OTAVIO AUGUSTO NOSCHANG MOREIRA
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Worsening of breast and cervical cancer stage at diagnosis due to COVID-19 pandemic(2021) MESSIAS, A. P.; BONADIO, R. R. D. C. C.; MOREIRA, O. A. N.; LEIS, L. Vecchi; ORSI, B. Zanin; BATISTA, D. Negrini; TESTA, L.; DIZ, M. D. P. Estevez
- Impact of the COVID-19 pandemic on breast and cervical cancer stage at diagnosis in Brazil(2021) BONADIO, Renata Colombo; MESSIAS, Ana Paula; MOREIRA, Otavio Augusto; LEIS, Leticia Vecchi; ORSI, Bruna Zanin; TESTA, Laura; ESTEVEZ-DIZ, Maria Del PilarBackground: The COVID-19 pandemic has led to the need for health services adjustments, which may have compromised management of other diseases. For cancer patients, delays may significantly impair outcomes in some situations. We aimed to assess the impact of the COVID-19 pandemic in breast and cervical cancer diagnosis and treatment compared to the same period prior to the pandemic. Methods: Data were collected from patients attending their first visit to a Brazilian cancer centre from 1 September 2020 to 31 January 2021 and from 1 September 2019 to 31 January 2020. The pandemic started in February 2020 in Brazil and is still ongoing. We considered this period (September/20-January/21) to be representative of the pandemic impact on cancer management. The primary endpoint was breast and cervical cancer stages at diagnosis. Results: A total of 268 breast cancer patients and 44 cervical cancer patients had their first consult in our cancer centre from September/20 to January/21; 457 and 60, respectively, occurred from September/19 to January/20. Patients who attended their first visit during the pandemic (September/20-January/21) presented with more advanced-stage breast cancer (p < 0.001) and cervical cancer (p = 0.328) than those in the period prior to the pandemic (September/19-January/20), although the difference was not statistically significant for cervical cancer. The proportion of cervical cancer patients diagnosed with locally advanced disease (stages III-IVA) was 56.8% (N = 25) in September/20-January/21 compared to 43.3% (N = 26) in September/19-January/20. Similarly, 37.3% (N = 100) of breast cancer patients had stage III disease in September/20-January/21 compared to 23.2% (N = 106) in September/19-January/20. Fewer breast cancer patients (13.7%) were diagnosed due to screening tests during the pandemic than before it (25.5%) (p < 0.001). Conclusions: Breast and cervical cancer patients had more advanced-stage diseases in their first visit to a cancer centre during the COVID-19 pandemic compared to a similar period prior to the pandemic. Efforts should be made not to compromise essential cancer services since this results in long-term negative impacts for oncologic patients.
- Breast cancer trends in women younger than 40 years in Brazil(2022) BONADIO, Renata Colombo; MOREIRA, Otavio Augusto; TESTA, LauraBackground: A recent Brazilian populational database analysis showed a concerning increase in breast cancer mortality rates among patients under 40 years. We aimed to evaluate the trends in the proportion of new breast cancer cases and deaths occurring in patients younger than 40 years over the last decade in Brazil. Methods: We evaluated all consecutive breast cancer patients treated from 2009 to 2020 in a Brazilian tertiary cancer center. The proportions of new cases and deaths in patients younger than 40 years was compared between two time periods (2015-2020 versus 2009-2014) using Chi-squared test. Linear regression was used to evaluate the trends in the proportion of new cases and deaths in young patients over the years. Results: From 2009 to 2020, a total of 12,569 breast cancer patients started treatment at our institution; 1441 were younger than 40 years. From 2009 to 2014, 9.9% (95% CI 9.2-10.7%) were patients younger than 40 years compared to 12.9% (95% CI 12.1-13.8%) from 2015 to 2020. Similarly, the proportion of deaths among breast cancer patients younger than 40 years increased during the period (2009-2014: 9.6%, 95% CI 7.8-11.6%; 2015-2020: 12.4%, 95% CI 10.9-14%). The linear regression model showed a trend for an increasing proportion of new breast cancer cases occurring in patients under 40 years (P = 0.005). Proportion increased from 7.9% (95% CI 6.2-9.8%) in 2009 to 21.8% (95% CI 19.1-24.8%) in 2020. The trend for the increase in the proportion of deaths in this young population was also observed in the linear regression model (P = 0.01). Conclusions: The proportion of new breast cancer cases and deaths among patients younger than 40 years has increased in a public Brazilian cancer center over the past decade. These results raise the concern for the need to reconsider primary and secondary prevention strategies for young women.
