ANA AMELIA FIALHO DE OLIVEIRA HOFF
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
bookPart Síndromes endócrinas neoplásicas e paraneoplásicas(2022) JúNIOR, Delmar Muniz Lourenço; HOFF, Ana Amélia Fialho de Oliveira; ALMEIDA, Madson Queiroz de- Cytoreductive Surgery of the Primary Tumor in Metastatic Adrenocortical Carcinoma: Impact on Patients' Survival(2022) SROUGI, Victor; BANCOS, Irina; DAHER, Marilyne; LEE, Jeffrey E.; GRAHAM, Paul H.; KARAM, Jose A.; HENRIQUEZ, Andres; MCKENZIE, Travis J.; SADA, Alaa; BOURDEAU, Isabelle; POIRIER, Jonathan; VAIDYA, Anand; ABBONDANZA, Tiffany; KIERNAN, Colleen M.; RAO, Sarika N.; HAMIDI, Oksana; SACHITHANANDAN, Nirupa; HOFF, Ana O.; CHAMBO, Jose L.; ALMEIDA, Madson Q.; HABRA, Mouhammed Amir; V, Maria C. B. FragosoContext The role of cytoreduction of adrenocortical carcinoma (ACC) remains poorly understood. Objective To analyze the impact of cytoreductive surgery of the primary tumor in patients with metastatic ACC. Design and Setting We performed a multicentric, retrospective paired cohort study comparing the overall survival (OS) in patients with metastatic ACC who were treated either with cytoreductive surgery (CR group) or without cytoreductive surgery (no-CR group) of the primary tumor. Data were retrieved from 9 referral centers in the American-Australian-Asian Adrenal Alliance collaborative research group. Patients Patients aged >= 18 years with metastatic ACC at initial presentation who were treated between January 1, 1995, and May 31, 2019. Intervention Performance (or not) of cytoreductive surgery of the primary tumor. Main outcome and measures A propensity score match was done using age and the number of organs with metastasis (<= 2 or >2). The main outcome was OS, determined from the date of diagnosis until death or until last follow-up for living patients. Results Of 339 patients pooled, 239 were paired and included: 128 in the CR group and 111 in the no-CR group. The mean follow-up was 67 months. Patients in the no-CR group had greater risk of death than did patients in the CR group (hazard ratio [HR] = 3.18; 95% CI, 2.34-4.32). Independent predictors of survival included age (HR = 1.02; 95% CI, 1.00-1.03), hormone excess (HR = 2.56; 95% CI, 1.66-3.92), and local metastasis therapy (HR = 0.41; 95% CI, 0.47-0.65). Conclusion Cytoreductive surgery of the primary tumor in patients with metastatic ACC is associated with prolonged survival.
conferenceObject Cabozantinib versus placebo in patients (pts) with radioiodine-refractory (RAIR) differentiated thyroid cancer (DTC) who progressed after prior VEGFR-targeted therapy: Outcomes in prespecified subgroups based on histology subtypes.(2022) CAPDEVILA, Jaume; ROBINSON, Bruce; SHERMAN, Steven I.; JARZAB, Barbara; LIN, Chia-Chi; VAISMAN, Fernanda; HOFF, Ana; HITRE, Erika; BOWLES, Daniel W.; WILLIAMSON, Denise; OLIVER, Jennifer Wright; KEAM, Bhumsuk; BROSE, Marcia S.- HOW TO IDENTIFY CERVICAL TRAUMATIC NEUROMAS IN THE POST-OPERATIVE NECK DISSECTION: BRIEF REVIEW OF THE CERVICAL PLEXUS ULTRASOUND(2022) MARCOS, Vincius neves; KULCSAR, Marco aurelio vamondes; HOFF, Ana oliveira; CHAMMAS, Maria cristina; FREITAS, Ricardo miguel costa DEtraumatic neuromas (CTNs) are a non-neoplastic hyperplasia of damaged nerves and may be misinterpreted as metastatic lymph nodes during cervical ultrasound of patients with thyroid cancer after lateral neck dissection, resulting in unnecessary and painful fin-needle aspiration biopsy. The anatomy of the cervical plexus is challenging, and the correct identification and recognition of its neural roots and branches on ultrasound are key to the correct CTN diagnosis. This review outlines the US technique used to characterize CTNs in 10 standardized steps and describes the sonographic features of the cervical plexus, to assist the radiologist in the recognition of CTNs and their differentiation from lymph node metastases. (E-mail: viniciusnevesm@gmail. com) (c) 2022 World Federation for Ultrasound in Medicine & Biology. All rights reserved.
