Karakteristik Klinikopatologik dan Luaran Klinik Pasien Ependimoma Di Rsup Dr. Kariadi Semarang
(1) Fakultas Kedokteran Universitas Diponegoro
(2) Rumah Sakit Umum Pusat Dr. Kariadi
(3) Rumah Sakit Umum Pusat Dr. Kariadi
(4) Rumah Sakit Umum Pusat Dr. Kariadi
(5) Rumah Sakit Umum Pusat Dr. Kariadi
(*) Corresponding Author
Abstract
Latar Belakang: Ependimoma merupakan salah satu penyumbang kematian akibat tumor intrakranial pada anak, karena beberapa dari subgrup tumor ini memiliki sifat agresifitas dan prognosis buruk terkait etiologi molekuler yang medasari tumor tersebut. Dilaporkan 2 subgrup yang memiliki prognosis buruk serta memiliki angka kematian yang tinggi, yaitu ST-EPN-RELA (RELA fusion) dan PF-EPN-A. Penelitian ini bertujuan untuk melihat perbedaan karakteristik klinikopatologik dan luaran klinik pasien ependimoma di RSUP Dr. Kariadi Semarang.
Metode: Penelitian dengan desain deskriptif analitik, dilakukan pada 31 kasus pasien terdiagnosis histopatologik ependimoma (28 kasus primer, 3 kasus berulang) periode 1 Januari 2017 hingga Desember 2021. Sampling dengan cara consecutive sampling, berdasarkan kriteria eksklusi dan inklusi usia, jenins kelamin, diagnsosis histopatologik (seluruh subtipe ependimoma), grading WHO, tindakan pembedahan, rekurensi dan laporan kematian. Analisis data menggunakan uji beda exact fischer dengan kemaknaan p:<0.05.
Hasil: Jumlah sampel yang didapatkan 31 kasus, sebagian besar terdiagnosis sebagai supratentorial ependimoma (100%) dengan mayoritas WHO grade II (33,3%), diderita oleh mayoritas laki-laki (52,9%) dan pasien sebagian besar berusia > 18 tahun. Dari 31 kasus ditemukam meninggal (50%), kasus berulang (100%) dan sisanya sembuh. Terdapat perbedaan bermakna luaran pasien dengan berbagai kelompok usia (p=0,036) dan dan kelompok menurut grading WHO (p=0,049).
Kesimpulan: Terdapat perbedaan bermakna antara luaran klinik pasien ependimoma, berdasarkan kelompok usia dan WHO grading.
Keywords
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Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 world health organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016; 131(6):803–20.
Pagès M, Pajtler KW, Puget S, Castel D, Boddaert N, Tauziède-Espariat A, et al. Diagnostics of pediatric supra-tentorial RELA ependymomas: inte-gration of information from histopathology, ge-netics, DNA methylation and imaging. Brain Pathol. 2019; 29 (3):325–35.
Perilongo G, Massimino M, Sotti G, Belfontali T, Masiero L, Rigobello L, et al. Analyses of prognostic factors in a restrospective review of 92 children with ependymoma: Italian Pediatric Neuro-oncology Group. Med Pediatr Oncol. 1997;29(2):79–85.
Peris-Bonet R, Martínez-García C, Lacour B, Petrovich S, Giner-Ripoll B, Navajas A, et al. Childhood central nervous system tumours - incidence and survival in Europe (1978-1997): report from automated childhood can-cer information system project. Eur J Cancer. 2006;42(13):2064–80.
World Health Organization. Global cancer observatory [Internet]. Inter-national agency for research on cancer. 2019. Available from: https://gco. iarc. fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf
Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Child’s Nerv Syst. 2001;17(9):503–11.
Pajtler KW, Witt H, Sill M, Jones DTW, Hovestadt V, Kratochwil F, et al. Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell. 2015;27(5):728–43.
Dahlan MS. Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan3. Jakarta: Salemba Medika; 2010.
Tiara Aninditha, Wiratman W. Buku ajar neurologi. Aninditha T, Wiratman W, editors. Jakarta: Departemen Neuro-logi Fakultas Kedokteran Universitas Indonesia; 2019.p. 103–137.
Guyotat J, Signorelli F, Desme S, Frappaz D, Madarassy G, Fevre Montange M, et al. Intracranial ependymomas in adult patients: analyses of prognostic factors. J Neurooncol. 2002;60(3):255–68.
