C., Liu, F., & Zhao, H. (2017). Increased mortality for colorectal cancer patients with preexisting diabetes mellitus: An updated meta-analysis. Oncotarget, 8(37), 62478–62488. https://doi.org/10.18632/oncotarget.19923
Limsui, D., Vierkant, R. A., Tillmans, L. S., Wang, A. H., Weisenberger, D. J., Laird, P. W., … Limburg, P. J. (2010). Cigarette smoking and colorectal cancer risk by molecularly defined subtypes. Journal of the National Cancer Institute, 102(14), 1012–1022. https://doi.org/10.1093/jnci/djq201
Majek, O., Gondos, A., Jansen, L., Emrich, K., Holleczek, B., Katalinic, A., … Brenner, H. (2013). Sex differences in colorectal cancer survival: Population-based analysis of 164,996 colorectal cancer patients in Germany. PLOS ONE, 8(7), e68077. https://doi.org/10.1371/journal.pone.0068077
Mohd Suan, M. A., Tan, W. L., Soelar, S. A., Ismail, I., & Abu Hassan, M. R. (2015). Intestinal obstruction: Predictor of poor prognosis in colorectal carcinoma? Epidemiology and Health, 37, e2015017. https://doi.org/10.4178/epih.e2015017
Phipps, A. I., Baron, J., & Newcomb, P. A. (2011). Prediagnostic smoking history, alcohol consumption, and colorectal cancer survival. Cancer, 117(21), 4948–4957. https://doi.org/10.1002/cncr.26114
Putra, Y. R. (2025). Peran prognostik microsatellite instability (MSI) dan ekspresi programmed death-ligand 1 (PD-L1) terhadap kesintasan hidup pasien kanker kolorektal [Tesis]. Universitas Gadjah Mada.
Razi, K., Yusuf, M., Meildi, M., Subhan, N., & Romi, R. (2025). Survival rate penderita kanker kolorektal di RSUD Dr. Zainoel Abidin tahun 2022–2024. Journal of Syntax Literate, 10(9).
Siegel, R., Miller, K., & Jemal, A. (2019). Cancer statistics, 2019. CA: A Cancer Journal for Clinicians, 69(1), 7–34.
Sinicrope, F., Foster, N., Sargent, D., O’Connell, M., & Rankin, C. (2010). Obesity is an independent prognostic variable in colon cancer survivors. Journal of Clinical Oncology, 28(25), 3754–3760.
Stiksma, J., Grootendorst, D. C., & van der Linden, P. W. G. (2014). CA 19-9 as a marker in addition to CEA to monitor colorectal cancer. Clinical Colorectal Cancer, 13(4), 239–244. https://doi.org/10.1016/j.clcc.2014.09.004
Van Eeghen, E. E., Bakker, S. D., van Bochove, A., & Loffeld, R. J. L. F. (2015). Impact of age and comorbidity on survival in colorectal cancer. Journal of Gastrointestinal Oncology, 6(6), 605–612. https://doi.org/10.3978/j.issn.2078-6891.2015.070
Walter, V., Jansen, L., Hoffmeister, M., Ulrich, A., Chang-Claude, J., & Brenner, H. (2015). Smoking and survival of colorectal cancer patients: Population-based study from Germany. International Journal of Cancer, 137(6), 1433–1445. https://doi.org/10.1002/ijc.29511
White, A., Ironmonger, L., Steele, R. J. C., Ormiston-Smith, N., Crawford, C., & Seims, A. (2018). A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK. BMC Cancer, 18(1), 1–11. https://doi.org/10.1186/s12885-018-4786-7
Wiratkapun, S., Kraemer, M., Seow-Choen, F., Ho, Y. H., & Eu, K. W. (2001). High preoperative serum carcinoembryonic antigen predicts metastatic recurrence in potentially curative colonic cancer. Diseases of the Colon & Rectum, 44(2), 231–235. https://doi.org/10.1007/BF02234298
Zhao, H., Chen, D., Cao, R., Wang, S., Yu, D., Liu, Y., Jiang, Y., Xu, M., Luo, J., & Wang, S. (2018). Alcohol consumption promotes colorectal carcinoma metastasis via a CCL5-induced and AMPK-pathway-mediated activation of autophagy. Scientific Reports, 8(1), 1–11. https://doi.org/10.1038/s41598-018-26856-w
Zhao, J., Zhu, Y., Wang, P., West, R., Buehler, S., Sun, Z., … Campbell, P. (2012). Interaction between alcohol drinking and obesity in relation to colorectal cancer risk: A case-control study in Newfoundland and Labrador, Canada. BMC Public Health, 12, 94.
Copyright (c) 2026 Ledia Ledia, Mamiek Dwi Putro, Vicky S Budipramana, Heru Purwanto, Fransiscus Arifin
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