- Is there a role for diagnostic scans in the management of intermediate-risk thyroid cancer?(2022) DANILOVIC, Debora L. S.; COURA-FILHO, George B.; RECCHIA, Giulianna M.; CASTRONEVES, Luciana A.; MARUI, Suemi; BUCHPIGUEL, Carlos A.; HOFF, Ana O.; KOPP, PeterRadioiodine (RAI) is selectively recommended for intermediate-risk differentiated thyroid carcinomas (DTC). The information gleaned from pretherapy stimulated thyroglobulin levels (sTg) and diagnostic I-131 whole-body scans (DxWBS) to guide therapy remains controversial. The present study aimed at evaluating the impact of preablation sTg and DxWBS in the management of intermediate-risk DTC. A retrospective analysis of 301 intermediate-risk DTC patients submitted to total thyroidectomy and RAI therapy was performed. Pretherapy sTg and DxWBS and post-therapy WBS (RxWBS) findings were analyzed and compared to outcomes. Fifty-two patients (17.3%) had metastases diagnosed by DxWBS and/or RxWBS. The DxWBS identified 10.6% of patients with functioning metastases, including unexpected distant metastases. If combined with SPECT-CT, DxWBS detected RAI-avid metastases more frequently, particularly lymph node metastases (13.1% vs 4.2% planar WBS, P = 0.015). The DxWBS findings modified patient management in 8.3%. A pretherapy sTg <1 ng/mL was associated with a low false-negative rate for the presence of metastases (5.2%), and its performance in excluding metastasis was improved by a negative DxWBS (2.7% of patients with both negative exams had metastases in RxWBS). A sTg <1 ng/mL predicted statistically significant lower rates of recurrent/persistent disease and biochemical/structural incomplete responses. In conclusion, preablation sTg and DxWBS contribute to the detection of unknown or persistent metastatic disease in intermediate-risk DTC patients. A sTg <1 ng/mL in combination with a negative DxWBS is highly suggestive of the absence of remaining malignant disease, and one may consider deferring RAI ablation if both exams are negative. A stunning effect is rarely observed and it does not impair proper treatment of metastases.
conferenceObject Effect of Age on the Efficacy and Safety of Cabozantinib compared to Placebo in Patients with radioiodine-refractory (RAIR) differentiated Thyroid Cancer (DTC) who progressed after VEGFR-directed Therapy: Subgroup Analysis of the Phase 3 COSMIC 311 Study(2022) DUQUE-AFONSO, J.; ROBINSON, B.; I, S. Sherman; KRAJEWSKA, J.; LIN, C-C; VAISMAN, F.; HOFF, A. O.; HITRE, E.; BOWLES, D. W.; HERNANDO, J.; BANERJEE, K.; LEVYTSKYY, R. M.; OLIVER, J. W.; KEAM, B.; CAPDEVILA, J.; BROSE, M.- LIBRETTO-531: a phase III study of selpercatinib in multikinase inhibitor-naive RET-mutant medullary thyroid cancer(2022) WIRTH, Lori J.; BROSE, Marcia S.; ELISEI, Rossella; CAPDEVILA, Jaume; HOFF, Ana O.; I, Mimi Hu; TAHARA, Makoto; ROBINSON, Bruce; GAO, Ming; XIA, Meng; MAEDA, Patricia; SHERMAN, EricSelpercatinib is a first-in-class, highly selective and potent, central nervous system-active RET kinase inhibitor. In the phase I/II trial, selpercatinib demonstrated clinically meaningful antitumor activity with manageable toxicity in heavily pre-treated and treatment-naive patients with RET-mutant medullary thyroid cancer (MTC). LIBRETTO-531 (NCT04211337) is a multicenter, open-label, randomized, controlled, phase III trial comparing selpercatinib to cabozantinib or vandetanib in patients with advanced/metastatic RET-mutant MTC. The primary objective is to compare progression-free survival (per RECIST 1.1) by blinded independent central review of patients with progressive, advanced, multikinase inhibitor-naive, RET-mutant MTC treated with selpercatinib versus cabozantinib or vandetanib. Key secondary objectives are to compare other efficacy outcomes (per RECIST 1.1) and tolerability of selpercatinib versus cabozantinib or vandetanib. Plain language summary: Selpercatinib (also known by the brand name Retevmo (R)/Retsevmo (R)) is a new treatment available in multiple countries for people with advanced or metastatic RET-mutant medullary thyroid cancer (MTC). Thyroid cancer starts in your thyroid gland and may spread or metastasize to other parts of the body, including lungs, bones, and occasionally the brain, which means the cancer is likely to be advanced. Advanced thyroid cancer can be driven by a gene in your body, one of which is RET. This is a summary of the LIBRETTO-531 study which compares selpercatinib, which is a strong and selective inhibitor of RET, with two approved drugs, cabozantinib and vandetanib. Patients with advanced or metastatic RET-mutant MTC who have not already received treatment with kinase inhibitors are being enrolled. This trial will evaluate how long people during and after treatment live with the disease without it getting worse. Selpercatinib may affect both healthy cells and tumor cells, which can result in side effects, which will also be evaluated in this study. This study is active and currently recruiting new patients.