American Brain Tumor Association. About brain tumors: a primer for patients and caregivers. Chicago: American Brain Tumor Association; 2015. p. 1–80. Avail-able from: https://www.abta.org/publi-cations/about-brain-tumors-a-primer-for-patients-and-caregivers/
Benesch M, Mynarek M, Witt H, Warmuth-Metz M, Pietsch T, Bison B, et al. Newly diagnosed metastatic intracranial ependymoma in children: frequency, molecular characteristics, treatment, and outcome in the prospective HIT series. Oncologist. 2019;24(9):e921 –9.
Lim KY, Lee K, Shim Y, Park JW, Kim H, Kang J, et al. Molecular subtyping of ependymoma and prognostic impact of Ki-67. Brain Tumor Pathol. 2022;39 (1):1–13.
Amirian ES, Armstrong TS, Aldape KD, Gilbert MR, Scheurer ME. Pre-dictors of survival among pediatric and adult ependymoma cases: A study using surveillance, epidemiology, and end results data from 1973 to 2007. Neuroepidemiology. 2012;39(2):116–24.
Lombardi G, Puppa A Della, Pizzi M, Cerretti G, Bonaudo C, Gardiman MP, et al. An overview of intracranial epen-dymomas in adults. Cancers (Basel). 2021;13(23).
Sun T, Plutynski A, Ward S, Rubin JB. An integrative view on sex differences in brain tumors. Cell Mol Life Sci. 2015;72(17):3323–42.
Gilmore TD, Herscovitch M. Inhibitors of NF-κB signaling: 785 and counting. Oncogene. 2006;25(51):6887–99.
Labbozzetta M, Notarbartolo M, Poma P. Can nf-κb be considered a valid drug target in neoplastic diseases? our point of view. Int J Mol Sci. 2020;21(9).
Hoesel B, Schmid JA. The complexity of NF-κB signaling in inflammation and cancer. Cell. 1986;46(5):705–16.
Kiefel H, Bondong S, Hazin J, Ridinger J, Schirmer U, Riedle S, et al. L1CAM: A major driver for tumor cell invasion and motility. Cell Adhes Migr. 2012;6 (4):374–84.
Yonezawa U, Karlowee V, Amatya VJ, Takayasu T, Takano M, Takeshima Y, et al. Radiology profile as a potential instrument to differentiate between posterior fossa ependymoma (PF-EPN) group a and b. World Neurosurg. 2020; 140:e320–7.
Massimino M, Miceli R, Giangaspero F, Boschetti L, Modena P, Antonelli M, et al. Final results of the second prospective AIEOP protocol for pediatric intracranial ependymoma. Neuro Oncol. 2016;18(10):1451–60.
Kresbach C, Neyazi S, Schüller U. Updates in the classification of epen-dymal neoplasms: The 2021 WHO clas-sification and beyond. Brain Pathol. 2022;32(4):1–11.
Wu J, Armstrong TS, Gilbert MR. Biology and management of ependy-momas. Neuro Oncol. 2016;18 (7): 902 –13.
Spiegler BJ, Bouffet E, Greenberg ML, Rutka JT, Mabbott DJ. Change in neurocognitive functioning after treat-ment with cranial radiation in childhood. J Clin Oncol. 2004; 22(4):706–13.
Indelicato DJ, Bradley JA, Rotondo RL, Nanda RH, Logie N, Sandler ES, et al. Outcomes following proton therapy for pediatric ependymoma. Acta Oncol (Madr). 2017;57(5):644–8.
Antony R, Wong KE, Patel M, Olch AJ, McComb G, Krieger M, et al. A retrospective analysis of recurrent in-tracranial ependymoma. Pediatr Blood Cancer. 2014;61:1195–201.
Feldman WB, Clark AJ, Safaee M, Ames CP, Parsa AT. Tumor control after surgery for spinal myxopapillary ependymomas: Distinct outcomes in adults versus children. J Neurosurg Spine. 2013;19(4):471–6.
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DOI: https://doi.org/10.26714/medart.4.2.2022.8-16
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Faculty of Medicine, Universitas Muhammadiyah Semarang
Jl. Kedungmundu Raya No. 18, Semarang, Indonesia
Email: medica.arteriana@unimus.ac.id