CRITICAL APPRAISAL
Disusun oleh :
Nama……
NIM……..
Dosen Pembimbing :
dr. ……………………………
Nama : ………………..
NIM : …………….
PICO
• Population : pasien laki-laki penderita Renal cell cancer (kanker ginjal)
• Intervention : malnutrisi pasien kanker ginjal
• Comparison : asupan nutrisi yang cukup bagi pasien sebelum operasi
• Outcomes : untuk mengetahui prognosis survival pasien saat dilakukan tindakan
bedah nefrektomi
1
Preoperative Nutritional Status Is an Important Predictor of Survival in Patients
Undergoing Surgery for Renal Cell
Carcinoma
REVIEW JURNAL
Pendahuluan
Given the prognostic importance of preoperative malnutrition in surgical patients with other
malignancies and its potentially modifiable nature, the significance of nutritional deficiency
(ND) in patients with RCC remains a key question. We hypothesized that nutritional status
would be associated with worse survival in RCC patients undergoing radical or partial
nephrectomy.
Metoda
We performed a retrospective cohort study of 369 consecutive patients who underwent
radical or partial nephrectomy for locoregional RCC from 2003 to 2008. Patients with distant
metastases were excluded; however, patients were not excluded for the presence of direct
adrenal invasion, regional lymph node metastases, or tumor thrombus.
Hasil
Eighty-five patients (23%) were categorized as ND. Three-year overall and disease-specific
survival was 58.5% and 80.4% in the ND cohort compared with 85.4% and 94.7% in
controls, respectively (p < 0.001). ND remained a significant predictor of overall mortality
(hazard ratio [HR]: 2.41, 95% confidence interval [CI], 1.40–4.18) and diseasespecific
mortality (HR: 2.76; 95% CI, 1.17–6.50) after correcting for age, CCI, preoperative anemia,
stage, grade, and nodal status. This study is limited by its retrospective nature.
Kesimpulan
ND is associated with higher mortality in patients undergoing surgery for locoregional RCC,
independent of key clinical and pathologic factors. Given this mortality risk, it may be
important to address nutritional status preoperatively and counsel patients appropriately.
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APAKAH HASIL PENELITIAN TERSEBUT VALID?
A. Petunjuk Primer
1. Apakah terdapat sampel yang representatif, terdefinisi jelas, dan berada pada kondisi
yang sama dalam perjalanan penyakitnya?
B. Petunjuk sekunder
1. Apakah kriteria outcome yang digunakan obyektif dan tanpa bias?
2. Bila ditemukan subgrup dengan prognosis yang beda, apakah dilakukan adjustment untuk
faktor-faktor prognostik yang penting?
3
3. Apakah dilakukan validasi pada suatu kelompok independen (test-set)?
TIDAK
4
APA HASILNYA?
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APAKAH HASIL PENELITIAN INI DAPAT DIAPLIKASIKAN?
1. Apakah pasien dalam penelitian tersebut serupa dengan pasien saya?
YA