Pengaruh Indeks Massa Tubuh terhadap Disease-Free Survival Lima Tahun Pasien Kanker Payudara di Rumah Sakit Kanker Dharmais Jakarta

WALTA GAUTAMA -  , Indonesia

DOI : 10.33371/ijoc.v10i1.410

There are some evidences that the metabolic changes in breast cancer patients with high body mass index (BMI) associated with insulin resistance and, in particular, the related alteration in cytokine production by adipose tissue which are major contributors to the aggressive behavior of breast cancer that develop through their effects in angiogenesis and stimulation of invasive capasity of cancer cells. Retrospective cohort study conducted at the Dharmais National Cancer Hospital aimed to determine the effect of BMI on five-year disease-free survival (DFS) breast cancer patients. This study was conducted from August to November 2014. The samples in this study were collected consecutively as many as 127 patients. From this study, it is known that the five-year DFS of breast cancer
patients was 70.0%. Based on the category of BMI, breast cancer patients with high BMI (>22.9 kg/m2) had the biggest DFS, followed by low BMI (<18.5 kg/m2) and normal BMI (18.5 22.9 kg/m2) that the precentages successively were 75.5%, 68.6%, and 60.4%. Multivariate analysis showed that BMI was not associated with the events of recurrence or metastases (HR 1.055; 95% CI 0.413-2.678) after being controlled by other variables, such as education, sosioeconomic, staging, lymph node involvement, histopathology, occupation, and biological subtypes.

Beberapa bukti menunjukkan perubahan metabolik pada pasien kanker payudara dengan indeks massa tubuh (IMT) tinggi berhubungan resistansi insulin dan khususnya perubahan terkait produksi sitokin oleh jaringan adiposa yang merupakan kontributor utama terhadap sifat agresif dari kanker payudara yang berkembang melalui pengaruhnya terhadap angiogenesis dan stimulasi kemampuan invasif dari sel kanker. Studi kohort retrospektif yang dilakukan di Rumah Sakit Kanker Dharmais ini bertujuan untuk mengetahui pengaruh IMT terhadap disease-free survival (DFS) lima tahun pasien kanker payudara. Penelitian ini dilakukan dari Agustus sampai November 2014. Sampel yang
digunakan pada studi ini diambil secara konsekutif sebanyak 127 pasien. Dari studi ini, diketahui bahwa DFS lima tahun pasien kanker payudara adalah 70,0%. Berdasarkan kategori IMT, pasien kanker payudara dengan IMT tinggi (>22,9 kg/m2) memiliki DFS lima tahun yang paling besar, yaitu 75,5% ; diikuti pasien dengan IMT rendah (<18,5 kg/m2) sebesar 68,6%; dan 60,4% untuk pasien dengan IMT normal (18,522,9 kg/m2). Hasil analisis multivariat menunjukkan bahwa IMT tidak memiliki asosiasi dengan kejadian kekambuhan atau metastase (HR=1,052, 95% CI 0,413-2,678) setelah dikontrol oleh variabel pendidikan, sosioekonomi, stadium, keterlibatan kelenjar getah bening, histopatologi, pekerjaan, dan subtipe biologis.

  1. Union for International Cancer Control. Estimates Of Worldwide Burden Of Cancer In 2008: Globocan 2008. Int. J. Cancer: 127, 28932917 (2010)
  2. Caldefie-Chezet F, Damez M, de Latour M, dkk. Leptin: A proliferative factor for breast cancer? Study on human ductal carcinoma. Biochem Biophys Res Commun 2005;334:73741
  3. Neels JG, Thinnes T, Loskutoff DJ. Angiogenesis in an in vivo model of adipose tissue development. Faseb J;18:9835. Epub: 14 April 2004
  4. Silha JV, Krsek M, Sucharda P, Murphy LJ. Angiogenic factors are elevated in overweight and obese individuals. Int J Obes 2005;29:130814
  5. Rose DP, Gilhooly EM, Nixon DW. Adverse effects of obesity on breast cancer prognosis and the biological actions of leptin (review). Int J Oncol 2002;21:128592
  6. Moon YW, dkk. Clinical Significance Of Progesterone Receptor And Her2 Status In Estrogen Receptor-Positive, Operable Breast Cancer With Adjuvant Tamoxifen. J Cancer Res Clin Oncol 2011 137: 1123-1130
  7. Nguyen PL, dkk.. Breast Cancer Subtype Approximated by Estrogen Receptor, Progesterone Receptor, and HER-2 Is Associated With Local and Distant Recurrence After Breast-Conserving Therapy. J Clin Oncol 2008 26:2373-2378. by American Society of Clinical Oncology
  8. Soerjomataram I, dkk. An Overview Of Prognostic Factors For Long-Term Survivors of Breast Cancer. Breast Cancer Res Treat (2008) 107:309-330. DOI 10.1007/s10549-007-9556-1.
  9. Springer Science and Business Media
  10. Turkoz FP, Solak M, Petekkaya I, dkk. The prognostic impact
  11. of obesity on molecular subtypes of breast cancer in premenopausal women. JBUON 2013; 18(2): 335-341
  12. Berclaz G, Li S, Price KN, dkk. Body Mass Index As A Prognostic Feature In Operable Breast Cancer: The International Breast Cancer Study Group Experience. Ann Oncol 2004
  13. :875 884
  14. Chen X, Lu W, Zheng W dkk. Obesity and weight change in relation to breast cancer survival. Breast Cancer Res Treat 2010; 122:823-833
  15. Yin N, Wang D, Zhang H, dkk. Molecular mechanisms involved in the growth stimulation of breast cancer cells by leptin. Cancer Res 2004;64:58705.

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Article Info
Submitted: 2016-05-12
Published: 2016-01-10
Section: Research Articles
Article Statistics: 244 322