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
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Histological Variants of Urothelial Carcinoma Predict No Response to Neoadjuvant Chemotherapy(2022) LEITE, Katia Ramos Moreira; BORGES, Leonardo Lima; RIBEIRO FILHO, Leopoldo; CHADE, Daher; COELHO, Rafael Ferreira; CORDEIRO, Mauricio; SROUGI, Miguel; NAHAS, Willian CarlosMicroabstract: This study shows that the presence of divergent histological differentiation and the immunexpression of CAIX in muscle invasive urothelial carcinoma, predicts no response to cisplatin based neoadjuvant chemotherapy. Background: Platinum-based neoadjuvant chemotherapy (NAC) in muscle-invasive urothelial bladder cancer (MIBC) has been adopted as a standard of care related to better survival outcomes. However, there is a considerable number of patients who do not respond, experiencing toxicity and delay in the surgical treatment. Our aim is to find biomarkers of response that could be easily adopted in the clinical practice. Methods: Between January 2009 and July 2016, 52 patients with MIBC were submitted to radical cystectomy after NAC. A tissue microarray containing 25 cases, who met the inclusion criteria was built for immunohistochemical analysis of Cytokeratins 5/6, 7, and 20, GATA3, Her2, EGFR, p63, p53, Carbonic-anhydrase IX (CAIX), MLH1, MSH2, MSH6, and PMS2. The surgery was performed in a mean time of 58.7 (+/- 21) days after the end of the NAC. Fisher's exact test was used to analyze the relationship between response (<= pT1) and histopathological and immunohistochemical results and Kaplan-Meier curves were designed for survival analysis. Results: Ten (40.0%) patients presented response to NAC. Histological variants of the urothelial carcinoma characterized by squamous, sarcomatous/rhabdoid, plasmacytoid, and micropapillary was present in 36.0% and none responded to NAC (P = .002). CAIX was expressed by 53.3% and none responded to NAC (P= .005). Lymph-node metastasis, divergent differentiation, and expression of cytokeratin 5/6 were related to short cancer specific survival. Conclusion: Histological variants and CAIX immune-expression are biomarkers of nonresponse to NAC of MIBC, and might be easily used in the clinical practice to select patients to be submitted to surgery upfront.
- A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy(2022) GUGLIELMETTI, Giuliano B.; ANJOS, Gabriel C. dos; SAWCZYN, Guilherme; RODRIGUES, Gilberto; CARDILI, Leonardo; CORDEIRO, Mauri Prime Cio D.; NEVES, Luiz C. O.; PONTES JUNIOR, Jose; FAZOLI, Arnaldo; COELHO, Rafael F.; SROUGI, Miguel; NAHAS, William C.Purpose: Partial nephrectomy is the standard treatment for renal tumors <7 cm, and the trend toward minimally invasive surgery has increased. However, data that could support its use and benefits are still lacking. Materials and Methods: We conducted a prospective, randomized controlled trial comparing surgical, functional and oncologic outcomes in patients undergoing open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN). Randomization was 1:1 to OPN or LPN for the treatment of renal tumors <7 cm. The primary endpoint was surgical complications up to 90 days after surgery. Secondary outcomes were comparison of surgical, oncologic and functional results. Results: We randomized 208 patients between 2012 and 2020 (110 with OPN vs 98 with LPN). Operative data showed no differences in operative time, warm ischemia time, estimated blood loss, transfusions or length of hospital stay. Zero ischemia was more frequent in the OPN (35.4% vs 15.5%, p=0.02). OPN was associated with more abdominal wall complications (31.2% vs 13.1%, p=0.004). Regarding oncologic outcomes, no differences were noted. The LPN group had less kidney function reduction at 3 (-5.2% vs -10%, p=0.04; CI 0.09 to 9.46) and 12 months after surgery (-0.8% vs -6.3%, p=0.02; CI 1.18 to 12.95), and a lower rate of downstaging on the chronic kidney disease classification at 12 months (14.1% vs 32.6%, p=0.006). Conclusions: Surgical and oncologic outcomes of LPN were similar to OPN. Minimally invasive surgery may provide better preservation of kidney function. More studies, especially those involving robotic surgery, are necessary to confirm our findings.
