MAURICIO DENER CORDEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Robotic-assisted radical cystectomy: the first multicentric Brazilian experience(2020) MOSCHOVAS, Marcio Covas; CHADE, Daher Cesar; ARAP, Marco Antonio; SARKIS, Alvaro Sadek; NAHAS, William Carlos; TANURE, Luiz Henrique Rodrigues; EBAID, Gustavo; FAZOLI, Arnaldo Jose de Carvalho; GUGLIELMETTI, Giuliano Betoni; BISTACCO, Carolina; CORDEIRO, Mauricio; AFONSO, Paulo; SIGHINOLFI, Maria Chiara; ROCCO, Bernardo; COELHO, Rafael FerreiraThe objective of this study is to report the first multicentric Brazilian series and learning curve of robotic radical cystectomy (RARC) with related intra- and postoperative outcomes. We retrospectively analyzed 37 RARC prospectively collected at four different centers in Brazil, from 2013 to 2019. We analyzed the patient's demographics, pathological tumor, and nodal status, as well as intra- and postoperative outcomes. Statistical analysis was performed with the IBM (SPSS version 25) software. Overall, 86% were male, and the median age was 69 years. 83% had muscle-invasive bladder cancer, and 17% a high-grade, recurrent non-muscle-invasive tumor. The median operative time was 420 min with 300 min as console time. Median blood loss was 350 ml and transfusion rate was 10%. In 68% of the cases, we performed an intracorporeal Bricker urinary diversion, 24% intracorporeal neobladder, and 8% ureterostomy. Six patients (16%) had a Clavien 1-2, 8% had Clavien 3, 2.5% had a Clavien 4, and 5% had Clavien 5. The median length of hospital stay was 7 days. The final pathological exam pointed out pT0 in 16%, pT1 in 8%, pT2 in 32%, >= pT3 in 27%, and 16% pTis. 95% had negative surgical margins. The survival at 30, 90, and 180 days was 98%, 95%, and 95%, respectively. To our knowledge, this is the first multicentric series of RARC reporting the learning curve in Brazil; even if still representing a challenging procedure, RARC could be safely and effectively faced by experienced surgeons at centers with high volumes of robotic surgery.
- Genomic Biomarkers and Underlying Mechanism of Benefit from BCG Immunotherapy in Non-Muscle Invasive Bladder Cancer(2020) BASTOS, Diogo A.; MATTEDI, Romulo L.; BARREIRO, Rodrigo; SANTOS, Filipe F. dos; BUZATTO, Vanessa; MASOTTI, Cibele; SOUZA, Jussara M.; LIMA, Mariana Z. T. de; FRIGUGLIETTI, Giulia W.; DZIK, Carlos; JARDIM, Denis L. F.; COELHO, Rafael; RIBEIRO FILHO, Leopoldo A.; CORDEIRO, Mauricio D.; NAHAS, William C.; MELLO, Evandro S. de; CHAMMAS, Roger; REIS, Luiz Fernando L.; BETTONI, Fabiana; GALANTE, Pedro A. F.; CAMARGO, Anamaria A.BACKGROUND: Optimal therapy for high-risk non-muscle invasive bladder cancer (NMIBC) includes intravesical instillation of Bacillus Calmette-Guerin (BCG). However, about 25-45% of patients do not benefit from BCG immunotherapy, and there is no biomarker to guide therapy. Also, many questions regarding BCG mechanisms of action remain unanswered. OBJECTIVE: To identify genomic biomarkers and characterize the underlying mechanism of benefit from BCG in NMIBC. PATIENTS AND METHODS: Pre-treatment archival index-tumors of 35 patients with NMIBC treated with BCG were analyzed by whole-exome sequencing (WES). Tumor mutation burden (TMB) and neoantigen load (NAL) were correlated with BCG response rate (RR) and recurrence-free survival (RFS). The presence of deleterious mutations in DNA damage response (DDR) genes was also compared between BCG-responsive (BCG-R, N= 17) and unresponsive (BCG-UR, N= 18) subgroups. RESULTS: TMB and NAL were higher in BCG-R compared to BCG-UR patients (median TMB 4.9 vs. 2.8 mutations/Mb, P = 0.017 and median NAL 100 vs. 65 neoantigens, P = 0.032). Improved RR and RFS were observed in patients with high vs. low TMB (RR 71% vs. 28%, P = 0.011 and mRFS 38.0 vs. 15.0 months, P = 0.009) and with high vs. low NAL (RR 71% vs. 28%, P = 0.011 and mRFS 36.0 vs. 18.5 months, P = 0.016). The presence of deleterious mutations in DDR genes was associated with improved RFS (mRFS 35.5 vs. 11.0 months, P = 0.017). CONCLUSIONS: In our cohort, improved outcomes after BCG immunotherapy were observed in patients with high TMB, high NAL and deleterious mutations in DDR genes. BCG may induce tumor-specific immune response by enhancing the recognition of neoantigens.
