LEANDRO CARDOSO BARCHI
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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, Ulyssesarticle Surgical outcome of Gastric Cancer in patients older than 80 years(2016) OLIVEIRA, Rodrigo José de; CHARRUF, Amir Zeide; JACOB, Carlos Eduardo; RAMOS, Marcus Kodama P.; DIAS, André Roncon; YAGI, Osmar K.; MUCERINO, Donato R.; BARCHI, Leandro; MESTER, Marcelo; BRESCIANI, Cláudio J. C.; LOPASSO, Fábio P.; ZILBERSTEIN, Bruno; CECCONELLO, Ivanarticle Morbimortality of extended local resection for advanced gastric cancer(2016) OLIVEIRA, Rodrigo José de; CHARRUF, Amir Zeide; JACOB, Carlos Eduardo; RAMOS, Marcus Kodama P.; DIAS, André Roncon; YAGI, Osmar K.; MUCERINO, Donato R.; BARCHI, Leandro; MESTER, Marcelo; BRESCIANI, Cláudio J. C.; LOPASSO, Fábio P.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan- Gastric partitioning for the treatment of malignant gastric outlet obstruction(2019) RAMOS, Marcus Fernando Kodama Pertille; BARCHI, Leandro Cardoso; OLIVEIRA, Rodrigo Jose de; PEREIRA, Marina Alessandra; MUCERINO, Donato Roberto; RIBEIRO JR., Ulysses; ZILBERSTEIN, Bruno; CECCONELLO, IvanBACKGROUND Gastric outlet obstruction (GOO) is one of the main complications in stage IV gastric cancer patients. This condition is usually managed by gastrojejunostomy (GJ). However, gastric partitioning (GP) has been described as an alternative to overcoming possible drawbacks of GJ, such as delayed gastric emptying and tumor bleeding. AIM To compare the outcomes of patients who underwent GP and GJ for malignant GOO. METHODS We retrospectively analyzed 60 patients who underwent palliative gastric bypass for unresectable distal gastric cancer with GOO from 2009 to 2018. Baseline clinicopathological characteristics including age, nutritional status, body mass index, and performance status were evaluated. Obstructive symptoms were graded according to GOO score (GOOS). Surgical outcomes evaluated included duration of the procedure, surgical complications, mortality, and length of hospital stay. Acceptance of oral diet after the procedure, weight gain, and overall survival were the long-term outcomes evaluated. RESULTS GP was performed in 30 patients and conventional GJ in the other 30 patients. The mean follow-up was 9.2 mo. Forty-nine (81.6%) patients died during that period. All variables were similar between groups, with the exception of worse performance status in GP patients. The mean operative time was higher in the GP group (161.2 vs 85.2 min, P < 0.001). There were no differences in postoperative complications and surgical mortality between groups. The median overall survival was 7 and 8.4 mo for the GP and GJ groups, respectively (P = 0.610). The oral acceptance of soft solids (GOOS 2) and low residue or full diet (GOOS 3) were reached by 28 (93.3%) GP patients and 22 (75.9%) GJ patients (P = 0.080). Multivariate analysis demonstrated that GOOS 2 and GOOS 3 were the main prognostic factors for survival (hazard ratio: 8.90, 95% confidence interval: 3.3823.43, P < 0.001). CONCLUSION GP is a safe and effective procedure to treat GOO. Compared to GJ, it provides similar surgical outcomes with a trend to better solid diet acceptance by patients.
- BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP(2020) BARCHI, Leandro Cardoso; RAMOS, Marcus Fernando Kodama Pertille; YAGI, Osmar Kenji; MUCERIN, Donato Roberto; BRESCIANI, Claudio Jose Caldas; RIBEIRO JUNIOR, Ulysses; ANDREOLLO, Nelson Adami; ASSUMPCAO, Paulo Pimentel; WESTON, Antonio Carlos; NETO, Ramiro Colleoni; ZILBERSTEIN, BrunoBackground: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.