conferenceObject Randomized phase II trial of neoadjuvant androgen deprivation therapy plus abiraterone and apalutamide for patients with high-risk localized prostate cancer: Pathologic response and PSMA imaging correlates.(2022) BASTOS, Diogo Assed; COELHO, Rafael; CARDILI, Leonardo; GALIZA, Felipe; ILARIO, Eder Nisi; VIANA, Ublio; MURTA, Claudio Bovolenta; GUGLIELMETTI, Giuliano; CORDEIRO, Mauricio; PONTES JR., Jose; MUNIZ, David Queiroz Borges; SILVA, Jamile Almeida; MOTA, Jose Mauricio; FREITAS, Guilherme Fialho De; LEITE, Katia Ramos Moreira; BUCHPIGUEL, Carlos Alberto; NAHAS, William Carlos- Neutrophil-to-Lymphocyte Ratio Predicts Cancer Outcome in Locally Advanced Clear Renal Cell Carcinoma(2022) CORDEIRO, Mauricio Dener; ILARIO, Eder Nisi; ABE, Daniel Kanda; CARVALHO, Paulo Afonso de; MUNIZ, David Queiroz Borges; SARKIS, Alvaro Sadek; COELHO, Rafael Ferreira; GUIMARAES, Ronaldo Morales; HADDAD, Michel Vitor; NAHAS, William CarlosBackground: To evaluate the association of neutrophil-to-lymphocyte ratio (NLR) with recurrence-free survival (RFS) and overall survival (OS) in patients with locally advanced nonmetastatic clear cell renal cell carcinoma (ccRCC) under-going radical nephrectomy. Material and Methods: We retrospectively identified 880 nephrectomies performed between January 2009 and December 2016 in a single center, reviewed data from 478 radical nephrectomies for kidney tumors and identified 187 patients with locally advanced nonmetastatic ccRCC (pT3-T4 N0M0). NLR was obtained preoperatively and calculated by dividing absolute neutrophil count by absolute lymphocyte count. OS and RFS were evaluated by the Kaplan-Meier method. Cox proportional-hazards regression models were used to evaluate predictors of RFS and OS. Results: Among 187 patients with ccRCC (mean age 63.4 +/- 11.5 years; 118 [63.1%] male), the median follow-up was 48.7 months. On univariate analysis, in patients with Fuhrman nuclear grade of differentiation 3-4, the median time to recurrence was significantly shorter with NLR >= 4 than < 4 (24 vs. 55 months, P = .045). On multivariable analysis adjusted for NLR >= 4, among all variables analyzed (NLR, microvascular invasion, sarcomatoid differentiation, tumor size and body mass index), only nuclear grade of differentiation was an independent predictor of recurrence (hazard ratio 2.18; 95% confidence interval 1.07-4.92, P = .03). The 3-year OS had no statistically significant difference between patients with NLR >= 4 or < 4. Conclusion: For patients with locally advanced, nonmetastatic ccRCC, RFS was reduced with high nuclear grade of differentiation and high preoperative NLR. These findings suggest an association between higher NLR and worse outcomes in locally advanced ccRCC.
- Reply by Authors(2022) GUGLIELMETTI, G. B.; ANJOS, G. C. Dos; SAWCZYN, G.; RODRIGUES, G.; CARDILI, L.; CORDEIRO, M. D.; NEVES, L. C. O.; PONTES JUNIOR, J.; FAZOLI, A.; COELHO, R. F.; SROUGI, M.; NAHAS, W. C.
