MARINA ALESSANDRA PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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conferenceObject OUTCOME OF GASTRIC CANCER PATIENTS SUBMITTED TO D1 LYMPH NODE DISSECTION DUE TO UNFAVORABLE MEDICAL CONDITIONS(2017) RAMOS, Marcus Kodama; PEREIRA, Marina; DIAS, Andre R.; YAGI, Osmar K.; BARCHI, Leandro C.; JACOB, Carlos E.; MUCERINO, Donato R.; LOPASSO, Fabio; MESTER, Marcelo; BRESCIANI, Claudio C.; CHARRUF, Amir Z.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO, Ulysses- One-level step section histological analysis is insufficient to confirm complete pathological response after neoadjuvant chemoradiation for rectal cancer (vol 21, pg 745, 2017)(2017) PEREIRA, M. A.; DIAS, A. R.; FARAJ, S. F.; NAHAS, C. S. R.; IMPERIALE, A. R.; MARQUES, C. F. S.; COTTI, G. C.; AZEVEDO, B. C.; NAHAS, S. C.; MELLO, E. S. de; RIBEIRO JR., U.Unfortunately, one of the author name was wrongly published in the original publication. The complete correct name should read as follows ""Beatriz Camargo Azevedo"". The original article was updated.
conferenceObject RISK FACTORS FOR LYMPH NODE METASTASIS IN WESTERN EARLY GASTRIC CANCER AFTER OPTIMAL SURGICAL TREATMENT(2017) RAMOS, Marcus Kodama; PEREIRA, Marina; DIAS, Andre R.; YAGI, Osmar K.; FARAJ, Sheila F.; SAFATLE-RIBEIRO, Adriana V.; MELO, Evandro Sobroza de; MALUF-FILHO, Fauze; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO, UlyssesconferenceObject PREDICTORS OF PATHOLOGICAL TUMOR RESPONSE IN GASTRIC CANCER PATIENTS AFTER NEOADJUVANT THERAPY(2017) RAMOS, Marcus Kodama; PEREIRA, Marina; CHARRUF, Amir Z.; DIAS, Andre R.; YAGI, Osmar K.; FARAJ, Sheila F.; PEREIRA, Guilherme L.; MELO, Evandro Sobroza de; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO, UlyssesconferenceObject DOES THE TYPE OF FIXATIVE SOLUTION CORRELATE TO LYMPH NODE YIELD IN LEFT COLON CANCER? A RANDOMIZED TRIAL COMPARING FORMALIN AND CARNOY.(2017) DIAS, A.; PINTO, R.; PEREIRA, M.; CAMARGO, M.; SOUSA, J.; MELLO, E.; NAHAS, S.; CECCONELLO, I.; RIBEIRO JUNIOR, U.conferenceObject Clinicopathological Characteristics and Prognostic Value of Epstein-Barr Virus-associated Gastric Cancer, Microsatellite Instability and PD-L1 Immunoexpression(2017) PEREIRA, Marina Alessandra; RAMOS, Marcus Fernando Kodama Pertille; DIAS, Andre Roncon; FARAJ, Sheila Friedrich; YAGI, Osmar Kenji; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; MELLO, Evandro Sobroza de; RIBEIRO JR., Ulysses- One-level step section histological analysis is insufficient to confirm complete pathological response after neoadjuvant chemoradiation for rectal cancer(2017) PEREIRA, M. A.; DIAS, A. R.; FARAJ, S. F.; NAHAS, C. S. R.; IMPERIALE, A. R.; MARQUES, C. F. S.; COTTI, G. C.; AZEVEDO, B. C.; NAHAS, S. C.; MELLO, E. S. de; RIBEIRO JR., U.Neoadjuvant chemoradiation therapy (nCRT) for rectal cancer may lead to cure. As we currently lack reliable methods to clinically confirm the absence of disease, some patients undergo radical resection and have pathological complete response (pCR) still undergo surgery. Furthermore, it is uncertain if conventional one-level histopathological analysis is accurate enough to determine complete response. Confirming pCR is essential to determine the prognosis and to consider the patient's inclusion in trials of adjuvant therapy. The aim of this study was to determine whether the current 1-level approach is sufficient to confirm pCR. Four hundred and thirty-five patients with rectal cancer who received nCRT followed by radical resection were analyzed. All cases identified as pCR by 1-level step section histological evaluation were reassessed with 3-level step sections and immunohistochemical analysis to verify the presence of residual