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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- Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis(2022) PAGLIONI, Mariana de Pauli; KHURRAM, Syed Ali; RUIZ, Blanca Iciar Indave; LAUBY-SECRETAN, Beatrice; NORMANDO, Ana Gabriela; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; PALMIER, Natalia Rangel; LOPES, Marcio Ajudarte; GUERRA, Eliete Neves da Silva; MELETI, Marco; MIGLIORATI, Cesar Augusto; CARVALHO, Andre Lopes; MATOS, Leandro Luongo de; KOWALSKI, Luiz Paulo; SANTOS-SILVA, Alan RogerObjective. We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]). Study Design. We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT. Results. Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT). Conclusions. Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD.
- Management of Older Patients with Head and Neck Cancer: A Comprehensive Review(2023) MATOS, Leandro L.; SANABRIA, Alvaro; ROBBINS, K. Thomas; HALMOS, Gyorgy B.; STROJAN, Primoz; NG, Wai Tong; TAKES, Robert P.; ANGELOS, Peter; PIAZZA, Cesare; BREE, Remco de; RONEN, Ohad; GUNTINAS-LICHIUS, Orlando; EISBRUCH, Avraham; ZAFEREO, Mark; MAKITIE, Antti A.; SHAHA, Ashok R.; COCA-PELAZ, Andres; RINALDO, Alessandra; SABA, Nabil F.; COHEN, Oded; LOPEZ, Fernando; RODRIGO, Juan P.; SILVER, Carl E.; STRANDBERG, Timo E.; KOWALSKI, Luiz Paulo; FERLITO, AlfioThe projected increase in life expectancy over the next few decades is expected to result in a rise in age-related diseases, including cancer. Head and neck cancer (HNC) is a worldwide health problem with high rates of morbidity and mortality. In this report, we have critically reviewed the literature reporting the management of older patients with HNC. Older adults are more prone to complications and toxicities secondary to HNC treatment, especially those patients who are frail or have comorbidities. Thus, this population should be screened prior to treatment for such predispositions to maximize medical management of comorbidities. Chronologic age itself is not a reason for choosing less intensive treatment for older HNC patients. Whenever possible, also older patients should be treated according to the best standard of care, as nonstandard approaches may result in increased treatment failure rates and mortality. The treatment plan is best established by a multidisciplinary tumor board with shared decision-making with patients and family. Treatment modifications should be considered for those patients who have severe comorbidities, evidence of frailty (low performance status), or low performance status or those who refuse the recommendations of the tumor board.
- Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study(2023) MEDAS, Fabio; DOBRINJA, Chiara; AL-SUHAIMI, Ebtesam Abdullah; ALTMEIER, Julia; ANAJAR, Said; ARIKAN, Akif Enes; AZARYAN, Irina; BAINS, Lovenish; BASILI, Giancarlo; BOLUKBASI, Hakan; BONONI, Marco; CREA, Carmela De; MANZINI, Nicolo de; MATOS, Leandro Luongo de; PASQUALE, Loredana De; RIO, Paolo Del; DEMARCHI, Marco Stefano; DHIWAKAR, Muthuswamy; DONATINI, Gianluca; DORA, Jose Miguel; D'ORAZI, Valerio; LORI, Eleonora; GAMGARAM, Viyey Kishore Doulatram; EISMONTAS, Vitalijus; KABIRI, El Hassane; MALKI, Hadj Omar El; ELZAHABY, Islam; ENCIU, Octavian; ESKANDER, Antoine; FEROCI, Francesco; FIGUEROA-BOHORQUEZ, David; FILIS, Dimitrios; QUINTANILLA-DIECK, Lourdes; FRANCOIS, Gorostidi; FRIAS-FERNANDEZ, Pedro; GAMBOA-DOMINGUEZ, Armando; GENC, Volkan; GIORDANO, Davide; GOMEZ-PEDRAZA, Antonio; GRACEFFA, Giuseppa; GRIFFIN, James; GUERREIRO, Sofia Cuco; GUPTA, Karan; LUCCHINI, Roberta; GUPTA, Keshav Kumar; GURRADO, Angela; HAJIIOANNOU, Jiannis; HAKALA, Tommi; HARAHAP, Wirsma Arif; HARGITAI, Lindsay; HARTL, Dana; HELLMANN, Andrzej; HLOZEK, Jiri; HOANG, Van Trung; MADANI, Amin; IACOBONE, Maurizio; INNARO, Nadia; IOANNIDIS, Orestis; JANG, J. H. Isabelle; XAVIER-JUNIOR, Jose Candido; JOVANOVIC, Milan; KADERLI, Reto Martin; KAKAMAD, Fahmi; KALISZEWSKI, Krzysztof; KARAMANLIEV, Martin; MANATAKIS, Dimitrios; KATOH, Hiroshi; KOSEC, Andro; KOVACEVIC, Bozidar; KOWALSKI, Luiz Paulo; KRALIK, Robert; YADAV, Sanjay Kumar; KUMOROVA, Adriana; LAMPRIDIS, Savvas; LASITHIOTAKIS, Konstantinos; LECLERE, Jean-Christophe; MARKOVIC, Ivan; LEONG, Eugene Kwong Fei; LEOW, Melvin