LEANDRO LUONGO DE MATOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina
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- Implication of the New AJCC pT Classification of SCC of the Lip Comparing With Other Oral Subsites(2021) TOLEDO, Loic Monginet; OLIVEIRA, Adriana Santos de; PINHEIRO, Renan Aguera; LEITE, Ana Kober Nogueira; MELLO, Evandro Sobroza de; MOYSES, Raquel Ajub; KULCSAR, Marco Aurelio V.; DEDIVITIS, Rogerio Aparecido; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoObjective To determine the implication of the new AJCC staging system for pT classification in a cohort of patients with SCC of the lip mucosa and compare it to other oral cavity sites. Methods Retrospective cohort of 744 patients treated between 2002 and 2017, by the Head and Neck Surgery Department of the University of Sao Paulo. Results Of 95 lip patients, 42 had pT upstage (58.1% of pT1 to pT2-3 and 50% of pT2 to pT3). Similar DFS/OS observed for those pT1 maintained or upstaged to pT2-3, pT2 patients upstaged to pT3 presented worse OS (49.4% versus 92.3%, P = .032). The comparison between lip and other mouth topographies, denoted better prognosis for pT1-2, but not for pT3-4a. Lip tumors had lower DOI, rates of perineural/angiolymphatic invasion, nodal metastasis, recurrence, and death. Conclusion The inclusion of DOI to the new pT classification better stratifies patients with SCC of the lip mucosa upstaged to pT3 by assessing inferior OS. Level of Evidence 3 Laryngoscope, 2021
- Tumor thickness as a predictive factor of lymph node metastasis and disease recurrence in T1N0 and T2N0 squamous cell carcinoma of the oral tongue(2014) MATOS, Leandro Luongo de; MANFRO, Gabriel; SANTOS, Ricardo Vieira dos; STABENOW, Elaine; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini F.; PINTO, Fabio Roberto; KULCSAR, Marco Aurelio Vamondes; BRANDAO, Lenine Garcia; CERNEA, Claudio RobertoObjective. The aim of the study was to compare the thickness of primary tumors with the frequency of nodal metastases and survival in patients surgically treated for T1/T2N0 oral tongue squamous cell carcinoma. Study Design. This is a retrospective longitudinal study with 74 patients. Results. None of the patients with a tumor thickness (TT) <= 7 mm presented with nodal metastasis, whereas 25 of the patients with a TT > 7 mm (51.0%) developed metastases (P < .0001). Multivariate analysis showed that TT > 7 mm was a risk factor for occult nodal metastasis (odds ratio = 8.7; P = .002) with 81.9% accuracy. TT > 10 mm was also a predictive factor of worse disease-free survival in these patients (hazard ratio = 12.2; P = .003). Conclusions. Tumor thickness of greater than 7 mm is predictive of a higher incidence of lymph node metastasis, and a TT > 10 mm is predictive of worse disease-free survival in squamous cell carcinoma of the oral tongue.
- Survival predictors in patients with head and neck cancer treated with surgical resection(2017) FRANCO, R. C. D. O.; MATOS, L. L. De; CASTRO JUNIOR, G. De; KULCSAR, M. A. V.; MARTA, G. N.
- Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma(2023) TREVISANI, Lorenzo Fernandes Moca; KULCSAR, Isabelle Fernandes; KULCSAR, Marco Aurelio Vamondes; DEDIVITIS, Rogerio Aparecido; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoIntroduction: Oral squamous cell carcinoma (OSCC) remains a significant public health concern. The variables utilized to determine appropriate treatment for this disease also represent its most unfavorable prognostic factors, with these parameters solely determined by the neoplasm and its behavior. However, a lack of well-established indices is evident in the literature that specifically relate to the patient and indicate a worse prognosis. Objective: To assess the prognostic impact of hematological indices in patients with OSCC. Methods: This retrospective cohort study included patients with oral squamous cell carcinoma (OSCC) who underwent curative-intent treatment. Treatment encompassed surgery, followed by adjuvant therapy, as necessary. Laboratory tests were conducted immediately prior to surgery, and demographic information was obtained from medical records. Results: The cohort comprised 600 patients, with 73.5% being male subjects. Adjuvant treatment was recommended for 60.3% of patients. Throughout the follow-up period, 48.8% of participants died. Univariate analysis indicated that perineural invasion, angiolymphatic invasion, pT4 tumors, lymph node metastases, extranodal extravasation, RDW > 14.3%, NLR (neutrophil-lymphocyte ratio) > 3.38, PLR (platelet-lymphocyte ratio) > 167.3, and SII (systemic inflammatory/immune response index) > 416.1 were factors associated with increased mortality. These threshold values were established through ROC curve analysis. In the multivariate analysis, angiolymphatic invasion (HR = 1.43; 95% CI: 1.076-1.925; p = 0.014), pT4a/b tumors (HR = 1.761; 95% CI: 1.327-2.337; p < 0.001), extranodal extravasation (HR = 1.420; 95% CI: 1.047-1.926; p = 0.024), and RDW (HR = 1.541; 95% CI: 1.153-2.056; p = 0.003) were identified as independent risk factors for decreased overall survival. Conclusions: RDW > 14.3% was proven to be a reliable parameter for assessing overall survival in patients with OSCC. Further studies are required to evaluate the clinical applicability of other hematological indices.
