Abstract
ABSTRACTThere 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 cancerpatients 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.ABSTRAKBeberapa 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 yangdigunakan 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.
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