LEANDRO LUONGO DE MATOS

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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

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  • article 1 Citação(ões) na Scopus
    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 Roger
    Objective. 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.
  • article 2 Citação(ões) na Scopus
    Epithelial-mesenchymal transition related to bone invasion in oral squamous cell carcinoma
    (2022) VANINI, Jaqueline Vaz; KOYAMA, Leonardo Kenji Sakaue; MATOS, Leandro Luongo de; FIGUEREDO JUNIOR, Jose Martins; CERNEA, Claudio Roberto; NAGANO, Cibele Pidorodeski; COUTINHO-CAMILLO, Claudia Malheiros; HSIEH, Ricardo; LOURENCO, Silvia Vanessa
    Introduction: Bone invasion is an important prognostic factor in oral squamous cell carcinoma, leading to a lower survival rate and the use of aggressive treatment approaches. Epithelial-mesenchymal transition (EMT) is possibly involved in this process, because it is often related to mechanisms of cell motility and invasiveness. This study examined whether a panel of epithelial-mesenchymal markers are present in cases of oral squamous cell carcinoma with bone invasion and whether these proteins have any relationship with patients' clinical-pathological parameters and prognostic factors. Methods: Immunohistochemical analysis of E-cadherin, twist, vimentin, TGF beta 1, and periostin was performed in paraffin-embedded samples of 62 oral squamous cell carcinoma cases. Results: The analysis revealed that most cases (66%) presented with a dominant tumor infiltrative pattern in bone tissue, associated with lower survival rates, when compared with cases with a dominant erosive invasion pattern (P = 0.048). Twenty-seven cases (43%) expressed markers that were compatible with total or partial EMT at the tumor-bone interface. There was no association between evidence of total or partial EMT and other demographic or prognostic features. E-cadherin-positive cases were associated with tobacco smoking (P = 0.022); vimentin-positive cases correlated with tumors under 4 cm (P = 0.043). Twistexpression was observed in tumors with a dominant infiltrative pattern (P = 0.041) and was associated with the absence of periostin (P = 0.031). Conclusion: We observed evidence of total or partial EMT in oral squamous cell carcinoma bone invasion. The transcription factor twist appears to be involved in bone invasion and disease progression. (C) 2022 The Authors.
  • article 11 Citação(ões) na Scopus
    The role of E-cadherin and β-catenin in laryngeal cancer
    (2018) NARDI, C. E.; DEDIVITIS, R. A.; ALMEIDA, R. C. de; MATOS, L. L. de; CERNEA, C. R.
    Epithelial cadherins with catenins form the E-cadherin-catenin complex that acts on cell-to-cell adhesion. The loss of these complex lead to the reduction or absence of epithelial cadherin expression in the cell membrane, cytoplasmic accumulation of β-catenin and its translocation to the nucleus, contributing to carcinogenic events. The objective of this study was to evaluate the expression of epithelial cadherin and β-catenin in patients with laryngeal tumor. A retrospective study of 52 patients with glottic or supraglottic squamous cell carcinoma was conducted and evaluated according to the tumor site, histological differentiation, TNM stage, survival analysis and compared with the immunohistochemical expression of epithelial cadherin and β-catenin. We observed statistically significant association between the epithelial cadherin expression reduction and supraglottic localization of the lesion, the presence of cervical metastasis, poorly differentiated tumors and locally advanced tumors when in glottic topography. Related to the expression of β-catenin, statistical significance was also found to the presence of cervical metastasis and tumor of low differentiation with the decreased expression of this marker. Regarding survival analysis, the low expression of β-catenin is related to worse overall survival and the reduction of expression of both markers to worse disease-free survival. We concluded that the reduction in expression of the markers studied leads to a prognostic impact as they are related to tumors with greater local aggressiveness and presence of cervical metastasis. © Nardi et al.
  • article 0 Citação(ões) na Scopus
    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 Luongo
    Introduction: 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.
  • article 1 Citação(ões) na Scopus
    Congenital Midline Cervical Cleft and Thyroglossal Duct Fibrous Cord-Like, is There a Mixed Presentation?
    (2023) KRUSCHEWSKY, Leonardo de Souza; MATOS, Leandro Luongo de; ALONSO, Nivaldo; SEIDLER, Cariline da Silva; LISBOA, Sonyara Rauedys Oliveira; SILVA, Roberto Cintra Lomanto Santos; GOLDENBERG, Dov Charles; SILVA, Tatiana Valeria Novais
    Introduction:Congenital midline cervical cleft is a rare condition and is frequently misdiagnosed as thyroglossal duct cyst. Otherwise, the combination of congenital midline cervical cleft and thyroglossal duct fibrosis in the same patient is as rare as important to be registered with the intention to inform and offer specific managements details for the literature.Case Presentation:Eight-year-old boy with simultaneous congenital midline cervical cleft and a thyroglossal duct fibrosis. The anatomic, clinical, radiologic, and pathologic characteristics of the congenital midline cervical cleft are described as well as surgical technique for removal and repair with Z-plasty.Conclusion:Congenital midline cervical cleft is a rare condition and when diagnosed must be surgically treated as early as possible. Its differential diagnosis is a clinical challenge.
  • article 1 Citação(ões) na Scopus
    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, Alfio
    The 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.
  • article 3 Citação(ões) na Scopus
    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 Luongo
    Abstract 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 1 Citação(ões) na Scopus
    The Impact of the COVID-19 Pandemic on Head and Neck Surgery Training: A Brazilian National Survey
    (2021) LEITE, Ana Kober; MATOS, Leandro Luongo; CERNEA, Claudio R.; KOWALSKI, Luiz Paulo
    Introduction The COVID-19 pandemic has had a high impact on surgical training around the world due to required measures regarding the suspension of elective procedures and the dismissal of nonessential personnel. Objectives To understand the impact the pandemic had on head and neck surgery training in Brazil. Methods We conducted a 29-question online survey with head and neck surgery residents in Brazil, assessing the impact the pandemic had on their training. Results Forty-six residents responded to the survey, and 91.3% of them reported that their residency was affected by the pandemic, but most residents were not assigned to work directly with patients infected with the new coronavirus (71.4%). All residents reported decrease in clinic visits and in surgical procedures, mostly an important reduction of similar to 75%. A total of 56.5% of the residents described that the pandemic has had a negative impact on their mental, health and only 4 (8.7%) do not have any symptoms of burnout. The majority (78.3%) of the residents reported that educational activities were successfully adapted to online platforms, and 37% were personally infected with the virus. Conclusion Most surgical residencies were greatly affected by the pandemic, and residents had an important decrease in surgical training. Educational activities were successfully adapted to online modalities, but the residency programs should search for ways of trying to compensate for the loss of practical activities.
  • article 3 Citação(ões) na Scopus
    Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field
    (2021) IMAMURA, Rui; BENTO, Ricardo F.; MATOS, Leandro L.; WILLIAM JR., William N.; MARTA, Gustavo N.; CHAVES, Aline L. F.; CASTRO JR., Gilberto de; KOWALSKI, Luiz P.
    Background With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known. Methods An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic. Results The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector. Conclusion COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.
  • article 4 Citação(ões) na Scopus
    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 de
    Background 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.