Khee-Shing; LIM, James Y.; LINO-SILVA, Leonardo S.; LIU, Shirley Yuk Wah; LLORACH, Nuria Perucho; LOMBARDI, Celestino Pio; LOPEZ-GOMEZ, Javier; MATERAZZI, Gabriele; MAZEH, Haggi; MERCANTE, Giuseppe; MEYER-ROCHOW, Goswin Yason; BORUMANDI, Farzad; MIHALJEVIC, Olgica; MILLER, Julie A.; MINUTO, Michele; MONACELLI, Massimo; MULITA, Francesk; MULLINERIS, Barbara; MUNOZ-DE-NOVA, Jose Luis; GIRARDI, Fabio Muradas; NADER, Saki; NAPADON, Tangjaturonrasme; BOZAN, Mehmet Bugra; NASTOS, Constantinos; OFFI, Chiara; RONEN, Ohad; ORAGANO, Luigi; OROIS, Aida; PAN, Yongqin; PANAGIOTIDIS, Emmanouil; PANCHANGAM, Ramakanth Bhargav; PAPAVRAMIDIS, Theodosios; PARIDA, Pradipta Kumar; BRENTA, Gabriela; PASPALA, Anna; PEREZ, Oscar Vidal; PETROVIC, Sabrina; RAFFAELLI, Marco; RAMACCIOTTI, Constanza Fernanda; GIMENEZ, Tomas Ratia; VAZQUEZ, Angel Rivo; ROH, Jong-Lyel; ROSSI, Leonardo; SANABRIA, Alvaro; BRUNAUD, Laurent; SANTEERAPHARP, Alena; SEMENOV, Arseny; SENEVIRATNE, Sanjeewa; SERDAR, Altinay; SHEAHAN, Patrick; SHEPPARD, Sean C.; SLOTCAVAGE, Rachel L.; SMAXWIL, Constantin; KIM, Soo Young; SORRENTI, Salvatore; BRUNNER, Maximilian; SPARTALIS, Eleftherios; SRIPHRAPRADANG, Chutintorn; TESTINI, Mario; TURK, Yigit; TZIKOS, George; VABALAYTE, Kristina; VARGAS-OSORIO, Kelly; SEBASTIAN, Rafael; RENTERIA, Vazquez; VELAZQUEZ-FERNANDEZ, David; BUEMI, Antoine; VITHANA, Sanura Malinda Pallegoda; YUCEL, Levent; YULIAN, Erwin Danil; ZAHRADNIKOVA, Petra; ZAROGOULIDIS, Paul; ZIABLITSKAIA, Evgeniia; ZOLOTOUKHO, Anna; CALO, Pietro Giorgio; CANU, Gian Luigi; CAPPELLACCI, Federico; CARTWRIGHT, Burchfield; FUSTE, Ignasi Castells; CAVALHEIRO, Beatriz; CAVALLARO, Giuseppe; CHALA, Andres; CHAN, Shun Yan Bryant; CHAPLIN, John; CHEEMA, Mustafa Sajjad; CHIAPPONI, Costanza; CHIOFALO, Maria Grazia; CHRYSOS, Emmanuel; D'AMORE, Annamaria; CILLIA, Michael deBackground Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. Methods In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. Findings Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78 center dot 6%] female patients and 4922 [21 center dot 4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1 center dot 4 [IQR 0 center dot 6-3 center dot 4]) compared with the prepandemic phase (2 center dot 0 [0 center dot 9-3 center dot 7]; p<0 center dot 0001) and pandemic decrease phase (2 center dot 3 [1 center dot 0-5 center dot 0]; p<0 center dot 0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69 center dot 0%] of 3704 vs 1515 [71 center dot 5%] of 2119; OR 1 center dot 1 [95% CI 1 center dot 0-1 center dot 3]; p=0 center dot 042), lymph node metastases (343 [9 center dot 3%] vs 264 [12 center dot 5%]; OR 1 center dot 4 [1 center dot 2-1 center dot 7]; p=0 center dot 0001), and tumours at high risk of structural disease recurrence (203 [5 center dot 7%] of 3584 vs 155 [7 center dot 7%] of 2006; OR 1 center dot 4 [1 center dot 1-1 center dot 7]; p=0 center dot 0039). Interpretation Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation. Funding None.
- Head and neck surgery recommendations during the COVID-19 pandemic(2020) GALLOWAY, Thomas J.; KOWALSKI, Luiz Paulo; MATOS, Leandro L.; CASTRO JUNIOR, Gilberto; RIDGE, John A.
- The hidden curve behind COVID-19 outbreak: the impact of delay in treatment initiation in cancer patients and how to mitigate the additional risk of dying-the head and neck cancer model(2021) MATOS, Leandro L.; FORSTER, Carlos Henrique Q.; MARTA, Gustavo N.; CASTRO JUNIOR, Gilberto; RIDGE, John A.; HIRATA, Daisy; MIRANDA-FILHO, Adalberto; HOSNY, Ali; SANABRIA, Alvaro; GREGOIRE, Vincent; PATEL, Snehal G.; FAGAN, Johannes J.; D'CRUZ, Anil K.; LICITRA, Lisa; MEHANNA, Hisham; HAO, Sheng-Po; PSYRRI, Amanda; PORCEDDU, Sandro; GALLOWAY, Thomas J.; GOLUSINSKI, Wojciech; LEE, Nancy Y.; SHIGUEMORI, Elcio H.; MATIELI, Jose Elias; SHIGUEMORI, Ana Paula A. C.; DIAMANTINO, Leticia R.; SCHIAVETO, Luiz Felipe; LEAO, Lysia; CASTRO, Ana F.; CARVALHO, Andre Lopes; KOWALSKI, Luiz PauloPurpose The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time-to-treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. Methods An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. Results The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time-to-treatment initiation. Conclusions This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.