ANDRE LOPES DE FARIAS E SILVA

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
  • article 2 Citação(ões) na Scopus
    Role of systematic pelvic and para-aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy cycles for high-grade serous ovarian carcinoma
    (2021) LOPES, Andre; GENTA, Maria L. N. D.; MIRANDA, Vanessa da Costa; ARANHA, Andrea; LOPEZ, Rossana V. M.; PIATO, Dariane S. A. M.; ANTON, Cristina; CARVALHO, Filomena M.; DIZ, Maria del Pilar Esteves; CARVALHO, Jesus P.
    Introduction We analyzed the role of systematic pelvic and para-aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy (NACT) cycles for advanced high-grade serous ovarian carcinoma. Materials and Methods We retrospectively reviewed patients with advanced ovarian carcinoma who underwent NACT with carboplatin-paclitaxel between 2008 and 2016. Patients were included only if they had FIGO IIIC-IVB high-grade serous carcinoma with clinically negative lymph nodes after six NACT cycles (carboplatin-paclitaxel) and underwent complete or near complete cytoreduction. Patients with partial lymphadenectomy or bulky nodes were excluded. Patients who underwent systematic pelvic and aortic lymphadenectomy and those who did not undergo lymph node dissection were compared. Progression-free and overall survivals were analyzed using the Kaplan-Meier method. Results Totally, 132 patients with FIGO IIIC-IVB epithelial ovarian carcinoma were surgically treated after NACT. Sixty patients were included (39 and 21 in the lymphadenectomy and nonlymphadenectomy group, respectively); 40% had suspicious lymph nodes before NACT. Patient characteristics, blood transfusion numbers, and complication incidence were similar between the groups. In the lymphadenectomy group, 12 patients (30.8%) had histologically positive lymph nodes and the surgical time was longer (229 vs. 164 min). The median overall survival in the lymphadenectomy and nonlymphadenectomy groups, respectively, was 56.7 (95% CI 43.4-70.1) and 61.2 (21.4-101.0) months (p = 0.934); the corresponding disease-free survival was 8.1 (6.2-10.1) and 8.3 (5.1-11.6) months (p = 0.878). Six patients exclusively presented with lymph node recurrence. Conclusions Systematic lymphadenectomy after six NACT cycles may have no influence on survival.
  • article 17 Citação(ões) na Scopus
    Cardiophrenic lymph node resection in cytoreduction for primary advanced or recurrent epithelial ovarian carcinoma: a cohort study
    (2019) LOPES, Andre; COSTA, Ronaldo Lucio Rangel; PAULA, Raphael di; ANTON, Cristina; CALHEIROS, Ytauan; SARTORELLI, Vivian; KANASHIRO, Yara Mitie; LIMA, Joao Alves de; YAMADA, Alayne; PINTO, Gabriel Lowndes de S.; VIANNA, Maria Regina; GENTA, Maria Luiza Nogueira Dias; RIBEIRO, Ulysses; SANTOS, Marcelo Oliveira dos
    Objectives To evaluate the clinical outcomes of epithelial ovarian carcinoma patients who underwent cardiophrenic lymph node resection. Methods We retrospectively reviewed the records of all surgically treated patients with advanced epithelial ovarian carcinoma (stages IIIC-IV) who underwent cardiophrenic lymph node resection between 2002 and 2018. Only those in whom cardiophrenic lymph node involvement was the only detectable extra-abdominal disease were included. Patients with suspected cardiophrenic lymph node metastasis on staging images underwent a transdiaphragmatic incision to access the para-cardiac space after complete abdominal cytoreduction achievement. Data on disease-free survival, overall survival, and surgical procedures performed concurrently with cardiophrenic lymph node resection were collected. Results Of the total 456 patients, 29 underwent cardiophrenic lymph node resection; of these, 24 patients met the inclusion criteria. Twenty-two, one, and one patients had high grade serous epithelial ovarian carcinoma, low grade epithelial ovarian carcinoma, and ovarian carcinosarcoma, respectively. Ten patients had recurrent disease (recurrence group). Fourteen patients underwent cytoreduction during primary treatment (primary debulking group); four underwent cytoreduction after neoadjuvant chemotherapy. Cardiophrenic lymph node resection was performed on the right side in 19 patients, left side in three, and bilaterally in two. The average procedural duration was 28 minutes, with minimal blood loss and no severe complications. Twenty-one patients had cardiophrenic lymph node positivity. The median disease-free intervals were 17 and 12 months in the recurrent and primary debulking surgery groups, respectively. The mediastinum was the first recurrence site in 10 patients. Five patients developed brain metastases. Five patients had an overall survival beyond 50 months. Conclusions Although rare, the cardiophrenic lymph nodes may be a site of metastasis of ovarian cancer. Although their presence might indicate future recurrence, some patients may achieve long-term survival. Resection should be considered in cases of suspicious involvement to confirm extra-abdominal disease and achieve complete cytoreduction.