conferenceObject Cabozantinib (C) versus placebo (P) in patients (pts) with radioiodine-refractory (RAIR) differentiated thyroid cancer (DTC) who have progressed after prior VEGFR-targeted therapy: Outcomes in prespecified subgroups based on prior VEGFR-targeted therapy.(2022) HERNANDO, Jorge; CAPDEVILA, Jaume; ROBINSON, Bruce; SHERMAN, Steven I.; JARZAB, Barbara; LIN, Chia-Chi; VAISMAN, Fernanda; HOFF, Ana; HITRE, Erika; BOWLES, Daniel W.; SEN, Suvajit; OLIVER, Jennifer Wright; KEAM, Bhumsuk; BROSE, Marcia S.- Risk factors associated with disease-specific mortality in papillary thyroid cancer patients with distant metastases(2022) NUNES, Kamilla Schmitz; MATOS, Leandro Luongo; CAVALHEIRO, Beatriz Godoi; MAGNABOSCO, Felipe Ferraz; TAVARES, Marcos Roberto; KULCSAR, Marco Aurelio; HOFF, Ana Oliveira; KOWALSKI, Luiz Paulo; LEITE, Ana KoberPurpose Papillary thyroid carcinoma (PTC) is among the most curable cancer types. Even though uncommon, some patients present distant metastatic disease at diagnosis or during the follow-up and most of them have long-term survival. However, there continues to be controversies regarding what clinicopathological features are associated with mortality in these patients. This paper evaluates the factors related to poor disease-specific survival (DSS) in patients with metastatic PTC. Methods A retrospective cohort study included PTC patients with distant metastasis from a tertiary public oncological center. Clinicopathological features, treatment modalities, and outcome were reviewed. Results Between 1986 and 2014, 108 patients were diagnosed with metastatic PTC. In the multivariate analysis male sex (HR = 2.65; 95%CI: 1.08-6.53; P = 0.033), radioiodine refractory disease (HR = 9.50; 95%CI: 1.23-73.38; P = 0.031) and metastasis at multiple sites (HR = 5.91; 95%CI: 1.80-19.32; P = 0.003) were independent risk factors for death in patients with metastatic PTC. Conclusion Male patients with metastatic PTC, with radioiodine refractory disease and metastasis at multiple sites have a high risk of death.
- Treatment strategies for low-risk papillary thyroid carcinoma: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)(2022) WARD, Laura Sterian; SCHEFFEL, Rafael Selbach; HOFF, Ana O.; FERRAZ, Carolina; VAISMAN, FernandaIncreasingly sensitive diagnostic methods, better understanding of molecular pathophysiology, and well-conducted prospective studies have changed the current approach to patients with thyroid cancer, requiring the implementation of individualized management. Most patients with papillary thyroid carcinoma (PTC) are currently considered to have a low risk of mortality and disease persistence/recurrence. Consequently, current treatment recommendations for these patients include less invasive or intensive therapies. We used the most recent evidence to prepare a position statement providing guidance for decisions regarding the management of patients with low-risk PTC (LRPTC). This document summarizes the criteria defining LRPTC (including considerations regarding changes in the TNM staging system), indications and contraindications for active surveillance, and recommendations for follow-up and surgery. Active surveillance may be an appropriate initial choice in selected patients, and the criteria to recommend this approach are detailed. A section is dedicated to the current evidence regarding lobectomy versus total thyroidectomy and the potential pitfalls of each approach, considering the challenges during long-term follow-up. Indications for radioiodine (RAI) therapy are also addressed, along with the benefits and risks associated with this treatment, patient preparation, and dosage. Finally, this statement presents the best follow-up strategies for LRPTC after lobectomy and total thyroidectomy with or without RAI. Arch Endocrinol Metab. 2022;66(4):522-32