Epidemiological Patterns Of Lung Adenocarcinoma With Pleural Metastasis: Lessons From RSUD Ahmad Yani Metro
Abstract
Latar Belakang: Efusi pleura ganas (EPG) merupakan manifestasi stadium lanjut dari berbagai keganasan, paling sering kanker paru, dan berhubungan dengan morbiditas yang tinggi serta prognosis yang buruk. Data epidemiologi menunjukkan bahwa laki-laki dan perokok lebih banyak terdampak, kemungkinan akibat paparan karsinogen dan risiko pekerjaan yang lebih tinggi.
Tujuan: Mendeskripsikan karakteristik demografi, distribusi pekerjaan, dan kebiasaan merokok pada pasien dengan diagnosis EPG, serta membahas kemungkinan penyebab dominasi kasus pada laki-laki dan perokok.
Metode: Penelitian deskriptif potong lintang dilakukan pada 77 pasien dengan EPG terkonfirmasi secara sitologi atau histopatologi. Data usia, jenis kelamin, pekerjaan, dan riwayat merokok diperoleh dari rekam medis dan dianalisis menggunakan statistik deskriptif.
Hasil: Mayoritas pasien berjenis kelamin laki-laki (59,4%) dan berusia >40 tahun (96,9%). Pekerjaan terbanyak adalah petani (37,5%), diikuti oleh pekerja konstruksi (15,6%). Sebagian besar pasien (62,5%) adalah perokok, dengan proporsi perokok berat mencapai 43,8%. Dominasi laki-laki perokok mencerminkan paparan karsinogen terkait tembakau dan debu pekerjaan yang lebih tinggi.
Kesimpulan: EPG lebih banyak ditemukan pada laki-laki usia lanjut dengan riwayat merokok signifikan dan pekerjaan berisiko tinggi. Upaya pencegahan sebaiknya difokuskan pada program berhenti merokok dan pengurangan paparan risiko pekerjaan pada kelompok ini.
Saran: Untuk mengatasi meningkatnya beban kanker paru-paru, beberapa strategi kunci direkomendasikan. Memperkuat program skrining kanker paru-paru sangat penting, terutama bagi kelompok berisiko tinggi seperti pria di atas 40 tahun, perokok berat, dan individu dengan paparan karsinogen tinggi di tempat kerja.
Kata kunci: adenokarsinoma paru, efusi pleura ganas, sitologi cairan pleura, merokok, paparan pekerjaan, Indeks Brinkman.
ABSTRACT
Background: Malignant pleural effusion (MPE) is a late-stage manifestation of various malignancies, most commonly lung cancer, and is associated with significant morbidity and poor prognosis. Epidemiological data indicate that men and smokers are disproportionately affected, possibly due to higher exposure to carcinogens and occupational hazards.
Objective: To describe the demographic characteristics, occupational distribution, and smoking habits of patients diagnosed with MPE, and to discuss possible explanations for the predominance among men and smokers.
Methods: A descriptive cross-sectional study was conducted on 77 patients with confirmed MPE. Data on age, gender, occupation, and smoking history were obtained from medical records and analyzed using descriptive statistics.
Results: The majority of patients were male (59.4%) and aged >40 years (96.9%). Farming was the most common occupation (37.5%), followed by construction work (15.6%). Most patients (62.5%) were smokers, with heavy smokers accounting for 43.8%. The predominance of male smokers reflects higher exposure to tobacco-related carcinogens and occupational dusts.
Conclusion: MPE is more prevalent in older males with significant smoking history and high-risk occupations. Preventive measures should target smoking cessation and reduction of occupational exposures in these groups.
SuggeStion To address the rising burden of lung cancer, several key strategies are recommended. Strengthening lung cancer screening programs is crucial, particularly for high-risk groups such as men over 40 years old, heavy smokers, and individuals with high occupational exposure to carcinogens.
Keywords : lung adenocarcinoma, malignant pleural effusion, pleural fluid cytology, smoking, occupational exposure, Brinkman Index.