  • article 3 Citação(ões) na Scopus
    Brazilian Society of Surgical Oncology consensus on fertility-sparing surgery for cervical cancer
    (2022) BAIOCCHI, Glauco; TSUNODA, Audrey Tieko; GUITMANN, Gustavo; VIEIRA, Marcelo Andrade; ZANVETTOR, Paulo Henrique; SILVESTRE, Janiceli Blanca Carlotto Hablich; SANTOS, Marcelo Henrique; SACRAMENTO, Raquel de Maria Maues; ARAUJO, Eliel Oliveira de; LOPES, Roberto Heleno; FALCAO, Deraldo; LOPES, Andre; SCHMIDT, Ronaldo; LYRA, Jorge Soares; ALMEIDA, Herbert Ives Barretto; CASTELEINS, William Augusto; CINTRA, Georgia Fontes; ZANINI, Lucas Adalberto Geraldi; REIS, Rosilene Jara; COELHO, Eid Goncalves; FIN, Fabio Roberto; REZENDE, Viviane; PANCAN, Thais Dvulatk Marques; VIEIRA, Sabas Carlos; SILVA, Jeancarllo Sousa; ANDRADE, Manoel Rodrigues de; CARNEIRO, Vandre Cabral Gomes; FOIATO, Tariane Friedrich; RITT, Guilherme Fonteles; IANAZE, Gustavo Castro; MORETTI-MARQUES, Renato; ANDRADE, Carlos Eduardo Mattos Cunha; MACIEL, Luiza Freitas; LIRA, Daniel Lourenco; MEDEIROS, Gustavo Mendes; LEITE, Amanda Lira Santos; CUCOLICCHIO, Guilherme Oliveira; TAYEH, Muhamed Read Ali; CRUZ, Ricardo Pedrini; GUTH, Gustavo Ziggiatti; LEAL, Renato Mazon Lina Verde; MAGNO, Valentino Antonio; LOPES, Francisco Carlos Oliveira; LAPORTE, Gustavo Andreazza; PUPO-NOGUEIRA, Alexandre; BARROS, Aldo Vieira; CUNHA, Juliano Rodrigues da; PESSINI, Suzana Arenhart; BRAGANCA, Joana Froes; FIGUEIREDO, Higino Felipe; LOUREIRO, Carlos Manoel Bulcao; BOCANEGRA, Ronald Enrique Delgado; AFFONSO, Renato Jose; FERNANDES, Paulo Henrique de Souza; RIBEIRO, Heber Salvador Castro; BATISTA, Thales Paulo; OLIVEIRA, Alexandre Ferreira; RIBEIRO, Reitan
    Objective Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer. Methods The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. Results The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition). Conclusions As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
  • article 0 Citação(ões) na Scopus
    Pregnancy after sugery and brachytherapy for vaginal cancer
    (2023) GERBASI, Giovana Junqueira; DECKERS, Paula; KANAGUCHI, Giuliana; PASTORE, Caroline B. P.; CINTRA, Georgia Fontes; MAIA, Maria Aparecida Conte; LOPES, Andre
    Introduction: Primary vaginal cancer is infrequent, corresponding to 1-2% of all female genital tract cancer diagnoses.Treatment for vaginal cancer varies depending on tumor histology, size, location and staging, and may include one or more of the following: surgical excision, radiation therapy and/or chemotherapy. All treatments negatively affect fertility/pregnancy outcomes.Pelvic radiation therapy, even in doses < 2 Gy, may extinguish up to 50% of immature oocytes. In addition, radiotherapy may cause modifications in cervical length, loss of uterine junctional zone anatomy and lead to myometrial atrophy and fibrosis, increasing the risk for adverse pregnancy outcomes.Methods: Case report of a patient who carried a pregnancy to term after surgery and brachytherapy for vaginal cancer.Results: A 28 year-old woman, presented with a 3 cm right midvagina wall tumor, diagnosed as grade 2, vaginal squamous cell carcinoma - FIGO 2009, stage IB. Computed tomography showed no evidence of lymph node involvement or distant metastasis. The patient underwent surgery followed by 4 fractions of vaginal brachytherapy, once a week, with a dose of 6 Gy at a 5 mm depth, amounting to a total dose of 24 Gy. One year and 9 months after treatment, the patient gave birth to a healthy child at 39 weeks pregnancy. A Csection was needed due functional dystocia during labor. Conclusion: This case report recounts a successful pregnancy carried to term after surgery and brachytherapy for squamous cell vaginal cancer.