- External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients(2017) MATOS, Leandro Luongo; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini F.; CERNEA, Claudio RobertoObjectives: To evaluate the new American Joint Committee on Cancer (AJCC) cancer staging manual (8th edition) in an independent cohort of patients surgically treated for oral squamous cell carcinoma in order to determine whether the upstaging of pT and pN classification was indicative of a worse prognosis. Methods: A cohort of 298 patients was analyzed retrospectively. Results: Of these patients, 22.8% received an upstaging when the depth of invasion was included into the pT classification. Similarly, 29.2% of them were upstaged when extracapsular extension was added to pN classification. Twenty-eight of 68 patients (41.2%) that received an upstaging of pT classification died, and 23 (33.8%) experienced disease recurrence compared to 98/229 (42.8%) and 68/229 (29.7%), respectively, for those with the same pT during follow-up. With regard to pN classification, 70.6% of upstaged patients (60/85) died, and 50.6% (43/85) developed recurrence of the disease compared to 63/205 (30.7%) and 42/205 (20.5%), respectively, for those with the same pN during follow-up. Patients who were upstaged in pT classification presented a worse DFS (51.1% versus 80.4%, P = 0.007) and OS (31.5% versus 58.6%, P = 0.017). Similarly, those that were upstaged in pN classification presented a worse DFS (17.1% versus 61.2%, P = 0.001) and OS (8.5% versus 37.9%, P < 0.001). Conclusion: The new AJCC cancer staging manual (8th edition) allows a better stratification of oral SCC patients. By including the depth of invasion to the pT classification and extranodal extension to the pN classification, a worse disease-free and overall survival was assessed for these patients.
- Practical tips to reduce complication rate in thyroidectomy(2017) CERNEA, Claudio; BRANDAO, Lenine G.; HOJAIJ, Flavio C.; CARLUCCI, Dorival De; VANDERLEI, Felipe; GOTODA, Renato; LEITE, Ana K.; KULCSAR, Marco A. V.; MATOS, Leandro L.; DEDIVITIS, Rogerio A.; ARAUJO-FILHO, Vergilius J. F.; TAVARES, Marcos R.Introduction: Thyroid cancer is the most frequent endocrine neoplasm, and its incidence has been consistently rising during the last decades. Surgical treatment is the choice, but the complications can be truly devastating. Methods: The objective of this article is to present some practical tips to reduce the complication rate in thyroid surgery. Results: The more frequent complications during a thyroidectomy are mentioned, as well as practical tips to try to prevent them: acute airway compression, nerve injuries (both inferior laryngeal and external branch of the superior laryngeal nerves), and hypoparathyroidism. Conclusion: The prevention of complications during a thyroidectomy is imperative. The only way that the surgeon can assure the safety is to strictly adhere to technical principles, with diligent hemostasis, thorough anatomical knowledge, and gentle handling of the anatomic structures adjacent to the thyroid gland.
- Nutritional and immunological parameters as prognostic factors in patients with advanced oral cancer(2022) TREVISANI, Lorenzo Fernandes Moça; KULCSAR, Isabelle Fernandes; LEITE, Ana Kober Nogueira; KULCSAR, Marco Aurélio Vamondes; LIMA, Graziele Aparecida Simões; DEDIVITIS, Rogerio Aparecido; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoAbstract Objective: The aim of the present study was to analyze the prognostic relationship of weight loss and preoperative hematological indexes in patients surgically treated for pT4a squamous cell carcinoma of the oral cavity. Methods: A retrospective cohort study. Results: Percent weight loss greater than 10% was identified in 49 patients (28.2%), and any weight loss in relation to the usual weight occurred in 140 patients (78.7%). Percent weight loss greater than 10% (HR = 1.679), Red cell distribution width (RDW) values greater than 14.3% (HR = 2.210) and extracapsular spread (HR = 1.677) were independent variables associated with risk of death. Conclusion: Patients with advanced squamous cell carcinoma of the oral cavity present significant weight loss and as significantly immunocompromised. Increased values of RDW and higher percentages of weight loss in relation to the individual’s usual weight, together with extracapsular spread of metastatic lymph nodes, were risk factors for lower survival, regardless of other clinical and anatomopathological characteristics. Level of evidence: 3.
