DANIEL JOSE SZOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- The Role of the Heat-Shock Proteins in Esophagogastric Cancer(2022) TUSTUMI, Francisco; AGARENO, Gabriel Andrade; GALLETTI, Ricardo Purchio; SILVA, Rafael Benjamim Rosa da; QUINTAS, Julia Grams; SESCONETTO, Lucas de Abreu; SZOR, Daniel Jose; WOLOSKER, NelsonHeat-shock proteins (HSPs) are a family of proteins that have received considerable attention over the last several years. They have been classified into six prominent families: high-molecular-mass HSP, 90, 70, 60, 40, and small heat shock proteins. HSPs participate in protein folding, stability, and maturation of several proteins during stress, such as in heat, oxidative stress, fever, and inflammation. Due to the immunogenic host's role in the combat against cancer cells and the role of the inflammation in the cancer control or progression, abnormal expression of these proteins has been associated with many types of cancer, including esophagogastric cancer. This study aims to review all the evidence concerning the role of HSPs in the pathogenesis and prognosis of esophagogastric cancer and their potential role in future treatment options. This narrative review gathers scientific evidence concerning HSPs in relation to esophagus and gastric cancer. All esophagogastric cancer subtypes are included. The role of HSPs in carcinogenesis, prognostication, and therapy for esophagogastric cancer are discussed. The main topics covered are premalignant conditions for gastric cancer atrophic gastritis, Barrett esophagus, and some viral infections such as human papillomavirus (HPV) and Epstein-Barr virus (EBV). HSPs represent new perspectives on the development, prognostication, and treatment of esophagogastric cancer.
- Prognostic Role of Neutrophil/Lymphocyte Ratio in Resected Gastric Cancer: A Systematic Review and Meta-analysis(2018) SZOR, Daniel Jose; DIAS, Andre Roncon; PEREIRA, Marina Alessandra; RAMOS, Marcus Fernando Kodama Pertille; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO-JUNIOR, UlyssesHigh levels of inflammatory markers and the neutrophil-lymphocyte ratio appear to be associated with worse overall survival in solid tumors. However, few studies have analyzed the role of the neutrophil-lymphocyte ratio in gastric cancer patients scheduled to undergo curative resection. In the present study, a systematic review and meta-analysis was performed to analyze the relationship between the neutrophil-lymphocyte ratio and overall survival in patients with gastric cancer submitted to curative resection and to identify the clinicopathological features (age, gender, tumor depth, nodal involvement and tumor differentiation) that are correlated with high neutrophil-lymphocyte ratios. A literature search of PubMed, Scopus, Cochrane and EMBASE through November 2017 was conducted. Articles that included gastric cancer patients submitted to curative resection and preoperatory neutrophil-lymphocyte ratio values were included. A total of 7 studies comprising 3264 patients from 5 different countries were included. The meta-analysis revealed an association of high neutrophil-lymphocyte ratios with older age, male gender, lower 5-year overall survival, increased depth of tumor invasion, positive nodal involvement but not with histological differentiation. Evaluation of the neutrophil-lymphocyte ratio is a cost-effective method that is widely available in preoperatory settings. Furthermore, it can effectively predict prognosis, as high values of this biomarker are related to more aggressive tumor characteristics. This ratio can also be used to stratify risk in patients within the same disease stage and may be used to assist in individualized follow-up and treatment.
- Adenoma hepático(2013) SZOR, Daniel José; URSOLINE, Mauricio; HERMAN, PauloBACKGROUND: Benign liver tumors, due to its relative easeness its imaging identification, have their incidence increasing in population in recent years, becoming frequent in the clinical picture and often a challenge for clinicians and surgeons. Doctors began to face dilemmas related to diagnosis in asymptomatic patients with liver nodules. AIM: Update the knowledge of hepatic adenomas due to the crescent diagnosis seen in the recent years. METHODS: Was performed a literature review consulting Medline/PubMed, SciELO, Embase, Lilacs database with the following descriptors: hepatic adenoma, surgery, medical treatment, diagnosis, pathophysiology and molecular biology. CONCLUSION: The diagnosis of incidental asymptomatic lesions is a major dilemma in clinical practice because it brings intense distress for patients and their families, and often become a challenge for the physician or surgeon. Injury is of particular interest because it can provide both benign evolution or potentially lethal complications. Recently, its resection is no more mandatory; currently, more individualized treatment are required, aiming less morbidity. In light of new advances in molecular biology, the physician who diagnoses the lesion must identify the potential unfavorable evolution, and recognize cases who need more aggressive medical management.
