LENINE GARCIA BRANDAO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
Resultados de Busca
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- Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth(2013) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. Objective: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. Method: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. Results: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. Conclusion: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.
- Anatomical study of jugular foramen in the neck(2020) FREITAS, Carlos Alberto Ferreira de; SANTOS, Luiz Roberto Medina dos; SANTOS, Andreza Negreli; AMARAL NETO, Augusto Barreto do; BRANDAO, Lenine GarciaIntroduction: The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy. Objective: To study the anatomy of the jugular foramen, internal jugular vein and glossopharyngeal, vagus and accessory nerves, and to identify the anatomical relationships among these structures in the jugular foramen region and lateral-pharyngeal space. Methods: A total of 60 sides of 30 non-embalmed cadavers were examined few hours after death. The diameters of the jugular foramen and its anatomical relationships were analyzed. Results: The diameters of the jugular foramen and internal jugular vein were greater on the right side in most studied specimens. The inferior petrosal sinus ended in the internal jugular vein up to 40 mm below the jugular foramen; in 5% of cases. The glossopharyngeal nerve exhibited an intimate anatomical relationship with the styloglossus muscle after exiting the skull, and the vagal nerve had a similar relationship with the hypoglossal nerve. The accessory nerve passed around the internal jugular vein via its anterior wall in 71.7% of cadavers. Conclusion: Anatomical variations were found in the dimensions of the jugular foramen and the internal jugular vein, which were larger in size on the right side of most studied bodies; variations also occurred in the trajectory and anatomical relationships of the nerves. The petrosal sinus can join the internal jugular vein below the foramen. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Epidemiological assessment and therapeutic response in hypopharyngeal cancer(2013) AMAR, Ali; CURIONI, Otavio Alberto; PAIVA, Diogenes Lopes de; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaDespite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. Objective: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. Method: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. Results: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. Conclusion: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
- Multifocal myositis ossificans in masticatory muscles 30 years after gunshot wound: case report and literature review(2019) CAVALHEIRO, Beatriz Godoi; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia
- Value of immunohistochemistry in the diagnosis of malignant cervical lymph nodes(2013) CALY, Decio de Natale; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe cervical lymph nodes are relevant due to the diversity of clinical entities. The use of immunohistochemistry is a real method to elucidate the diagnosis of adenopathy, both primary and metastatic neoplasms. Objective: To assess the value of immunohistochemistry in the diagnosis of cervical lymph nodes malignancies. Method: Retrospective study of the database histopathological specimens from 2009 to 2011. Results: Out of 32 biopsies of cervical lymph nodes, in 16 (50%) the immunohistochemistry was employed, being 68.75% (11) in hematological neoplasms and 31.25% (5) in carcinomas. It was used in all cases of lymphoma. Conclusion: The immunohistochemistry was used in 50% of the biopsies of lymph nodes under suspicion of malignancy, being 31.25% in epithelial lesions and 68.75% in lymphoproliferative lesions.
- Pharyngocutaneous fistula following total laryngectomy(2012) AIRES, Felipe Toyama; DEDIVITIS, Rogerio Aparecido; CASTRO, Mario Augusto Ferrari de; RIBEIRO, Daniel Araki; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaPharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. Objectives: To establish the incidence of this complication and to analyze the predisposing factors. Method: This is a cross-sectional study of a historical cohort including 94 patients who underwent total laryngectomy. The following aspects were correlated to the occurrence of PCF: gender, age, tumor site, TNM staging, type of neck dissection, previous radiation therapy, previous tracheotomy, and use of stapler for pharyngeal closure. The following were considered in PCF cases: the day into postoperative care when the fistula was diagnosed, duration of occurrence, and proposed treatment. Results: Twenty (21.3%) patients had PCF. The incidence of PCF was statistically higher in T4 tumors when compared to T2 and T3 neoplasms (p = 0.03). The other analyzed correlations were not statistically significant. However, 40.9% of the patients submitted to tracheostomy previously had fistulae, against 21.1% of the patients not submitted to this procedure. Conclusion: Advanced primary tumor staging is correlated with higher incidences of PCF.