- Retrograde Release of the Neurovascular Bundle with Preservation of Dorsal Venous Complex During Robot -assisted Radical Prostatectomy: Optimizing Functional Outcomes(2020) CARVALHO, Paulo Afonso de; BARBOSA, Joao A. B. A.; GUGLIELMETTI, Giuliano B.; CORDEIRO, Mauricio Dener; ROCCO, Bernardo; NAHAS, William C.; PATEL, Vipul; COELHO, Rafael Ferreira
conferenceObject Neutrophil-to-lymphocyte ratio as a predictor of oncologic outcomes in locally advanced non-metastatic clear cell renal carcinoma(2020) RODRIGUES, Gilberto; SIERRA, Pablo; ALBUQUERQUE, Emanuel; GALLUCCI, Fabio Pescarmona; ILARIO, Eder Nisi; CARVALHO, Paulo Afonso de; MUNIZ, David Queiroz Borges; SARKIS, Alvaro; COELHO, Rafael; CORDEIRO, Mauricio; NAHAS, William Carlos- Oncologic Outcomes in Young Adults With Kidney Cancer Treated During the Targeted Therapy Era(2020) SIERRA, Pablo S.; CORDEIRO, Mauricio D.; V, Emanuel Albuquerque; BASTOS, Diogo A.; BONADIO, Renata C.; SARKIS, Alvaro S.; CAVALCANTE, Alexandre; PONTES JR., Jose; COELHO, Rafael F.; NAHAS, William C.We studied the oncologic outcomes of young adults with kidney cancer who were treated after the introduction of targeted therapy. Additionally, we analyzed the impact of young age (< 40 years) on survival and recurrencefree survival. We found that young patients usually present with more advanced stages of the disease and have worse overall survival. Background: The objective of this study was to determine the outcomes of young adults with kidney cancer treated during the targeted therapy era and evaluate the impact of young age on survival. Materials and Methods: We reviewed the records from 445 patients younger than 55 years with kidney cancer at a single institution from 2006 to 2017. Overall survival (OS) and recurrence-free survival were estimated with the Kaplan-Meier method and log-rank test. Cox proportional hazards regression was used to determine the impact of clinical and pathologic variables on all-cause mortality. Results: Overall, 104 (23%) patients 40 years or younger were compared with 341 (77%) patients who were 41 to 55 years old. Younger patients presented with more advanced stages of the disease, including metastasis at diagnosis, positive lymph nodes, venous tumor thrombus and had more non-clear cell tumors (54% vs. 30%; P < .001). Young adults had significantly worse OS at 2 and 5 years (67% vs. 82% and 53% vs. 69%, respectively). Younger patients with metastatic disease received targeted agents less often compared with the older group (64% vs. 75%). There was no difference in recurrence-free survival across patients with localized disease. Independent prognostic factors associated with increased mortality were metastasis at diagnosis, pT2 or greater, and age younger than 40 years (hazard ratio, 1.65; 95% confidence interval, 1.0-2.6; P = .03). Conclusion: Patients younger than 40 years with kidney tumors treated during the targeted therapy era have worse OS compared with older adults. Young age is an independent predictor of mortality.
conferenceObject ROBOT-ASSISTED LEVEL II AND III INFERIOR VENA CAVA THROMBECTOMY: STEP-BY-STEP OF TWO DIFFERENT TECHNIQUES(2020) RODRIGUES, Gilberto; FAZOLI, Arnaldo; TANURE, Luis; GUGLIELMETTI, Giuliano; CORDEIRO, Mauricio; COELHO, Rafael; NAHAS, William