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Abstrak :
Latar belakang : Tumor ganas adneksa mata merupakan keganasan epitel yang berasal dari kelopak mata, konjungtiva dan kelenjar kelenjar yang berada pada jaringan tersebut. Tumor ini sebenarnya mempunyai prognosis baik bila diobati pada stadium dini. Metode : Dilakukan studi historical cohort dengan survival analysis. Subyek adalah penderita tumor ganas adneksa mata yang berobat ke poliklinik subbagian Tumor Mata FKUI/RSUPN Dr. Cipto Mangunkusumo pada periode 1 Januari 1996 sampai 31 Desember 2000 mendapat tindakan operasi. Analisis data menggunakan cara cox proportional hazard dan analisis life table menurut metode Kaplan-Meier. Hasil : Dari 74 penderita tumor ganas adneksa mata didapat angka harapan hidup 74.24%. Penderita terbanyak adalah karsinoma sel skuamosa (51.4%), karsinoma set basal (28.4%), adenokarsinoma (14.8%) dan melanoma maligna (5.4%). Metastasis memberikan resiko tertinggi terhadap kematian HR 51.69(9.72-274.76), kelompok tumor karsinoma sel skuarnosa - adenokarsinoma HR 4.91 (0.62-38.81), penderita mendapat tambahan radiasi HR 10.72(1.25-92.18), dan jenis operasi eksenterasi HR 7.63(1.59-36.48) Kesimpulan : Faktor resiko yang berhubungan dengan kematian adalah metastasis, kelompok tumor karsinoma sel skuamosa dan adenokarsinoma, dilakukan tindakan radiasi dan tindakan eksenterasi orbita. ......Background : Malignant eye adnexa tumor originates from epithelium of eye lid, conjunctiva, and nodes of those tissues. The prognosis of this tumor is good if it is treated during the initial stadium. Method : A historical cohort study was carried out with survival analysis. The subject of the study were patients with malignant eye adnexa tumor who went to Sub-division of Eye Tumor FKUI/RSUPN Dr. Cipto Mangunkusumo from the period of January I, 1996 to December 31, 2000 and received surgical treatment. Data analysis used was cox proportional hazard and life table analysis with Kaplan Meier method. Result : From 74 patients with malignant eye adnexa tumor we obtained a survival rate of 74.24%. Most of them suffer from squamous cell carcinoma (51.4%), basal cell carcinoma (28.4%), adenocarcinoma (14.8%) and melanoma maligna (5.4%). Metastasis contributes to a high risk of death HR 51.69 (9.72-274.76), squamous cell carcinoma - adenocarcinoma group type HR 4.91 (0.62-38.81), patients receiving additional radiation treatment HR 10.72 (1.25-92.18), and exenteration HR 7.63 (1.59-36.48). Conclusion : The risk factor which causes death is metastasis, squamous cell carcinoma and adenocarcinoma group type, radiation treatment and exenteration of the orbit were done.

Abstrak :
Latar Belakang: Skrining kanker kulit dilakukan sebagai salah satu upaya dalam mengurangi morbiditas dan mortalitas yang ditimbulkan akibat kanker kulit. Karsinoma sel basal (KSB) merupakan salah satu kanker kulit yang paling sering ditemukan. KSB berpigmen seringkali menunjukkan fitur klinis yang menyerupai melanoma, sehingga kriteria klinis ABCDE diduga dapat menjadi salah satu pilihan dalam membantu penegakan diagnosis. Tujuan: Mengevaluasi kriteria klinis ABCDE sebagai alat bantu skrining KSB berpigmen dibandingkan dengan baku emas histopatologik. Metode: Penelitian potong lintang analitik ini dilakukan pada bulan Januari sampai dengan Juni 2023 di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSUPNCM). Pasien dengan lesi tumor kulit berpigmen dari tahun 2017 sampai dengan 2022 yang mempunyai data klinis, histopatologis, dan foto dokumentasi yang lengkap direkrut ke dalam penelitian secara konsekutif. Kriteria eksklusi mencakup lesi berukuran lebih dari 2 cm, ras kulit putih (tipe kulit Fitzpatrick 1-3), serta hasil pembacaan histopatologis lesi tumor sesuai dengan penyakit prakanker dan kanker kulit lainnya. Data diolah secara statistik menggunakan perangkat lunak Stata versi 16 (StataCorpTM) dan Medcalc diagnostic evaluation test calculator. Hasil: Sebanyak 84 pasien direkrut ke dalam penelitian dengan total 95 lesi yang mencakup 61 lesi KSB dan 34 lesi non-KSB. Median usia subjek KSB lebih tua dibandingkan dengan usia subjek non-KSB (p<0,001). Median ukuran lesi KSB lebih besar dibandingkan dengan ukuran lesi non-KSB (p<0,001). Lesi pada subjek KSB lebih banyak di wajah dibandingkan dengan subjek non-KSB (p=0,005). Proporsi kepositivan KSB berdasarkan kriteria klinis ABCDE adalah 87,5%. Kriteria klinis ABCDE menunjukkan sensitivitas 57,4% (interval kepercayaan [IK] 95% 44,0%–70,0%); spesifisitas 85,3% (IK 95% 68,9%–95,0%); nilai duga positif 87,5% (IK 95% 75,2%–94,2%); nilai duga negatif 52,7% (IK 95% 44,7%–60,6%); dan akurasi 67,4% (IK 95% 57,0%–76,6%) dalam mendiagnosis KSB berpigmen. Kesimpulan: Kriteria klinis ABCDE secara lengkap mempunyai nilai diagnostik yang kurang baik sebagai alat bantu skrining KSB berpigmen. ......Background: Skin cancer screening is performed as an effort to reduce the morbidity and mortality caused by skin cancer. Basal cell carcinoma (BCC) is one of the most common skin cancers. Pigmented BCC often shows clinical features resembling melanoma, so that ABCDE clinical criteria are thought to be a potential modality to help establishing the diagnosis of pigmented BCC. Objective: To evaluate the ABCDE clinical criteria for the screening of pigmented BCC compared to histopathological examination as the gold standard examination. Method: This analytical cross-sectional study was performed from January to June 2023 in dr. Cipto Mangunkusumo National Central General Hospital (RSUPNCM). Subjects with pigmented skin lesions visiting RSUPNCM from 2017 to 2022 whose clinical data, histopathological data, and photographs were documented completely were recruited to the study consecutively. Exclusion criteria included lesion’s size more than 2 cm, light skin (Fitzpatrick skin type 1-3), and histopathological diagnosis in line with precancerous lesion or other skin cancer. Data were analyzed with Stata software version 16 (StataCorpTM) and Medcalc diagnostic evaluation test calculator. Results: A total of 84 subjects were recruited to the study with a total of 95 lesions consisting of 61 BCC lesions and 35 non-BCC lesions. Median age of the BCC subjects was older than that of non-BCC subjects (p<0.001). Median lesion’s size of the BCC lesions was larger than that of non-BCC lesions (p<0.001). The lesion location in BCC subjects was significantly prevalent on the face (p=0.005). The proportion of BCC positivity based on ABCDE clinical criteria was 87.5%. ABCDE criteria had sensitivity of 57.4% (95% Confidence Interval [CI] 44.0%–70.0%); specificity of 85.3% (95% CI 68.9%–95.0%); PPV of 87.5% (95% CI 75.2%–94.2%); NPV of 52.7% (95% CI 44.7%–60.6%); and accuracy of 67.4% (95% CI 57.0%–76.6%) in diagnosing pigmented BCC. Conclusion: Fulfilling all ABCDE clinical criteria had poor diagnostic value for the screening of pigmented BCC.