ANTONIO ADOLFO GUERRA SOARES BRANDAO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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- Clinical, Laboratory, and Genetic Features of Erdheim-Chester Disease Patients from Two Reference Centers in a Developing Country(2020) BRANDAO, Antonio Adolfo Guerra Soares; FATOBENE, Giancarlo; ABDO, Andre; LAGE, Luis Alberto De Padua Covas; BENDIT, Israel; NARDINELLI, Luciana; SIQUEIRA, Sheila Aparecida Coelho De; LEVY, Debora; PEREIRA, Juliana; REGO, Eduardo M.; ROCHA, Vanderson
- LYMPHOCYTE COUNT AND PLATELET VOLUME PREDICTS POSTOPERATIVE COMPLICATIONS IN ESOPHAGECTOMY FOR CANCER: A COHORT STUDY(2019) TUSTUMI, Francisco; TAKEDA, Flávio Roberto; BRANDÃO, Antonio Adolfo Guerra Soares; SALLUM, Rubens Antonio Aissar; RIBEIRO JUNIOR, Ulysses; CECCONELLO, IvanABSTRACT BACKGROUND: Biomarkers from routine complete blood count are known predictive factors of long-term outcomes in cancer patients. The value of these biomarkers in the setting of trimodal therapy for esophageal cancer in predicting early postoperative outcomes is not studied. OBJECTIVE: The present study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by curative intent esophagectomy for cancer in predicting postoperative mortality and morbidity. METHODS: A cohort of 149 consecutive patients that underwent chemoradiotherapy using platinum- and taxane-based regimens followed by esophagectomy was analyzed. Cellular components of blood collected before neoadjuvant therapy (period A) and before surgery (period B) were assessed for postoperative mortality and complications. Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. RESULTS: Postoperative morbidity was present in 46% of the patients. On multiple regression analysis platelet volume (B) (OR: 1.53; 95% CI: 1.2-2.33) was an independent predictor of general complications. Severe postoperative surgical complications were present in 17% of the patients. On multiple regression analysis, lymphocyte decrease between B-A periods (OR: 0.992; 95% CI: 0.990-0.997) was related to higher risk for severe complications. Cervical anastomotic leakage was present in 25.6% of the patients. On univariate analysis eosinophil count in A and B periods was related to cervical anastomotic leakage. For this outcome, multivariate joint model could not identify independent risk variables of cellular components of blood. The 30-day mortality rate was 7.4%. On univariate analysis, platelet count in period B was associated to higher risk for mortality. The multivariate joint model could not accurately predict mortality due to the few number of patients in the mortality group. CONCLUSION: This is the first study to assess the relationship between peripheral blood count variables changes during neoadjuvant chemoradiotherapy using a platinum- and taxane-based regimen followed by curative intent esophagectomy for cancer in predicting postoperative complications. The platelet volume prior to surgery is related to postoperative complications and the lymphocyte count change prior to surgery predicts severe postoperative complications in the setting of trimodal therapy for esophageal cancer.
bookPart Distúrbios da hemostasia no departamento de emergência(2021) BRANDãO, Antonio Adolfo Guerra SoaresbookPart Distúrbios da hemostasia no departamento de emergência(2022) BRANDãO, Antonio Adolfo Guerra Soares- The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer(2020) TUSTUMI, Francisco; TAKEDA, Flavio Roberto; VIYUELA, Mateus Silva; CRUZ JUNIOR, Jurandir Batista da; BRANDAO, Antonio Adolfo Guerra Soares; SALLUM, Rubens Antonio Aissar; RIBEIRO JUNIOR, Ulysses; CECCONELLO, IvanBackground Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. Methods A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease-free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. Results Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79-0.92) and high neutrophil-to-lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07-1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58-0.88), red cell distribution width (RDW) (C-A) (HR, 1.16; 95% CI, 1.02-1.31), and NLR (C-A) (1.06; 95% CI, 1.03-1.09) were related to poor DFS. RDW (B-A) (HR, 1.15; 95% CI, 1.08-1.22), RDW (C) (HR, 1.12; 95% CI, 1.04-1.2), NLR (C) (HR, 1.12; 95% CI, 1.08-1.17) were related to systemic recurrence. Conclusion Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.
