R. Noviyani

DIFFERENCE OF SGOT AND SGPT LEVEL IN STADIUM IIB-IIIB SQUAMOUS CELL CERVICAL CANCER PATIENTS BEFORE AND AFTER CHEMOTHERAPY AT SANGLAH HOSPITAL DENPASAR

Introduction

difference of sgot and sgpt level in stadium iib-iiib squamous cell cervical cancer patients before and after chemotherapy at sanglah hospital denpasar. Investigate SGOT/SGPT levels in stage IIB-IIIB squamous cell cervical cancer patients before/after Paclitaxel Carboplatin chemotherapy. Research at Sanglah Hospital found no significant liver function difference.

Abstract

Objective:Cervical cancer became Indonesia’s highest prevalent gynecological cancer in 2013 and the highest prevalent gynecological cancer at Sanglah Hospital.Paclitaxel Carboplatin is one of the regimens used for cervical cancer treatment at Sanglah Hospital, Denpasar. Aside of providing therapeutic effect, this regimen also causes hepatotoxicity. This research was trying to determine the toxic effect of Paclitaxel Carboplatin towards liver function based on the difference of SGOT and SGPT levels before chemotherapy cycle I and after chemotherapy cycle VI. Method:This wasa prospective observational research with a study case method conducted from January 2017 until June 2017 at Obstetric Polyclinic of Sanglah Hospital, Denpasar.Samples’ SGOT and SGPT level before and after chemotherapy I and VI were recorded and were then analysed with Shapiro-Wilk normality test. If the data were distributed normally, they would undergo tpaired test and Wilcoxon test at 95% confidence level if they were not distributed normally. Results: Tenpatients fulfilled the research criteria. There was a meaningless increase for SGOT level (p=0.575) along with a meaningless increase for SGPT level (p=0.074) before and after Paclitaxel Carboplatin chemotherapy cycle I and VI respectively.Conclusion: Research of toxic effect from Paclitaxel Carboplatin chemotherapy in 10 squamous cell cervical cancer patients showed a meaningless difference of both SGOT and SGPT level with the value of p>0.05 in stadium IIB-IIIB squamous cell cervical cancer patients before and after Paclitaxel Carboplatin chemotherapy cycle I and VI respectively.

Review

This research addresses a clinically relevant question regarding the hepatotoxic effects of the Paclitaxel Carboplatin regimen in patients with advanced squamous cell cervical cancer (stadium IIB-IIIB). Given cervical cancer's prevalence in Indonesia and the widespread use of this chemotherapy, evaluating potential liver damage markers like SGOT and SGPT is highly pertinent for patient management and safety. The objective to determine the difference in these markers before and after chemotherapy cycles I and VI is clearly stated, and the prospective observational design provides a direct clinical assessment of the regimen's impact within a specific hospital setting. However, a significant limitation that substantially undermines the robustness of the findings is the extremely small sample size of ten patients. While the abstract reports a "meaningless increase" for both SGOT (p=0.575) and SGPT (p=0.074), these p-values are likely a reflection of insufficient statistical power rather than conclusive evidence of no hepatotoxic effect. With such a limited number of participants, even clinically relevant changes might not reach statistical significance, leading to a high risk of a Type II error. Furthermore, the observational nature, while practical, does not allow for robust control of confounding factors that might influence liver function, and the relatively short study period (January to June 2017) might miss delayed or cumulative toxic effects beyond the sixth cycle. The abstract's conclusion of a "meaningless difference" should therefore be interpreted with extreme caution, as it could merely indicate an underpowered study. In conclusion, while the study tackles an important clinical issue, its findings regarding the "meaningless difference" in SGOT and SGPT levels before and after Paclitaxel Carboplatin chemotherapy in advanced cervical cancer patients must be interpreted in light of severe methodological constraints, primarily the very small sample size. This preliminary data *suggests* that significant acute hepatotoxicity as measured by these markers might not be prevalent with this regimen in this specific patient group, but it is far from conclusive. To provide clinically actionable insights and validate these initial observations, future research is strongly recommended with a substantially larger cohort of patients. Expanding the scope to include other, potentially more sensitive markers of liver injury, longer follow-up periods, and potentially a comparative arm with other regimens would significantly enhance the clinical utility and scientific rigor of such investigations.

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