Hubungan antara Nilai Serum Alkali Fosfatase dengan Skor Huvos dan Tingkat Rekurensi pada Kasus Osteosarkoma

Oleh :
Arie Kurniawan - S932002001 - Fak. Kedokteran

Introduction: Osteosarcoma is a common bone cancer, frequently occurring in individuals aged 10-14 years and over 65 years, particularly in the metaphyses of long bones. In Indonesia, the incidence of osteosarcoma is relatively high, with 219 cases at Cipto Mangunkusumo Hospital from 1995-2007. Although treatments such as chemotherapy can achieve remission, recurrence occurs in 30-40% of patients. Contributing factors include residual cancer cells and chemotherapy resistance. Tumor markers such as alkaline phosphatase (ALP) can be used to monitor therapy and recurrence.Methods: This study uses an observational analytic design with a prospective cohort and cross-sectional approach, conducted at Dr. Moewardi Regional General Hospital and Prof. Dr. R. Soeharso Orthopedic Hospital in Surakarta from July to December 2024. The study subjects were osteosarcoma patients who had undergone neoadjuvant chemotherapy and limb salvage/ablative surgery. The sample was taken using purposive sampling, consisting of 13 respondents. Data analysis was performed using Spearman Rank correlation and Eta tests to examine the relationship between ALP levels, HUVOS scores, and recurrence in patients.Results: This study involved 13 osteosarcoma patients at Dr. Moewardi Regional General Hospital and Prof. Dr. R. Soeharso Orthopedic Hospital. The results showed a decrease in serum ALP levels after chemotherapy (p=0.0499). However, no significant relationship was found between ALP (pre, post, and Δ ALP) and HUVOS scores (p>0.05) or recurrence events (p>0.05). Despite differences in ALP distribution between recurrent and non-recurrent groups, statistical analysis did not support ALP as a strong indicator for recurrence in osteosarcoma.Conclusion: This study shows that there is no relationship between pre-neoadjuvant chemotherapy ALP levels, post-neoadjuvant chemotherapy ALP levels, and HUVOS scores. Therefore, it can be concluded that ALP cannot be used as a tumor marker to represent the level of tumor cell necrosis after neoadjuvant chemotherapy in osteosarcoma patients. Additionally, low ALP levels do not show a linear correlation with tissue necrosis levels.