article 26 Citação(ões) na Scopus Pectoralis major myocutaneous flap for head and neck reconstruction: risk factors for fistula formation(2014) LEITE, A. K. N.; MATOS, L. L. De; BELLI, M.; KULCSAR, M. A. V.; CERNEA, C. R.; BRANDAO, L. Garcia; PINTO, F. R.The pectoralis major myocutaneous flap (PMMF) is a safe and versatile flap used widely for head and neck cancer reconstructions, but one of the major and most feared complications is oro- or pharyngocutaneous fistula. Herein, we attempt to establish risk factors for fistula formation in reconstructions of mucosal defects in the head and neck using PMMF through retrospective analysis of PMMF performed during 3 years at a single institution, with a total of 84 procedures. There were 69 men and 15 women, with a mean age of 59.5 years. There were 15 cases of partial flap loss, two total flap losses and 31 fistulas. The independent risk factors for fistula formation were preoperative serum hemoglobin <13 g/dl, preoperative serum albumin <3.4 g/dl and hypopharynx reconstruction. The PMMF is still a very useful flap and this is the first multivariate analysis analysing risk factors for fistula formation. These findings are helpful in selecting patients with elevated risk of fistula formation, and therefore preventive measures can be undertaken to avoid potentially serious complications.- MicroRNA-mediated extracellular matrix remodeling in squamous cell carcinoma of the oral cavity(2021) MENDERICO JUNIOR, Gilberto Mendes; THEODORO, Therese Rachell; PASINI, Fatima Solange; ISHIKAWA, Marina de Menezes; SANTOS, Nayara Stephanie Sousa; MELLO, Evandro Sobroza de; PINHAL, Maria Aparecida da Silva; MOYSES, Raquel Ajub; KULCSAR, Marco Aurelio Vamondes; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; KOWALSKI, Luiz Paulo; MATOS, Leandro Luongo deBackground We evaluated microRNAs and extracellular matrix component profiles in squamous cell carcinoma of the oral cavity (OSCC) in comparison to healthy mucosa. Methods Retrospective study investigating 64 microRNAs related to oncogenic process and to constituents of the extracellular matrix. We also performed immunohistochemical assays for molecules involved in the same biological processes. Results High expression of miR-21-5p (p < 0.001) and miR-106-5p (p < 0.001) and low expression of miR-320a (p = 0.001) and miR-222-3p (p = 0.001) were predictors of malignancy. Individually, miR-21-5p exhibited the best statistical performance (area under the curve = 0.972; 95% confidence interval: 0.911-1.000) in the differentiation between tumor tissue and healthy mucosa. Moreover, tumor sample showed increased expression of MMP-2, MMP-9, alpha-laminin, and beta-laminin in tumor-related fibroblasts and lower continuity of type IV collagen in the basement membrane. Conclusion The present study demonstrates the biological effects of microRNAs on the carcinogenesis of OSCC as well as the intense modification of the tumor microenvironment.
- Oral Cancer Treatment: Still an Indication for Elective Neck Dissection?(2018) KOYAMA, Leonardo Kenji Sakaue; MATOS, Leandro Luongo; KULCSAR, Marco Aurelio Vamondes; ARAUJO FILHO, Vergilius Jose Furtado de; CERNEA, Claudio RobertoIntroduction: Oral squamous cell carcinoma has a high incidence and, although elective neck dissection is recommended, the removed nodes frequently present without metastasis. This surgical approach causes disabilities and increases possible surgical complications. Objective: To evaluate the possibility of a watchful waiting approach in oral cancer. Methods: We compared 78 patients with clinical and pathological node metastases and their counterparts with pathological node metastases but without evident clinical neck disease. Therefore, we provided a theoretical comparison between the patients who had an elective neck dissection and those who waited until a clinically positive node was evident. Results: The prognostic factor rates were similar between the groups. Their regional recurrence and mortality rates had no statistical differences. Conclusion: A watchful waiting policy could be applied to selected oral cancer patients who can undergo a very close follow-up. This option would be more cost effective and less harmful than elective neck dissection. (C) 2018 S. Karger AG, Basel