- Clinical, laboratory and genetic features of Erdheim-Chester disease patients: analysis of a retrospective cohort of two reference centers in Latin America(2022) BRANDAO, Antonio Adolfo Guerra Soares; ABDO, Andre Ramires Neder; LAGE, Luis Alberto de Padua Covas; FATOBENE, Giancarlo; PEREIRA, Juliana; ROCHA, VandersonObjectives and Methods: Erdheim-Chester disease (ECD) is a rare histiocytic neoplasm with a heterogeneous clinical course, ranging from localized and asymptomatic bone lesions to a multisystem disease, causing significant morbidity and mortality. There are few cohorts published, mainly from North America and Europe. We retrospectively collected clinical data on sixteen biopsy-proven ECD patients diagnosed and treated at two Brazilian reference centres for histiocytic disorders from January 2006 to February 2020. Results: Median time from onset of symptoms to diagnosis was 13 months (0.1-142). The main organ involved in ECD was bone (75%) and also 75% of the patients presented involvement of more than one organ, characterizing a multi-organic form. BRAF status was available in 81.2% of patients and BRAF V600E mutation was detected by Sanger sequencing in only 18.8%, which can be explained by the low sensitivity of this technique. All patients were treated due to symptomatic disease and a median of two lines (range: 1-7) of therapy were needed. The most common first-line therapy used was alpha-interferon (75%). The median progression-free survival was 7.5 months, and the median OS was not reached. Discussion and Conclusion: In the largest Latin American cohort of patients with ECD reported to date, we observed findings which resemble demographic characteristics, sites of involvement and treatment choices reported by other groups. The outcomes may be better with target therapies such as BRAF and MEK inhibitors in patients with mutation and with the adoption of recently published consensus recommendations for the management of ECD patients.
- Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital(2021) BRANDAO, Antonio Adolfo Guerra Soares; OLIVEIRA, Cleyton Zanardo de; ROJAS, Salomon Ordinola; ORDINOLA, Amanda Ayako Minemura; QUEIROZ, Victoria Masi; FARIAS, Danielle Leao Cordeiro de; SCHEINBERG, Phillip; VEIGA, Viviane CordeiroObjectives: To describe the incidence of thromboembolic events in adult patients with severe COVID-19 and identify clinical and laboratory factors associated with these events. Design: Observational retrospective cohort study of 243 adult patients with severe COVID-19 admitted to an intensive care unit (ICU) at a Brazilian tertiary hospital. Results: The incidence of all thromboembolic events was 14.8%, in which 3.8% developed deep vein thrombosis, 7.8% pulmonary embolism, 2.5% acute myocardial infarction, 1.2% stroke, and 1.2% peripheral artery occlusion. Risk factors identified were D-dimer at admission >3000 ng/mL (P=<0.0013) and major bleeding (P=0.001). The cumulative risk of developing thromboembolic events at day 28 after ICU admission was 16.0%. The rate of major bleeding was 4.1%. After receiver operating characteristic curve analysis, the D-dimer cut-off at admission correlating with thromboembolic events was 1140.5 ng/mL. Conclusions: The rate of thromboembolic events in our study was lower than previously described. High D-dimer level at admission was the leading risk factor; the optimal cut-off was 1140.5 ng/mL. The occurrence of thromboembolic events did not have an impact on the median overall survival rate. The optimal anticoagulant strategy in this context still needs to be established. (C) 2021 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
bookPart Distúrbios da hemostasia no departamento de emergência(2022) BRANDãO NETO, Rodrigo Antonio; ALENCAR, Júlio César Garcia de; BRANDãO, Antonio Adolfo Guerra SoaresconferenceObject Educational and financial impact of a recommendation on cancer-associated thrombosis (CAT) management: experience of a Brazilian oncological Public Hospital for adults(2021) ROTHSCHILD, C.; DIZ, M. P. E.; ZERATI, A. E.; SABANAI, A. H.; ALBUQUERQUE, G. M.; TAKAHASHI, T. T.; BRANDAO, A. A. G. S.; PEREIRA, J.; ROCHA, V.conferenceObject Pharmaceutical vigilance and education: the first 6 months of a new anticoagulant at a Brazilian cancer institute(2021) ROTHSCHILD, C.; SABANAI, A. H.; SANTOS, A. A.; SOUSA, C. O.; SIQUEIRA, R. S.; FERRETTI, T.; BRANDAO, A. A. G. S.; DIZ, M. P. E.; PEREIRA, J.; ROCHA, V.