  • article 1 Citação(ões) na Scopus
    Persistent postoperative ascites successfully identified and treated with laparoscopic indocyanine green fluorescence
    (2020) FERNANDES, Rodrigo; ANTON, Cristina; LOPES, Andre; SILVA, Alexandre Silva e; LEBLANC, Eric; JR, Ulysses Ribeiro; CARVALHO, Jesus Paula
  • article 4 Citação(ões) na Scopus
    Ten years of experience with endometrial cancer treatment in a single Brazilian institution: Patient characteristics and outcomes
    (2020) ANTON, Cristina; KLEINE, Rodolpho Truffa; MAYERHOFF, Eric; DIZ, Maria del Pilar Esteves; FREITAS, Daniela de; CARVALHO, Heloisa de Andrade; CARVALHO, Joao Paulo Mancusi de; SILVA, Alexandre Silva e; GENTA, Maria Luiza Nogueira Dias; SILVA, Andre Lopes de Faria e; SALIM, Rafael Calil; ARANHA, Andrea; LOPEZ, Rossana Veronica Mendoza; CARVALHO, Filomena Marino; BARACAT, Edmund Chada; CARVALHO, Jesus Paula
    Few reports have described the clinical and prognostic characteristics of endometrial cancer, which is increasing worldwide, in large patient series in Brazil. Our objective was to analyze the clinicopathological characteristics, prognostic factors, and outcomes of patients with endometrial cancer treated and followed at a tertiary Brazilian institution over a 10-year period. This retrospective study included 703 patients diagnosed with endometrial cancer who were treated at a public academic tertiary hospital between 2008 and 2018. The following parameters were analyzed: age at diagnosis, race, body mass index, serum CA125 level before treatment; histological type and grade, and surgical stage. Outcomes were reported relative to histological type, surgical staging, serum CA125, lymph-vascular space involvement (LVSI), and lymph-node metastasis. The median patient age at diagnosis was 63 (range, 27-93) years (6.4% were < 50 years). Minimally invasive surgeries were performed in 523 patients (74.4%). Regarding histological grade, 468 patients (66.5%) had low-grade endometrioid histology and 449 patients (63.9%) had stage I tumors. Tumors exceeded 2.0 cm in 601 patients (85.5%). Lymphadenectomy was performed in 551 cases (78.4%). LVSI was present in 208 of the patients' tumors (29.5%). Ninety-three patients (13.2%) had recurrent tumors and 97 (13.7%) died from their malignant disease. The robust prognostic value of FIGO stage and lymph node status were confirmed. Other important survival predictors were histological grade and LVSI [overall survival: hazard ratio (HR) = 3.75, p < 0.001 and HR = 2.01, p = 0.001; recurrence: HR = 2.49, p = 0.004 and HR = 3.22, p = 0.001, respectively). Disease-free (p = 0.087) and overall survival (p = 0.368) did not differ significantly between patients with stage II and III disease. These results indicate that prognostic role of cervical involvement should be explored further. This study reports the characteristics and outcomes of endometrial cancer in a large population from a single institution, with systematic surgical staging, a predominance of minimally invasive procedures, and well-documented outcomes. Prognostic factors in the present study population were generally similar to those in other countries, though our patients' tumors were larger than in studies elsewhere due to later diagnosis. Our unexpected finding of similar prognoses of stage II and III patients raises questions about the prognostic value of cervical involvement and possible differences between carcinomas originating in the lower uterine segment versus those originating in the body and fundus. The present findings can be used to guide public policies aimed at improving the diagnosis and treatment of endometrial cancer in Brazil and other similar countries.
  • conferenceObject
    OVARIAN TUMOR IN PATIENTS WITH PREVIOUS GASTROINTESTINAL CARCINOMA
    (2019) NOBREGA, F.; ANTON, C.; SILVA, A. Lopes de Farias e; GENTA, M. L. Nogueira Dias; CARVALHO, J. P. Mancusi de; CARVALHO, J. Paula
  • conferenceObject
    HISTOPATHOLOGICAL RESPONSE ON CLINICORADIOLOGICAL PRESENTATION AND PROGNOSIS OF PATIENTS WITH ADVANCED HIGH GRADE SEROUS OVARIAN CARCINOMA TREATED WITH NEOADJUVANT CHEMOTHERAPY
    (2019) LOPES, A.; GENTA, M. L. Nogueira D.; MIRANDA, V. da Costa; LOPEZ, R. V. Mendonza; CARVALHO, F. Marino; CARVALHO, J. Paula
  • conferenceObject
    OUTCOMES OF WOMEN DIAGNOSED WITH CERVICAL CANCER AS PART OF A SCREENING PROGRAM IN MOZAMBIQUE: A SUBSET-ANALYSIS OF THE MULHER STUDY
    (2022) BATMAN, Samantha; RANGEIRO, Ricardina; BAKER, Ellen; MONTEIRO, Eliane; CARRILHO, Carla; CHANGULE, Dercia; DAUD, Siro; OSMAN, Nafissa; NEVES, Andrea; JESUS, Celda De; MARIANO, Arlete; MORETTI-MARQUES, Renato; VIEIRA, Marcelo; FONTES-CINTRA, Georgia; LOPES, Andre; BATWARE, Jean Claude; LUIS, Elvira; LORENZONI, Cesaltina; SCHMELER, Kathleen; SALCEDO, Mila P.