conferenceObject THE IMPACT OF INSTITUTIONAL VOLUME OF TOTAL GASTRECTOMY FOR PATIENTS WITH GASTRIC CANCER ON SHORT-TERM OUTCOMES AND COSTS IN BRAZILIAN PUBLIC HEALTH SYSTEM(2023) SZOR, Daniel J.; TUSTUMI, Francisco; SILVA, Thaysa Venturini da; ARVATE, Gabriela Gerote; SANTOS, Maria Eduarda Carvalhal; GOUVEA, Fabiana Pereira Riviello; OLIVEIRA, Julia Politano de; MIHICH, Juliana Salem; WOLOSKER, Nelson- The impact of sarcopenia on esophagectomy for cancer: a systematic review and meta-analysis(2023) PARK, Amanda; ORLANDINI, Marina Feliciano; SZOR, Daniel Jose; RIBEIRO, Ulysses; TUSTUMI, FranciscoBackgroundEsophagectomy is the gold-standard treatment for locally advanced esophageal cancer but has high morbimortality rates. Sarcopenia is a common comorbidity in cancer patients. The exact burden of sarcopenia in esophagectomy outcomes remains unclear. Therefore, this systematic review and meta-analysis were performed to establish the impact of sarcopenia on postoperative outcomes of esophagectomy for cancer.MethodsWe performed a systematic review and meta-analysis comparing sarcopenic with non-sarcopenic patients before esophagectomy for cancer (Registration number: CRD42021270332). An electronic search was conducted on Embase, PubMed, Cochrane, and LILACS, alongside a manual search of the references. The inclusion criteria were cohorts, case series, and clinical trials; adult patients; studies evaluating patients with sarcopenia undergoing esophagectomy or gastroesophagectomy for cancer; and studies that analyze relevant outcomes. The exclusion criteria were letters, editorials, congress abstracts, case reports, reviews, cross-sectional studies, patients undergoing surgery for benign conditions, and animal studies. The meta-analysis was synthesized with forest plots.ResultsThe meta-analysis included 40 studies. Sarcopenia was significantly associated with increased postoperative complications (RD: 0.08; 95% CI: 0.02 to 0.14), severe complications (RD: 0.11; 95% CI: 0.04 to 0.19), and pneumonia (RD: 0.13; 95% CI: 0.09 to 0.18). Patients with sarcopenia had a lower probability of survival at a 3-year follow-up (RD: -0.16; 95% CI: -0.23 to -0.10).ConclusionPreoperative sarcopenia imposes a higher risk for overall complications and severe complications. Besides, patients with sarcopenia had a lower chance of long-term survival.
- Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma(2020) DIAS, Andre R.; PEREIRA, Marina A.; OLIVEIRA, Rodrigo J.; RAMOS, Marcus F. K. P.; SZOR, Daniel J.; RIBEIRO, Ulysses; ZILBERSTEIN, Bruno; CECCONELLO, IvanIntroduction Multivisceral resection (MVR) is potentially curative for selected gastric cancer patients, supposedly at the cost of increased complications. However, current data comparing MVR to standard gastrectomy (SG) is lacking. Objectives Compare complications and survival after MVR and SG. Methods In a retrospective cohort of 1015 patients with gastric adenocarcinoma, 58 underwent MVR and 466 SG. Groups were compared concerning their characteristics, complications, and survival. Results One hundred seventy-six patients had postoperative complications. Major complications were more frequent after MVR (P = .002). Surgical mortality was 8.6% and 4.9% for MVR and SG (P = .221). Older age, higher morbidities, and MVR were independent risk factors for major complications. The odds ratio for major complications was 5.89 for MVR with one or two organs and 38.01 for MVR with three or more organs. The pancreas was the most commonly removed organ and pT4b disease were confirmed in 34 (58.6%) of the MVR cases. Disease-free survival (DFS) was lower in MVR patients (51% vs 77.8%; P < .001), being worse according to the number of organs resected. In pN+ patients, DFS was worse after MVR. DFS was equivalent to pT4b and non-pT4b in the MVR group. Conclusions Increased morbidity and lower survival are expected for gastric cancer patients undergoing MVR.