Keywords
Full Text:
PDFReferences
Acencio, M. M. P., Marchi, E., Teixeira, L. R., Vargas, F. S., & Antonangelo, L. (2020). Evaluation of cellular alterations and inflammatory profile of mesothelial cells and/or neoplastic cells exposed to talc used for pleurodesis. Oncotarget, 11(41), 3730–3736. https://doi.org/10.18632/oncotarget.27750
Alberg, A. J., & Samet, J. M. (2003). Epidemiology of lung cancer. Chest, 123(1 Suppl), 21S–49S. https://doi.org/10.1378/chest.123.1_suppl.21S
Alsayed, S., Al-Ali, M., Al-Hashimi, H., & Al-Qudah, R. (2015). Malignant pleural effusion biomarkers as predictor for chemical pleurodesis success. Egyptian Journal of Chest Diseases and Tuberculosis, 64(1), 153–160. https://doi.org/10.1016/j.ejcdt.2014.08.005
American Cancer Society. (2023). Cancer facts & figures 2023. American Cancer Society. https://www.cancer.org
Aydin, Y., et al. (2009). Malignant pleural effusions: Appropriate treatment approaches. The Eurasian Journal of Medicine, 41(3), 186–193. http://www.ncbi.nlm.nih.gov/pubmed/25610100
Bibby, A. C., et al. (2018). ERS/EACTS statement on the management of malignant pleural effusions. European Respiratory Journal, 52(1), 1–23. https://doi.org/10.1183/13993003.00349-2018
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2022). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 72(3), 209–249. https://doi.org/10.3322/caac.21708
Charalampidis, C., et al. (2015). Physiology of the pleural space. Journal of Thoracic Disease, 7(Suppl 1), S33–S37. https://doi.org/10.3978/j.issn.2072-1439.2014.12.48
Divisi, D., & Crisci, R. (2021). Malignant pleural effusions. Journal of Xiangya Medicine, 6, 13–22. https://doi.org/10.21037/jxym-20-121
Dixit, R., et al. (2017). Diagnosis and management options in malignant pleural effusions. Lung India, 34(2), 160–166. https://doi.org/10.4103/0970-2113.201305
Ferlay, J., et al. (2021). Cancer statistics for the year 2020: An overview. International Journal of Cancer, 149(4), 778–789. https://doi.org/10.1002/ijc.33588
Goldstraw, P., et al. (2016). The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings. Journal of Thoracic Oncology, 11(1), 39–51. https://doi.org/10.1016/j.jtho.2015.09.009
Hirsch, F. R., Scagliotti, G. V., Mulshine, J. L., Kwon, R., Curran, W. J., Wu, Y. L., & Paz-Ares, L. (2017). Lung cancer: Current therapies and new targeted treatments. The Lancet, 389(10066), 299–311. https://doi.org/10.1016/S0140-6736(16)30958-8
International Agency for Research on Cancer (IARC). (2021). Global Cancer Observatory: Indonesia fact sheet. World Health Organization. https://gco.iarc.fr/today
Islami, F., Torre, L. A., & Jemal, A. (2015). Global trends of lung cancer mortality and smoking prevalence. Translational Lung Cancer Research, 4(4), 327–338. https://doi.org/10.3978/j.issn.2218-6751.2015.08.04
Jardins, T. D. (2012). The mediastinum. In T. D. Jardins (Ed.), Cardiopulmonary anatomy and physiology (6th ed., p. 46.8). Illinois: Department of Respiratory Care, Parkland College
Kementerian Kesehatan Republik Indonesia. (2019). Laporan Nasional Riskesdas 2018. Badan Penelitian dan Pengembangan Kesehatan. https://www.litbang.kemkes.go.id/laporan-riskesdas-2018
National Cancer Institute. (2023). SEER cancer statistics review. https://seer.cancer.gov
National Comprehensive Cancer Network (NCCN). (2023). NCCN clinical practice guidelines in oncology: Non-small cell lung cancer. https://www.nccn.org
Patel, M. I., et al. (2019). Challenges in managing malignant pleural effusion. Chest, 156(3), 536–547. https://doi.org/10.1016/j.chest.2019.05.008
Porcel, J. M. (2016). Malignant pleural effusion. Current Opinion in Pulmonary Medicine, 22(4), 356–361. https://doi.org/10.1097/MCP.0000000000000287
Rivera, M. P., Mehta, A. C., & Wahidi, M. M. (2013). Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 143(5 Suppl), e142S–e165S. https://doi.org/10.1378/chest.12-2353
Riskesdas. (2018). National Basic Health Research Report 2018. Ministry of Health of Indonesia.
Siegfried, J. M. (2014). Gender differences in lung cancer. Lung Cancer, 84(1), 1–3. https://doi.org/10.1016/j.lungcan.2014.02.001
Stayner, L., Kuempel, E., Gilbert, S., Hein, M., & Dement, J. (2008). An epidemiological study of the role of occupational asbestos exposure in the causation of lung cancer in men exposed to chrysotile asbestos. American Journal of Epidemiology, 167(5), 554–562. https://doi.org/10.1093/aje/kwm360
Travis, W. D., et al. (2015). The 2015 World Health Organization classification of lung tumors. Journal of Thoracic Oncology, 10(9), 1243–1260. https://doi.org/10.1097/JTO.0000000000000630
World Health Organization (WHO). (2020). WHO report on the global tobacco epidemic 2020. Geneva: WHO.
World Health Organization (WHO). (2023). Cancer fact sheet. https://www.who.int/news-room/fact-sheets/detail/cancer
Yoon, D. W., et al. (2021). Advances in pleural disease management. Journal of Thoracic Disease, 13(3), 1784–1798. https://doi.org/10.21037/jtd-20-3202
Zhang, Y., et al. (2022). Lung cancer epidemiology, prevention, and control. Chest, 162(5), 1302–1316. https://doi.org/10.1016/j.chest.2022.07.035
DOI: https://doi.org/10.33024/jkm.v11i8.22116
Refbacks
- There are currently no refbacks.
Copyright (c) 2025 JKM (Jurnal Kebidanan Malahayati)
Policies | Submissions | Other |
| Focus and Scope Section Policies Peer Review Process Publication Frequency Open Access Policy | Online Submissions Author Guidelines Copyright Notice Privacy Statement Author Fees | Journal Sponsorship Journal History Site Map About this Publishing System |