disease. Out of 435 patients, 75 (17.2%) were staged as ypT0. Of these, 6 had lymph node involvement and 1 had distant metastasis, leaving 68 (15.6%) who had pCR. After the additional step sections, residual tumor was detected in 12 (17.6%) of these 68. The final pCR rate was 12.9%. Distant recurrence was detected in 7.1% of real-pCR patients compared to 16.7% in the false-pCR group (p = 0.291). Sensitivity of clinical assessment for detecting pCR was 35.7%, and the accuracy of 1-section histological evaluation to identify pCR was 82.4%. Histopathological analysis with 1-level step section is insufficient to determine complete tumor eradication. The 3-level sections methodology revealed residual tumor cells in patients initially classified as ypT0. Further studies with larger sample size are required to verify the clinical relevance of these residual tumor cells. Caution should continue to be applied to watch and wait strategies following nCRT.
- DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS(2017) PEREIRA, Marina Alessandra; RAMOS, Marcus Fernando Kodama Pertille; DIAS, Andre Roncon; YAGI, Osmar Kenji; FARAJ, Sheila Friedrich; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; MELLO, Evandro Sobroza de; RIBEIRO-JR, UlyssesABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. Aim: To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Methods: Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). Results: A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). Conclusion: The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging.
conferenceObject Predictors of pathological response and tumor regression following neoadjuvant therapy in advanced gastric cancer patients.(2017) RIBEIRO, Ulysses; RAMOS, Marcus Fernando Kodama Pertille; PEREIRA, Marina Alessandra; DIAS, Andre Roncon; YAGI, Osmar Kenji; FARAJ, Sheila- Lymphoepithelioma-like gastric carcinoma: clinicopathological characteristics and infection status(2017) RAMOS, Marcus Fernando Kodama Pertille; PEREIRA, Marina Alessandra; DIAS, Andre Roncon; FARAJ, Sheila Friedrich; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; MELLO, Evandro Sobroza de; RIBEIRO JUNIOR, UlyssesBackground: Lymphoepithelioma-like gastric carcinoma (LLGC) is a rare subtype of gastric carcinoma (GC) characterized by prominent lymphocytic infiltration. LLGC may be associated with latent Epstein-Barr virus (EBV) infection or microsatellite instability (MSI). This study aims to assess the clinicopathological characteristics, EBV infection, and MSI status in LLGC. Methods: A retrospective analysis of GC patients submitted to potentially curative resection between 2009 and 2014 was performed. The LLGC subtype specimens were examined for EBV by in situ hybridization and MSI by immunohistochemical analysis. The LLGC profile was analyzed accordingly to clinicopathological parameters. Results: From 255 patients, seven were identified on the pathological report as LLGC. Six cases were EBV-positive and one had MSI, showing loss of MLH1 and PMS2 expression. LLGC was more frequently seen in men, and the mean age was 69 years. When compared to non-LLGC, LLGC cases were larger (similar to 5.8 cm) poorly differentiated tumors and had lower incidence of lymph node metastasis (P = 0.045). Mean number of lymph nodes dissected in the LLGC group was 39.5, and only one patient had a single positive lymph node. In addition, two patients presented associated lesions. LLGC was not associated with HER-2, chromogranin and synaptophysin positivity or Helicobacter pylori infection. Conclusions: Distinct pathological aspects and clinical behavior of LLGC reinforce the need for proper recognition of this histological subtype to choose better therapeutic approaches.