- Preoperative albumin-bilirubin score is a prognostic factor for gastric cancer patients after curative gastrectomy(2023) SZOR, Daniel Jose; PEREIRA, Marina Alessandra; RAMOS, Marcus Fernando Kodama Pertille; TUSTUMI, Francisco; DIAS, Andre Roncon; ZILBERSTEIN, Bruno; RIBEIRO, UlyssesBACKGROUNDAlbumin-bilirubin (ALBI) score is an indicator of liver dysfunction and is useful for predicting prognosis of hepatocellular carcinomas. Currently, this liver function index has been used to predict prognosis in other neoplasms. However, the significance of ALBI score in gastric cancer (GC) after radical resection has not been elucidated.AIMTo evaluate the prognostic value of the preoperative ALBI status in patients with GC who received curative treatment.METHODSPatients with GC who underwent curative intended gastrectomy were retrospectively evaluated from our prospective database. ALBI score was calculated as follows: (log10 bilirubin x 0.660) + (albumin x -0.085). The receiver operating characteristic curve with area under the curve (AUC) was plotted to evaluate the ability of ALBI score in predicting recurrence or death. The optimal cutoff value was determined by maximizing Youden's index, and patients were divided into low and high-ALBI groups. The Kaplan-Meier curve was used to analyze the survival, and the log-rank test was used for comparison between groups.RESULTSA total of 361 patients (235 males) were enrolled. The median ALBI value for the entire cohort was -2.89 (IQR -3.13; -2.59). The AUC for ALBI score was 0.617 (95%CI: 0.556-0.673, P < 0.001), and the cutoff value was -2.82. Accordingly, 211 (58.4%) patients were classified as low-ALBI group and 150 (41.6%) as high-ALBI group. Older age (P = 0.005), lower hemoglobin level (P < 0.001), American Society of Anesthesiologists classification III/IV (P = 0.001), and D1 lymphadenectomy P = 0.003) were more frequent in the high-ALBI group. There was no difference between both groups in terms of Lauren histological type, depth of tumor invasion (pT), presence of lymph node metastasis (pN), and pathologic (pTNM) stage. Major postoperative complication, and mortality at 30 and 90 days were higher in the high-ALBI patients. In the survival analysis, the high-ALBI group had worse disease-free survival (DFS) and overall survival (OS) compared to those with low-ALBI (P < 0.001). When stratified by pTNM, the difference between ALBI groups was maintained in stage I/II and stage III CG for DFS (P < 0.001 and P = 0.021, respectively); and for OS (P < 0.001 and P = 0.063, respectively). In multivariate analysis, total gastrectomy, advanced pT stage, presence of lymph node metastasis and high-ALBI were independent factors associated with worse survival.CONCLUSIONThe preoperative ALBI score is able to predict the outcomes of patients with GC, where high-ALBI patients have worse prognosis. Also, ALBI score allows risk stratification of patients within the same pTNM stages, and represents an independent risk factor associated with survival.
- Achalasia: A syndrome(2021) TUSTUMI, Francisco; TAVARES, Guilherme; TRISTAO, Luca Schiliro; MORRELL, Andre Luiz Gioia; SZOR, Daniel Jose; DIAS, Andre Roncon
- Reply to: ""Association between neutrophil-lymphocyte ratio and prognosis after potentially curative resection for gastric cancer""(2018) SZOR, Daniel J.; DIAS, Andre R.; PEREIRA, Marina A.; RAMOS, Marcus F. K. P.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO JR., Ulysses
- Neutrophil-lymphocyte ratio change after curative gastrectomy for gastric cancer: a subgroup analysis(2020) SZOR, Daniel Jose; DIAS, Andre Roncon; PEREIRA, Marina Alessandra; RAMOS, Marcus Fernando Kodama Pertille; ZLBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO JUNIOR, UlyssesObjective: To evaluate the impact of neutrophil-lymphocyte ratio change after curative surgery for gastric cancer. Methods: A retrospective analysis of patients with gastric cancer who underwent curative surgery between 2009 and 2017 was performed. A cutoff value was established for the neutrophil-lymphocyte ratio in the pre- and postoperative periods, according to the median value, and four subgroups were formed (low-low/low-high/high-low/high-high). Clinical-pathological and survival data were analyzed and related to these subgroups. Results: A total of 325 patients were included in the study. The cutoff values of the neutrophil-lymphocyte ratio were 2.14 and 1.8 for the pre and postoperative periods, respectively. In patients with stages I and II, the high-high subgroup presented worse overall survival (p=0.016) and disease-free survival (p=0.001). Complications were higher in the low-high subgroup of patients. Conclusion: The neutrophil-lymphocyte ratio is a low cost, efficient and reproducible marker. The prognosis individualization can be performed according to the identification of subgroups at a higher risk of complications and worse prognosis.