Analisis Disease Free Survival Pada Pasien Kanker Payudara Stadium III Di Rumah Sakit Onkologi Surabaya Menggunakan Regresi Cox

Sari, Adienda Safira Nurmala (2025) Analisis Disease Free Survival Pada Pasien Kanker Payudara Stadium III Di Rumah Sakit Onkologi Surabaya Menggunakan Regresi Cox. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Kanker payudara merupakan salah satu jenis kanker dengan angka insidensi dan kematian tertinggi di dunia, termasuk di Indonesia. Berdasarkan data Global Burden of Cancer (2022), kanker payudara menjadi penyebab kematian tertinggi pada wanita. Di Indonesia, lebih dari 80% kasus kanker payudara ditemukan pada stadium lanjut, sehingga memperburuk prognosis dan meningkatkan risiko kekambuhan. Salah satu indikator penting untuk menilai keberhasilan pengobatan dan kekambuhan adalah Disease-Free Survival (DFS), yaitu periode waktu pasien tetap bebas dari kekambuhan setelah dinyatakan remisi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang memengaruhi Disease-Free Survival pasien kanker payudara stadium III yang telah menjalani pembedahan dan mencapai remisi di Rumah Sakit Onkologi Surabaya. Analisis dilakukan menggunakan model regresi Cox, dengan pengujian asumsi proportional hazard melalui uji residual Schoenfeld dan uji Grambsch Therneau. Karena variabel status HER2 tidak memenuhi asumsi, digunakan pendekatan Stratified Cox Regression. Hasil analisis menunjukkan bahwa estimasi DFS rate 3 tahun pada pasien adalah sebesar 88,1%, menunjukkan tingkat remisi yang cukup tinggi dalam kurun waktu tersebut. Model terbaik dipilih berdasarkan nilai AICc terkecil, dan melibatkan variabel kemoterapi neoadjuvant serta radioterapi sebagai prediktor signifikan. Masing-masing memiliki hazard ratio sebesar 1,898 dan 1,833, yang menunjukkan bahwa pasien dengan terapi tersebut memiliki risiko kekambuhan yang lebih tinggi. Hal tersebut dapat mengindikasikan bahwa terapi tersebut lebih sering diberikan pada pasien dengan kondisi yang lebih berat sehingga perlu dilakukan evaluasi kembali dalam pemilihan variabel pengambilan data.
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Breast cancer is one of the leading causes of cancer incidence and mortality worldwide, including in Indonesia. According to the Global Burden of Cancer (2022), breast cancer ranks as the top cause of cancer-related deaths among women. In Indonesia, over 80% of breast cancer cases are diagnosed at an advanced stage, complicating treatment outcomes and increasing the risk of recurrence. One of the key indicators to evaluate treatment success and recurrence is Disease-Free Survival (DFS), defined as the length of time after treatment during which a patient remains free from cancer recurrence. This study aims to analyze the factors affecting Disease-Free Survival among stage III breast cancer patients who have undergone surgery and achieved remission at the Oncology Hospital Surabaya. The analysis was conducted using the Cox proportional hazards model, with the proportional hazards assumption tested using Schoenfeld residuals and Grambsch Therneau Test. Due to a violation of this assumption by the HER2 status variable, a Stratified Cox Regression model was applied. The results showed that the estimated 3-year DFS rate was 88.1%, indicating a relatively high remission rate during the observed period. The best-fitting model, selected based on the smallest AICc value, identified neoadjuvant chemotherapy and radiotherapy as significant predictors, with hazard ratios of 1.898 and 1.833, respectively. These findings suggest that patients receiving these therapies may have a higher risk of recurrence, potentially reflecting more severe initial disease conditions. Therefore, reevaluation in data collection and treatment selection is recommended.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	Disease Free Survival, Kanker payudara, Kombinasi Pengobatan, Regresi Cox Proportional hazard, Regresi Stratified Cox, Remisi, Disease Free Survival, Breast cancer, Treatment Combination, Cox proportional hazard regression, Stratified Cox Regression, Remission
Subjects:	Q Science > QA Mathematics > QA278.2 Regression Analysis. Logistic regression R Medicine > R Medicine (General) > R853.S7 Survival analysis (Biometry) R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science and Data Analytics (SCIENTICS) > Statistics > 49201-(S1) Undergraduate Thesis
Depositing User:	Adienda Safira Nurmala Sari
Date Deposited:	24 Jul 2025 09:31
Last Modified:	24 Jul 2025 09:31
URI:	http://repository.its.ac.id/id/eprint/121363

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