Rakhman, Nabila Athira (2026) Analisis Disease Free Survival Pasien Kanker Tiroid Menggunakan Regresi Cox Proportional Hazard Di Rumah Sakit Onkologi Surabaya. Other thesis, Institut Teknologi Sepuluh Nopember.
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Abstract
Kanker tiroid merupakan salah satu jenis kanker yang menyerang kelenjar tiroid dengan tingkat kekambuhan yang bervariasi antar pasien. Penelitian ini bertujuan untuk menggambarkan pola disease free survival pasien kanker tiroid di Rumah Sakit Onkologi Surabaya serta mengidentifikasi faktor-faktor yang memengaruhi risiko kekambuhan menggunakan metode Regresi Cox Proportional Hazard. Data yang digunakan merupakan data sekunder rekam medis pasien kanker tiroid periode 1 Januari 2011 hingga 17 Mei 2026 dengan jumlah subjek sebanyak 172 pasien. Variabel yang dianalisis meliputi usia pasien, jenis kelamin, jenis histologi, ukuran tumor, metastasis kelenjar getah bening, metastasis jauh, jenis operasi, radioablasi, dan terapi hormonal. Hasil uji dependensi antarkovariat menggunakan uji Pearson Chi-Square menunjukkan terdapat tujuh pasangan kovariat yang saling dependen pada taraf signifikansi 0,05. Hasil estimasi kurva Kaplan–Meier menunjukkan bahwa disease free survival rate pasien kanker tiroid pada follow-up lima tahun sebesar 74,2%. Berdasarkan pemodelan Regresi Cox Proportional Hazard dengan seleksi variabel menggunakan metode forward selection berbasis nilai AIC, diperoleh tiga variabel yang berpengaruh signifikan terhadap disease free survival pasien kanker tiroid, yaitu metastasis kelenjar getah bening dan radioablasi pada taraf signifikansi α = 0,05, serta usia pasien pada taraf signifikansi α = 0,1. Model terbaik yang terbentuk telah memenuhi asumsi proportional hazard baik secara visual melalui plot residual Schoenfeld maupun secara formal melalui uji Grambsch–Therneau. Nilai hazard ratio menunjukkan bahwa pasien dengan usia 55 tahun atau lebih memiliki risiko kekambuhan 1,85 kali lebih tinggi, pasien dengan metastasis kelenjar getah bening memiliki risiko kekambuhan 2,317 kali lebih tinggi, sedangkan pasien yang menjalani radioablasi memiliki risiko kekambuhan 93,3% lebih rendah dibandingkan kelompok pembandingnya.
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Thyroid cancer is a malignancy of the thyroid gland, with recurrence rates varying among patients. This study aims to describe the disease free survival pattern of thyroid cancer patients at Surabaya Oncology Hospital and to identify factors affecting recurrence risk using the Cox proportional hazard regression method. The data used were secondary data from medical records of thyroid cancer patients for the period of January 1, 2011 to May 17, 2026, with a total of 172 subjects. Variables analyzed included patient age, sex, histological type, tumor size, lymph node metastasis, distant metastasis, type of surgery, radioablation, and hormonal therapy. The Pearson Chi-Square test of dependency between covariates showed that seven pairs of covariates were significantly dependent at the 0.05 significance level. The Kaplan–Meier curve estimation showed that the disease free survival rate of thyroid cancer patients at five-year follow-up was 74.2%. Based on Cox proportional hazard regression modeling with variable selection using the AIC-based forward selection method, three variables were found to significantly influence disease free survival, namely lymph node metastasis and radioablation at the 0.05 significance level, and patient age at the 0.1 significance level. The best model satisfied the proportional hazard assumption both visually through Schoenfeld residual plots and formally through the Grambsch–Therneau test. The hazard ratio values indicate that patients aged 55 years or older have a 1.85 times higher recurrence risk, patients with lymph node metastasis have a 2.317 times higher recurrence risk, while patients who underwent radioablation have a 93.3% lower recurrence risk compared to their respective reference groups.
| Item Type: | Thesis (Other) |
|---|---|
| Uncontrolled Keywords: | Disease Free Survival, Forward Selection, Hazard Ratio, Kanker Tiroid, Regresi Cox Proportional Hazard, Cox Proportional Hazard Regression, Disease Free Survival, Forward Selection, Hazard Ratio, Thyroid Cancer |
| Subjects: | Q Science Q Science > QA Mathematics Q Science > QA Mathematics > QA278.2 Regression Analysis. Logistic regression R Medicine > R Medicine (General) R Medicine > R Medicine (General) > R853.S7 Survival analysis (Biometry) R Medicine > RC Internal medicine 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: | Nabila Athira Rakhman |
| Date Deposited: | 28 Jul 2026 07:24 |
| Last Modified: | 28 Jul 2026 07:24 |
| URI: | http://repository.its.ac.id/id/eprint/138755 |
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