Faktor-faktor prognostik pada glioma: sebuah tinjauan pustaka
https://doi.org/10.22146/bns.v20i2.105951 Yudhanto Utomo(1*), Kusumo Dananjoyo(2), Indarwati Setyaningsih(3)
(1) SMF Saraf RSA Universitas Gadjah Mada, Yogyakarta
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta/RSUP Dr Sardjito
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta/RSUP Dr Sardjito
(*) Corresponding Author
Abstract
In adults, glioma is one of the most common primary brain tumors apart from meningioma. Gliomas account for one-third of all primary brain tumors. Half of gliomas are malignant and considered as lethal tumors. Because of its malignant nature, glioma is still one of the most difficult tumors to treat. The characteristics of gliomas naturally vary in spectrum and degree. The WHO classification has considered genetic aspects such as IDH mutation, 1p/19q codeletion, TERT mutation, ATRX mutation, and others in determining the diagnosis of glioma and in assessing patient prognosis as well. In general, gliomas are classified as either low-grade (LGG) or high-grade (HGG) tumors. The two groups have different characteristics, and cause different morbidity and recurrence. A number of factors including clinical, histopathologic and genetic factors of glioma have been studied in the last decade. The role of these factors in determining glioma prognosis deserves attention. These factors can be recognized from the time the glioma causing the initial clinical manifestations to the time when the diagnosis is made. This will help clinicians objectively detect glioma early, make accurate diagnoses, manage glioma, and measure the likelihood of therapeutic success and outcomes. To date, prognostic factors that have positive or negative significance on glioma patient outcomes are still being developed and studied. This literature review aims to further examines and summarizes the factors that have significance to the clinical prognosis of glioma.
ABSTRAK
Pada orang dewasa, glioma merupakan salah satu tumor primer otak yang paling banyak ditemui selain meningioma. Glioma memiliki insidensi mencapai sepertiga dari seluruh kasus tumor primer otak. Setengah dari glioma merupakan tumor ganas yang bersifat lethal. Karena sifat malignanya, sampai saat ini gloma masih menjadi salah satu tumor yang sulit ditangani. Karakteristik glioma secara alamiah memiliki spektrum dan derajat yang beragam. Klasifikasi oleh WHO telah mempertimbangkan aspek genetik seperti halnya profil mutasi IDH, kodelesi 1p/19q, mutasi TERT, mutasi ATRX, dan lainnya dalam penentuan diagnosis glioma dan termasuk menilai prognosis pasien. Secara umum, glioma dikelompokkan sebagai tumor derajat rendah (LGG) maupun derajat tinggi (HGG). Kedua kelompok tersebut memiliki karakteristik yang berbeda, serta menimbulkan morbiditas dan rekurensi yang berbeda. Sejumlah faktor mencakup faktor klinis, histopatologis, dan genetis glioma banyak diteliti dalam dekade terakhir. Peran faktor-faktor tersebut dalam menentukan prognosis glioma perlu mendapatkan perhatian. Faktor-faktor tersebut dapat dikenali sejak glioma menimbulkan manifestasi klinis awal sampai dengan saat telah tegak diagnosis. Hal tersebut membantu klinisi secara objektif dalam melakukan deteksi dini, ketepatan diagnosis, tata laksana, dan mengukur kemungkinan keberhasilan terapi serta luaran yang mungkin dicapai. Hingga saat ini, faktor-faktor prognostik yang memiliki signifikansi positif maupun negatif terhadap luaran pasien glioma tersebut masih terus berkembang dan dipelajari. Tinjauan pustaka ini bertujuan untuk mengkaji lebih dalam dan merangkum mengenai faktor-faktor yang memiliki signifikansi terhadap prognosis glioma secara klinis.
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