- Epidemiology and Outcomes of Patients With Brain Metastases From Colorectal Cancer-Who Are These Patients?(2021) BONADIO, Renata Colombo; FREITAS, Guilherme Fialho; BATISTA, Daniel Negrini; MOREIRA, Otavio Augusto Noschang; DIAS, Carla A. R.; CASTRIA, Tiago Biachi; SABBAGA, Jorge; HOFF, Paulo M.Brain metastases have been seen more frequently in the late course of colorectal cancer. In this large cohort, we showed that, despite the advances in systemic therapy, prognosis remains poor for patients who develop brain metastases. Aggressive local therapy should be considered for selected patients. Background: Brain metastases (BMs) from colorectal cancer (CRC) are unusual; however, an increase in incidence has been reported. The evidence available on the subject is scarce, and a better understanding is warranted. We aimed to characterize the epidemiology and the outcomes of patients with BMs from CRC. Patients and Methods: A cohort of patients with BMs from CRC was retrospectively evaluated. Patients were treated in a single center between May 2008 and April 2019. BMs were confirmed by brain computed tomography or magnetic resonance imaging. Results: A total of 247 consecutive patients were evaluated. Most patients had a left-sided primary tumor (193, 78%) and at least two extra-cranial metastatic sites (194, 78%). Ninety-six patients (39%) were RAS wild-type; 68 patients (27%) were RAS mutated; and 83 patients (34%) were not characterized. Median time from the initial diagnosis to BMs was 27.6 months (interquartile range, 13.1-46.9). Regarding local therapy, 43 patients (17.4%) were treated with BM surgery alone, 76 patients (30.8%) with radiotherapy (RT) alone, and 58 patients (23.5%) with both surgery and RT. Median overall survival (OS) was 2.9 months (95% confidence interval [CI], 2.2-3.5). Six-month and 1-year OS rates were 29% (95% CI, 23-25) and 13.5% (95% CI, 9.2-18.6), respectively. In a multivariable analysis, BM surgery alone (hazard ratio [HR], 0.56; P =.018), RT alone (HR, 0.51; P =.001), and surgery plus RT (HR, 0.27; P <.001) were associated with superior OS, whereas Eastern Cooperative Oncology Group Performance Status 3 or 4 (HR, 2.01; P =.009) and male gender (HR, 1.46; P =.012) were negative prognostic factors. RAS status was not associated with OS. Conclusion: BMs occur late during the course of colorectal cancer and are more common in patients with a left-sided primary tumor and a high volume of metastatic disease. BMs from colorectal cancer are still associated with an extremely poor prognosis; however, selected patients may benefit from treatment with surgical resection and radiotherapy.
- Does undertreatment of elderly patients with early breast cancer impact outcome?(2022) VASCONCELLOS, J. Monteiro; BONADIO, R. Colombo; MENDES, S. Vidaurre; ORSI, B. Zanin; LEIS, L. Vecchi; MESSIAS, A. P.; MOREIRA, O. A.; PEREIRA, M. Baptista; FREIR, P. J. Galvao; ARAUJO NETO, A. Rodrigues De; ROCHA, E. Andrade; PETRY, V.; TESTA, L.
- Breast cancer in women younger than 40 years: Increasing proportion of new cases and deaths in Brazil(2021) BONADIO, R. R. D. C. C.; MOREIRA, O. A. N.; TESTA, L.