RAFAEL FERREIRA COELHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
article ROBOT-ASSISTED EXTENDED PELVIC LYMPH NODE DISSECTION IN PROSTATE CANCER, WHEN AND HOW?(2019) SIERRA, Pablo S.; LESTINGI, Jean F. P.; ALBUQUERQUE, Emanuel V.; PONTES JR., Jose; CARVALHO, Paulo A. de; CAVALCANTE, Alexandre; GUGLIELMETTI, Giuliano B.; NAHAS, William C.; COELHO, Rafael F.OBJECTIVE: To review the literature evaluating the role of the extended pelvic lymph node dissection ePLND during robot assisted radical prostatectomy (RARP) in the management of PCa patients, as well as the preoperative clinic pathologic factors that predict lymph node metastases (LNM). The technique and current outcomes of robotic ePLND will be presented. METHODS: Medline (R)/Pubmed (R) were searched up to august 2018 to find comparative studies of different anatomic limits of pelvic lymph node dissection (PLND) during RARP, open or pure laparoscopic surgery that reported number of nodes retrieved, oncologic outcomes and complications. The search was complemented to identify studies that evaluated diagnostic images and factors that predict LNM. Overall, 44 articles were included for full text review. RESULTS: There is not an imaging technique with an acceptable performance to select patients for PLND, the decision to perform a PLND is based on clinical characteristics described on validated nomograms. Median lymph node yield at RARP range from 5 to 21 depending on the extent of PLND, positivity rate of LN as high as 37% depending on the risk stratification of patients. Robot-assisted can be carried out to any extent with lymph node yields and safety concerns comparable to the open approach. CONCLUSION: Extended pelvic lymph node dissection is recommended to be performed at the time of RARP in intermediate and high-risk patients and cannot be replaced by other modalities. A benefit in terms of oncologic outcomes remains to be established. The robot assisted approach offers shorter length of hospital stay, lower transfusion rates and comparable outcomes compared to other surgical approaches.- A rare case of tumor-to-tumor metastasis: Prostate cancer to chromophobe renal cell carcinoma(2019) CAVALCANTE, Alexandre; CORDEIRO, Mauricio D.; SIERRA, Pablo S.; JR, Jose Pontes; V, Emanuel Albuquerque; BARBOSA, Paulyana F.; MATTEDI, Romulo L.; FARAJ, Sheila F.; COELHO, Rafael F.; NAHAS, William C.
conferenceObject CORRELATION BETWEEN MICRORNAS AND MRNA EXPRESSION PROFILES WITH THE PROGNOSIS OF CLINICALLY LOCALIZED PENILE CANCER(2019) MURTA, Claudio; PONTES JR., Jose; FURUYA, Tatiane; UNO, Miyuki; CARRASCO, Alexis; COELHO, Rafael; GUGLIELMETTI, Giuliano; CORDEIRO, Mauricio; FARAJ, Sheila; LEITE, Katia; SICHERO, Laura; VILLA, Luisa; SROUGI, Miguel; CHAMMAS, Roger; NAHAS, William- Tumor contact length used as a biomarker to predict extracapsular extension, lymph node involvement, and biochemical recurrence.(2019) VIANA, Publio; RODRIGUES, Thiana; MOTA, Davi Alves Martins; GUGLIELMETTI, Giuliano; BASTOS, Diogo Assed; FAZOLI, Arnaldo; NAHAS, William Carlos; COELHO, Rafael; CORDEIRO, Mauricio; HORVAT, Natally
bookPart Trauma geniturinário(2019) CEZARINO, Bruno Nicolino; CURY, José; GUGLIELMETTI, Giuliano B.; COELHO, Rafael Ferreira; SROUGI, Miguel- Is Extraprostatic Extension of Cancer Predictable? A Review of Predictive Tools and an External Validation Based on a Large and a Single Center Cohort of Prostate Cancer Patients(2019) ROCCO, Bernardo; SIGHINOLFI, Maria Chiara; SANDRI, Marco; EISSA, Ahmed; ELSHERBINY, Ahmed; ZOEIR, Ahmed; TADZIA, Harvey; PALAYAPALAYAM, Hariharan; KAMEH, Darien; COELHO, Rafael; PULIATTI, Stefano; ZUCCOLOTTO, Paola; MONTIRONI, Rodolfo; WIKLUND, Peter; MICELI, Salvatore; BIANCHI, Giampaolo; PATEL, VipulOur aim was to review and externally validate all the available predictive tools (PTs) predicting extraprostatic extension (EPE) using the area under the curve, calibration plots, and scaled Brier score. A literature search was performed showing 19 models predicting EPE. External validation was carried out on 6360 prostate cancer patients submitted to RP. Most of the PTs showed poor discrimination and unsatisfactory calibration. The majority of the available PTs are not reliable for the prediction of EPE in populations other than the development one; thus, they may not be completely appropriate for patients' counselling or for surgical strategy preplanning. (C) 2019 Elsevier Inc.
- Changing clinical trends in 10 000 robot-assisted laparoscopic prostatectomy patients and impact of the 2012 US Preventive Services Task Force's statement against PSA screening(2019) ONOL, Fikret F.; GANAPATHI, Hariharan P.; ROGERS, Travis; PALMER, Kenneth; COUGHLIN, Geoff; SAMAVEDI, Srinivas; COELHO, Rafael; JENSON, Cathy; SANDRI, Marco; ROCCO, Bernardo; PATEL, VipulObjectives To evaluate the clinical trend changes in our robot-assisted laparoscopic prostatectomy (RALP) practice and to investigate the effect of 2012 US Preventive Services Task Force (USPSTF) statement against PSA screening on these trends. Patients and Methods Data of 10 000 RALPs performed by a single surgeon between 2002 and 2017 were retrospectively analysed. Time trends in successive 1000 cases for clinical, surgical and pathological characteristics were analysed with linear and logistic regression. Time-trend changes before and after the USPSTF's statement were compared using a logistic regression model and likelihood-ratio test. Results Unfavourable cancer characteristics rate, including D'Amico high risk, pathological non-organ-confined disease and Gleason score >= 4+4 increased from 11.5% to 23.3%, 14% to 42.5%, and 7.7% to 20.9%, respectively, over time (all P < 0.001). Significant time-trend changes were detected after the USPSTF's statement with an increase in the positive trend of Gleason >= 4+4 and increase in the negative trends of Gleason <= 3+4 tumours. There was a significant negative trend in the rate of full nerve-sparing (NS) with a decrease from 59.3% to 35.7%, and a significant positive trend in partial NS with an increase from 15.8% to 62.5% over time (both P < 0.001). The time-trend slope in 'high-grade' partial NS significantly decreased and 'low-grade' partial NS significantly increased after the USPSTF's statement. The overall positive surgical margin rate increased from 14.6% to 20.3% in the first vs last 1000 cases (P < 0.001), with a significant positive slope after the USPSTF's statement. Conclusions The proportion of high-risk patients increased in our series over time with a significant impact of the USPSTF's statement on pathological time trends. This stage migration resulted in decreased utilisation of high-quality NS and increased performance of poor-quality NS.
- Multiparametric magnetic resonance imaging (mpMRl) and PSA density for the prediction of reclassification among patients under active surveillance.(2019) VIANA, Publio; HORVAT, Natally; PESSOA, Rodrigo Rodrigues; HORVAT, Joao; PARK, Rubens; GUGLIELMETTI, Giuliano; BASTOS, Diogo Assed; CORDEIRO, Mauricio; COELHO, Rafael; VARGAS, Hebert Alberto; NAHAS, William Carlos