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Rabbinu Rangga Pribadi
"ABSTRAK
Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harus
dievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),
namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukuran
kekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudah
dibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostik
KGT pada pasien kanker di Indonesia.
Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapis
malnutrisi pasien kanker rawat jalan di RSCM.
Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun di
poliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGT
dianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai dengan
menghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.
Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, dan
malnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT
pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf
dengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2%
dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4.
Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuan
berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasien
kanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT
Background: Malnutrition has a huge impact on cancer patients and therefore it
has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming
nature and the need of trained health personnels. Measurement of
HGS is faster and easier, but there is no sufficient information regarding its cutoff
point
and diagnostic
accuracy
for cancer
patients
in Indonesia.
Aim:
defining cut-off point and diagnostic accuracy of HGS as a malnutrition
screening modality for outpatient cancer population at RSCM.
Method: A cross-sectional study was conducted at RSCM oncology outpatient
clinic from May 4
th
-October 1
st
, 2015. Subjects were 18-59 years old. Cut-off
point and diagnostic accuracy of HGS were analyzed to generate sensitivity,
specificity, PPV, NPV, LR+, and LR- .
Result: The proportion of well nourished, moderately malnourished, and severely
malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal
HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf
respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV
92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4.
Conclusion: The optimal HGS cut-off point in male and female cancer patients
were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a
malnutrition screening modality in male and female cancer patients were good and moderately good.
;Background: Malnutrition has a huge impact on cancer patients and therefore it
has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming
nature and the need of trained health personnels. Measurement of
HGS is faster and easier, but there is no sufficient information regarding its cutoff
point
and diagnostic
accuracy
for cancer
patients
in Indonesia.
Aim:
defining cut-off point and diagnostic accuracy of HGS as a malnutrition
screening modality for outpatient cancer population at RSCM.
Method: A cross-sectional study was conducted at RSCM oncology outpatient
clinic from May 4
th
-October 1
st
, 2015. Subjects were 18-59 years old. Cut-off
point and diagnostic accuracy of HGS were analyzed to generate sensitivity,
specificity, PPV, NPV, LR+, and LR- .
Result: The proportion of well nourished, moderately malnourished, and severely
malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal
HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf
respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV
92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4.
Conclusion: The optimal HGS cut-off point in male and female cancer patients
were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a
malnutrition screening modality in male and female cancer patients were good and moderately good.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Hendra Koncoro
"Latar Belakang: Sarkopenia mempengaruhi prognosis karsinoma sel hati (KSH). Dalam penilaian klasifikasi Barcelona Clinic Liver Cancer (BCLC) terkandung penilaian status performa Eastern Cooperative Oncology Group (ECOG). Status performa ECOG merupakan penilaian aktivitas fisik terkait sarkopenia. Pemeriksaan baku emas sarkopenia pada KSH mahal dan membutuhkan banyak waktu. Pemeriksaan tebal otot paha dapat digunakan sebagai modalitas yang baru. Studi ini bertujuan untuk menilai hubungan antara status performa ECOG dengan sarkopenia pada KSH, mengetahui perbedaan rerata antara tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH, dan mengetahui perbedaan rerata antara tebal otot paha pasien sarkopenia dengan non sarkopenia pada KSH.
Metode: Studi ini dilakukan di RS tersier selama Januari – Oktober 2021. Analisis statistik dilakukan untuk memperoleh hubungan antara status performa ECOG, tebal otot paha, dan status sarkopenik pasien KSH.
Hasil: Delapan puluh lima subjek pasien KSH (usia median, 52 tahun) dilakukan analisis. Sarkopenia diamati pada 30,6% pasien KSH. Setelah melalui analisis multivariat, status performa ECOG buruk berhubungan dengan sarkopenia pada KSH (adjusted OR = 6,35, IK 95% 2,06-19,60). Terdapat perbedaan signifikan rerata tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH (p < 0,001). Terdapat juga perbedaan signifikan rerata tebal otot paha pasien sarkopenia dan non sarkopenia (p < 0,001).
Kesimpulan: Terdapat hubungan antara status performa ECOG tinggi dengan sarkopenia pada KSH (aOR = 6,35, IK 95% 2,06-19,60). Rerata tebal otot paha pasien status performa ECOG rendah lebih besar dibanding dengan status performa ECOG tinggi pada karsinoma sel hati. Rerata tebal otot paha pasien non sarkopenia lebih besar dibanding dengan sarkopenia pada karsinoma sel hati.

Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. HCC staging consists of Eastern Cooperative Oncology Group performance status (ECOG-PS). ECOG-PS is an assessment of physical activity related to sarcopenia. Gold standard examinations for sarcopenia in HCC are expensive and time-consuming. Thigh muscle thickness can be used as a new modality. This study was aimed to explore the association between ECOG-PS with sarcopenia, to seek thigh muscle thickness difference between poor and good performance status, and to know thigh muscle thickness difference between sarcopenic and non-sarcopenic patients with HCC.
Methods: The study was conducted in a tertiary hospital during January – October 2021. Statistical analysis was performed to obtain an association between ECOG-PS, thigh muscle thickness, and sarcopenic status of HCC patients.
Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 30,6% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 6,35, 95% CI 2,06-19,6, p < 0,001). There was a significant difference in thigh muscle thickness between good and poor performance status (p < 0,001). There was also a significant difference in thigh muscle thickness between sarcopenic and non-sarcopenic patients (p < 0,001).
Conclusion: There were association between ECOG-PS and sarcopenia in HCC (aOR = 6,35, IK 95% 2,06-19,60). Mean thigh muscle thickness was larger in HCC patients with good ECOG-PS than poor ECOG-PS. Mean thigh muscle thickness was larger in non-sarcopenic HCC patients than sarcopenic ones.
"
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library