- Oral cavity squamous cell carcinoma: factors related to occult lymph node metastasis(2015) D'ALESSANDRO, Andre Fernandes; PINTO, Fabio Roberto; LIN, Chin Shien; KULCSAR, Marco Aurelio Vamondes; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia; MATOS, Leandro Luongo deIntroduction: Elective neck dissection is recommended in cases of oral cavity squamous cell carcinoma without lymph node metastasis because of the risk of occult metastasis. Objective: The present study aimed to evaluate predictive factors for occult lymph node metastasis in patients with oral cavity squamous cell carcinoma treated with elective neck dissection and their impact on overall and disease-free survival. Methods: Forty surgically treated patients were retrospectively included. Results: Ten cases (25%) had lymphatic metastasis. Of the studied variables, perineural and angiolymphatic invasion in addition to tumor thickness were statistically associated with lymph node metastasis. Only angiolymphatic invasion was identified as an independent risk factor for occult metastasis in the logistic regression (OR=39.3; p=0.002). There was no association between overall and disease-free survival with the presence of occult lymph node metastasis. Conclusion: Metastatic disease rate was similar to that found in the literature. Perineural and angiolymphatic invasion and tumor thickness were associated with occult metastasis, but only angiolymphatic invasion showed to be an independent risk factor (C) 2015 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Indications and pitfalls of immunohistochemistry in head and neck cancer(2013) CALY, Decio de Natale; VIANA, Acklei; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CURIONI, Otavio Alberto; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaImmunohistochemistry (IHC) has been employed in the differential diagnosis of tumors. Objective: To assess the use of IHC in cases of head and neck tumor. Method: This is a retrospective study of the cases included in the Cancer Registry of the institution. Results: IHC was used in 76 (11%) of 704 pathology tests. Most cases were carcinomas (85.80%), and 83.66% of them were squamous cell carcinomas. All tests were done with diagnostic purposes. The most frequently used antibodies were 34BE12 (37.18%), AE1/AE3 (35.9%), 35BH11 (28.21%), CD45 (25.64%), CD20 (24.36V, CD30 (24.36%), CK7 (23.08%) and CD3 (23.08%). Conclusions: IHC was used in 10.67% of the head and neck tumor cases submitted to pathology testing, mostly for carcinoma (5.26%). In the determination of squamous cell carcinoma, IHC accounted for 18.42% of all tumors.
- The density of metastatic lymph node as prognostic factor in squamous cell carcinoma of the tongue and floor of the mouth(2012) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe presence of metastatic lymph nodes is a relevant prognostic factor in oral cancer. Objective: This paper aims to assess metastatic lymph node density (pN+) in patients with tongue and floor-of-mouth squamous cell carcinoma (SCC) and the association of this parameter with disease-free survival (DFS). Materials and Methods: A group of 182 patients seen between 1985 and 2007 was included, 169 of which were males. Five were on stage I, 35 on stage II, 56 on stage III, and 85 on stage IV. Median values were considered in lymph node density assessment, and the Kaplan-Meier curve was used to evaluate DFS; survival differences within the group were elicited through the log-rank test. Results: An average 3.2 metastatic lymph nodes were excised from the patients in the group. Density ranged from 0.009 to 0.4, with a mean value of 0.09. Five-year DFS rates were of 44% and 28% for the groups with lymph node densities below and above the median respectively (p = 0.006). Two-year local/regional control was achieved for 71% and 49% for the patients below and above the median density respectively (p = 0.01). In terms of pN staging, local/regional control was achieved in 70% and 54% of pN1 and pN2 patients respectively, albeit without statistical significance (0.20%). Conclusion: Lymph node density may be used as a prognostic indicator for tongue and floor-ofmouth SCC.
- Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers(2012) AMAR, Ali; CHEDID, Helma Maria; RAPOPORT, Abrao; CERNEA, Claudio Roberto; DEDIVITIS, Rogerio Aparecido; CURIONI, Otavio Alberto; BRANDAO, Lenine GarciaThe presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. Objective: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. Methods: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110 cases and bilateral in 33. Of these, 78 were radical and 98 selective. The patients were broken down into three groups, according to the 33 and 66 percentiles of the number of lymph nodes resected. Results: The mean number of resected lymph nodes was 27; 24 in selective dissections and 31 in the complete ones. We did not have statistically significant differences when associated to the T and N stages. Conclusions: The larger number of lymph nodes dissected in the neck dissection identifies the group of better prognoses among pN0 cases.