- MINIMALLY INVASIVE SURGERY FOR GASTRIC CANCER: TIME TO CHANGE THE PARADIGM(2016) BARCHI, Leandro Cardoso; JACOB, Carlos Eduardos; BRESCIANI, Cláudio José Caldas; YAGI, Osmar Kenji; MUCERINO, Donato Roberto; LOPASSO, Fábio Pinatel; MESTER, Marcelo; RIBEIRO-JÚNIOR, Ulysses; DIAS, André Roncon; RAMOS, Marcus Fernando Kodama Pertille; CECCONELLO, Ivan; ZILBERSTEIN, BrunoABSTRACT Introduction: Minimally invasive surgery widely used to treat benign disorders of the digestive system, has become the focus of intense study in recent years in the field of surgical oncology. Since then, the experience with this kind of approach has grown, aiming to provide the same oncological outcomes and survival to conventional surgery. Regarding gastric cancer, surgery is still considered the only curative treatment, considering the extent of resection and lymphadenectomy performed. Conventional surgery remains the main modality performed worldwide. Notwithstanding, the role of the minimally invasive access is yet to be clarified. Objective: To evaluate and summarize the current status of minimally invasive resection of gastric cancer. Methods: A literature review was performed using Medline/PubMed, Cochrane Library and SciELO with the following headings: gastric cancer, minimally invasive surgery, robotic gastrectomy, laparoscopic gastrectomy, stomach cancer. The language used for the research was English. Results: 28 articles were considered, including randomized controlled trials, meta-analyzes, prospective and retrospective cohort studies. Conclusion: Minimally invasive gastrectomy may be considered as a technical option in the treatment of early gastric cancer. As for advanced cancer, recent studies have demonstrated the safety and feasibility of the laparoscopic approach. Robotic gastrectomy will probably improve outcomes obtained with laparoscopy. However, high cost is still a barrier to its use on a large scale.
- Predicting recurrence after curative resection for gastric cancer: External validation of the Italian Research Group for Gastric Cancer (GIRCG) prognostic scoring system(2016) BARCHI, L. C.; YAGI, O. K.; JACOB, C. E.; MUCERINO, D. R.; RIBEIRO JR., U.; MARRELLI, D.; ROVIELLO, F.; CECCONELLO, I.; ZILBERSTEIN, B.Background: Most nomograms for Gastric Cancer (GC) were developed to predict overall survival (OS) after curative resection. The Italian Research Group for Gastric Cancer (GIRCG) prognostic scoring system (PSS) was designed to predict the recurrence risk after curative treatment based on pathologic tumor stage and treatment performed (D1 D2/D3 lymphadenectomy). This study was carried out to externally validate the GIRCG's PSS. Patients and methods: Adopting the same criteria used by GIRCG to build the PSS, 185 patients with GC operated with curative intention were selected. The median follow-up period was 77.8 months (1.93-150.8) for all patients and 102.5 months (60.9-150.8) for patients free of disease. The NRI (net reclassification improvement) was calculated to estimate the overall improvement in the reclassification of patients using the PSS in place of the TNM stage system. Results: GC recurrence occurred in 70 (37.8%) patients. The mean time to recurrence was 22.2 (range 1.9-98.1) months. For patients with recurrence, the gain in the proportion of reclassification was 0.257 (p < 0.001), indicating an improvement of 26%. For patients without recurrence, the gain in the proportion of reclassification was 0.122 (p < 0.001), indicating a worsening of 12%. The NRI calculated was 0.135 (p = 0.0527). Conclusion: The GIRCG's PSS, which predicts the likelihood of recurrence after radical surgical treatment for GC, is more accurate than TNM system to predict recurrence mainly for high-risk patients. Yet, the PSS does not have the same effectiveness for low-risk patients, overestimating the chance of recurrence occurs even for disease-free patients.
conferenceObject GLUCOSE LEVEL BEHAVIOR IN TYPE 2 DIABETIC PATIENTS WITH GASTRIC CANCER SUBMITTED TO GASTRECTOMY AND ROUX EN Y RECONSTRUCTION: THE FOREGUT HYPOTHESIS(2015) BARCHI, Leandro Cardoso; ZILBERSTEIN, Bruno; LOPASSO, Fabio Pinatel; YAGI, Osmar Kenji; MUCERINO, Donato; JACOB, Carlos Eduardo; BRESCIANI, Claudio Jose Caldas; RAMOS, Marcus Fernando Kodama Pertille; DIAS, Andre Roncon; FRANCISS, Maurice Youssef; CECONNELLO, Ivan