- miRNA and mRNA Expression Profiles Associated with Lymph Node Metastasis and Prognosis in Penile Carcinoma(2022) MURTA, Claudio B.; FURUYA, Tatiane K.; CARRASCO, Alexis G. M.; UNO, Miyuki; SICHERO, Laura; VILLA, Luisa L.; FARAJ, Sheila F.; COELHO, Rafael F.; GUGLIELMETTI, Giuliano B.; CORDEIRO, Mauricio D.; LEITE, Katia R. M.; NAHAS, William C.; CHAMMAS, Roger; PONTES JR., JosePenile cancer (PeC) is a rare disease, and no prognostic biomarkers have been adopted in clinical practice yet. The objective of the present study was to identify differentially expressed miRNAs (DEmiRs) and genes (DEGs) as potential biomarkers for lymph node metastasis and other prognostic factors in PeC. Tumor samples were prospectively obtained from 24 patients with squamous cell carcinoma of the penis. miRNA microarray analysis was performed comparing tumors from patients with inguinal lymph node metastatic and localized disease, and the results were validated by qRT-PCR. Eighty-three gene expression levels were also compared between groups through qRT-PCR. Moreover, DEmiRs and DEGs expression levels were correlated with clinicopathological variables, cancer-specific (CSS), and overall survival (OS). TAC software, TM4 MeV 4.9 software, SPSS v.25.0, and R software v.4.0.2 were used for statistical analyses. We identified 21 DEmiRs in microarray analysis, and seven were selected for validation. miR-744-5p and miR-421 were overexpressed in tissue samples of metastatic patients, and high expression of miR-421 was also associated with lower OS. We found seven DEGs (CCND1, EGFR, ENTPD5, HOXA10, IGF1R, MYC, and SNAI2) related to metastatic disease. A significant association was found between increased MMP1 expression and tumor size, grade, pathological T stage, and perineural invasion. Other genes were also associated with clinicopathological variables, CSS and OS. Finally, we found changes in mRNA-miRNA regulation that contribute to understanding the mechanisms involved in tumor progression. Therefore, we identified miRNA and mRNA expression profiles as potential biomarkers associated with lymph node metastasis and prognosis in PeC, in addition to disruption in mRNA-miRNA regulation during disease progression.
- Holmium Laser Resection of Large Bladder Tumors: Technique Description, Feasibility, and Histopathological Quality Analysis(2022) ISCAIFE, Alexandre; RIBEIRO FILHO, Leopoldo Alves; PEREIRA, Maikon Willian Aparecido; GALLUCCI, Fabio Pescarmona; CHADE, Daher; MURTA, Claudio Bovolenta; CORDEIRO, Mauricio Dener; CARDILI, Leonardo; SARKIS, Alvaro Sadeki; SROUGI, Miguel; NAHAS, William C.BACKGROUND The HoLERBT (Holmium Laser En-bloc Resection of Bladder Tumors) has emerged as an alternative to classical TURBT (Transurethral Resection of Bladder Tumor). Recent randomized trial and meta-analysis corroborate with the benefits in pathological analysis, perioperative and longterm oncological outcomes.(1-3) However, the treatment of large tumors and the technique of extraction from the bladder is a problem to be overcome.(1,4) OBJECTIVE To describe the laser resection of bladder tumors and demonstrate the feasibility of this procedure even for large tumors throughout a series of cases. It is also discussed the quality of the histopathological analysis. METHODS A series of 8 cases randomized selected to be the pilot for a trial comparing TURBT and HoLERBT in large tumors (>3 cm) in progress was analyzed (Brazilian Registry of Clinical Trials number RBR-67npwrk). The perioperative data and 1-year outcomes were assessed and the quality of histopathological analysis after morcellation was evaluated in terms of histopathology, grade, and stage. The entire procedure of one case is shown in a step-by-step video. RESULTS The mean follow-up was 12.6 months. The mean age was 59.6 (42-85) years, and the mean tumor size was 4.7 (4-8) cm. All the resections were En-bloc. There were 2 cases of NMIBC, 4 cases of MIBC, 1 paraganglioma, and 1 adenocarcinoma. The histopathological analysis confirmed the presence of detrusor muscle layer and accurate diagnosis and staging in all cases (100%). There were no perioperative Clavien-Dindo > 1 complications, no blood transfusion, and no bladder perforations. The histopathology analysis reveals excellent quality without artifacts of fulguration. CONCLUSION The holmium laser resection followed by morcellation of large bladder tumors is a feasible procedure. No complications occurred in our series of cases and all cases provided excellent material for histopathological analysis. (C) 2022 Elsevier Inc.
conferenceObject Correlation of the expression of microRNA and their predicted targets with prognosis and mortality of penile squamous cell carcinoma(2022) MURTA, C. B.; FURUYA, T. K.; UNO, M.; CARRASCO, A. G. M.; SICHERO, L.; VILLA, L. L.; FARAJ, S. F.; COELHO, R. F.; GUGLIELMETTI, G. B.; CORDEIRO, M. D.; LEITE, K. R. M.; NAHAS, W. C.; CHAMMAS, R.; PONTES, Jr J.