MARCELO SIMAS DE LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
conferenceObject Probe-Based Confocal Endomicroscopy May Improve the Diagnosis of Clinical Complete Response After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Neoplasia(2018) SAFATLE-RIBEIRO, Adriana; MARQUES, Carlos; PIRES, Clelma; BABA, Elisa; MEIRELLES, Luciana; FARAJ, Sheila; ARRAES, Livia; ARAUJO, Diogo; GUSMON, Carla; KAWAGUTI, Fabio; LENZ, Luciano; SIMAS, Marcelo; MARTINS, Bruno; NAHAS, Caio; NAHAS, Sergio; RIBEIRO JR., Ulysses; MALUF FILHO, Fauze- Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer(2018) GUSMON-OLIVEIRA, Carla Cristina; KUBOKI, Yeda Mayumi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; MARTINS, Bruno Costa; TOLENTINO, Luciano Lenz; SAFATLE-RIBEIRO, Adriana Vaz; KULCSAR, Marco Aurelio; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground. Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis. Patients and methods. This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks. Results. From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial. Conclusion. The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.
- Long-term result of endoscopic treatment of an ampullary adenoma with extension into the common bile duct(2018) SCOMPARIN, Rodrigo Corsato; BENTO, Luiza Haendchen; BATISTA, Clelma Pires; LIMA, Marcelo Simas de; PAULO, Gustavo Andrade de; MARTINS, Bruno Costa; MALUF-FILHO, Fauze
- Self-expandable metal stent for malignant esophagorespiratory fistula: predictive factors associated with clinical failure(2018) RIBEIRO, Maria Sylvia Ierardi; MARTINS, Bruno da Costa; LIMA, Marcelo Simas de; FRANCO, Matheus Cavalcante; SAFATLE-RIBEIRO, Adriana Vaz; MEDEIROS, Vitor de Sousa; BASTOS, Victor Rossi; KAWAGUTI, Fabio Shiguehissa; SALLUM, Rubens Antonio Aissar; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and Aims: Malignant esophagorespiratory fistulas (MERFs) usually are managed by the placement of self-expandable metal stents (SEMSs) but with conflicting results. This study aimed to identify risk factors associated with clinical failure after SEMS placement for the treatment of MERFs. Methods: This was a retrospective analysis of a prospectively maintained database used at a tertiary-care cancer hospital, with patients treated with SEMS placement for MERFs between January 2009 and February 2016. Logistic regression was used to identify predictive factors for clinical outcomes and to estimate the odds ratio (OR) and the 95% confidence interval (CI). The Kaplan-Meier method was used for survival analysis, and comparisons were made by using the log-rank test. Results: A total of 71 patients (55 male, mean age 59 years) were included in the study, and 70 were considered for the final analysis (1 failed stent insertion). Clinical failure occurred in 44% of patients. An Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4 and fistula development during esophageal cancer treatment were associated with an increased risk of clinical failure. ECOG status of 3 or 4, pulmonary infection at the time of SEMS placement, and prior radiation therapy were predictive factors associated with lower overall survival. Dysphagia scores improved significantly 15 days after stent insertion. The overall stent-related adverse event rate was 30%. Stent migration and occlusion caused by tumor overgrowth were the most common adverse events. Conclusion: SEMS placement is a reasonable treatment option for MERFs; however, ECOG status of 3 or 4 and fistula development during esophageal cancer treatment may be independent predictors of clinical failure after stent placement.
conferenceObject CLINICAL AND ENDOSCOPIC FEATURES OF METASTASES TO THE GASTROINTESTINAL TRACT(2018) BENTO, Luiza H.; MINATA, Mauricio K.; PIRES, Clelma Batista; SCOMPARIN, Rodrigo Corsato; LENZ, Luciano; LIMA, Marcelo S. de; MARTINS, Bruno da Costa; GUSMON, Carla C.; KAWAGUTI, Fabio S.; PENNACCHI, Caterina; GEIGER, Sebastian N.; UEMURA, Ricardo S.; FRANCO, Matheus C.; PAULO, Gustavo A. de; BABA, Elisa R.; SAFATLE-RIBEIRO, Adriana V.; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- Probe-based confocal endomicroscopy is accurate for differentiating gastric lesions in patients in a Western center(2018) SAFATLE-RIBEIRO, Adriana Vaz; BABA, Elisa Ryoka; SCOMPARIN, Rodrigo Corsato; FARAJ, Sheila Friedrich; LIMA, Marcelo Simas de; LENZ, Luciano; MARTINS, Bruno Costa; GUSMON, Carla; KAWAGUTI, Fabio Shiguehissa; PENNACCHI, Caterina; ZILBERSTEIN, Bruno; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeObjective: Probe-based confocal laser endomicroscopy (pCLE) technique may improve the diagnosis of gastric mucosal lesions allowing acquisition of high-resolution in vivo images at the cellular and microvascular levels. This study aims to evaluate the accuracy of pCLE for the differential diagnosis of non-neoplastic and neoplastic gastric lesions. Methods: Twenty gastric mucosal lesions from 10 patients were evaluated during endoscopic procedure and were examined by pCLE. Diagnostic pCLE was followed by biopsies or endoscopic resection of suspected lesions. A senior pathologist evaluated the specimens and was blinded to the pCLE results. Results: Patients' mean age was 68.3 (range, 42-83) years and six were men. Thirteen suspicious flat or elevated lesions (classified as 0-Is, 0-IIa or 0-IIa + IIc) and seven pre-malignant lesions (atrophy and intestinal metaplasia) were evaluated. One patient was studied during his long-term follow-up after partial gastrectomy and presented severe atrophy, intestinal metaplasia, and xanthomas at the stump mucosa. The location of gastric lesions was in the body (n=10 lesions), the antrum (n=9) and the incisura angularis (n=1). All neoplastic lesions and all but one benign lesion were properly diagnosed by pCLE. pCLE incorrectly diagnosed one small antrum lesion as adenoma, however the final diagnosis was intestinal metaplasia. The final histological diagnosis was neoplastic in 9 and benign lesions in 11. In this small case series, pCLE accuracy was 95% (19/20 lesions). Conclusions: pCLE is accurate for real time histology of gastric lesions. pCLE may change the management of patients with gastric mucosal lesions, guiding biopsies and endoscopic resection, and avoiding further diagnostic workup or unnecessary therapy.