ANA CAROLINA PRADO RIBEIRO E SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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- Impact of tumor site on the prognosis of salivary gland neoplasms: A systematic review and meta-analysis(2021) SANTOS, Erison Santana dos; RODRIGUES-FERNANDES, Carla Isabelly; SPEIGHT, Paul M.; KHURRAM, Syed Ali; ALSANIE, Ibrahim; NORMANDO, Ana Gabriela Costa; PRADO-RIBEIRO, Ana Carolina; BRANDAO, Thais Bianca; KOWALSKI, Luiz Paulo; GUERRA, Eliete Neves Silva; LOPES, Marcio Ajudarte; VARGAS, Pablo Agustin; SANTOS-SILVA, Alan Roger; LEME, Adriana Franco PaesIn numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a metaanalysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrencefree survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
- Leiomyoma and Leiomyosarcoma (Primary and Metastatic) of the Oral and Maxillofacial Region: A Clinicopathological and Immunohistochemical Study of 27 Cases(2022) ARAUJO, Gabriela Ribeiro de; COSTA, Sara Ferreira dos Santos; MESQUITA, Ricardo Alves; GOMEZ, Ricardo Santiago; SANTOS, Jean Nunes dos; PONTES, Helder Antonio Rebelo; ANDRADE, Bruno Augusto Benevenuto de; ROMANACH, Mario Jose; AGOSTINI, Michelle; VARGAS, Pablo Agustin; CACERES, Cinthia Veronica Bardalez Lopez de; SANTOS-SILVA, Alan Roger; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; TOMASI, Ramiro Alejandro; FERREYRA, Ruth Salome; ALMEIDA, Oslei Paes de; FONSECA, Felipe PaivaSmooth muscle neoplasms represent an important group of lesions which is rare in the oral cavity. Leiomyoma (LM) is benign smooth muscle/pericytic tumor usually presenting as non-aggressive neoplasm, while leiomyosarcoma (LMS) represents its malignant counterpart. The rarity of these lesions, together with its unspecific clinical presentation and a variable histopathological appearance, lead to a broad list of differential diagnoses, hampering their diagnoses. Therefore, in this study we describe the clinical and microscopic features of a series of oral and maxillofacial LMs and LMSs. A retrospective search from 2000 to 2019 was performed and all cases diagnosed as LM and LMS affecting the oral cavity and gnathic bones were retrieved. Clinical and demographic data were obtained from the patients' pathology records, while microscopic features and immunohistochemistry were reviewed and completed when necessary to confirm the diagnoses. Twenty-two LMs and five LMSs were obtained. In the LM group, males predominated, with a mean age of 45.7 years. The upper lip was the most affected site, and 18 cases were classified as angioleiomyomas and four as solid LM. In the LMS group, females predominated, with a mean age of 47.6 years. The mandible was the most affected site. Diffuse proliferation of spindle cells, with necrosis and mitotic figures, were frequent microscopic findings. LMs and LMSs were positive for alpha-smooth muscle actin, HHF-35 and h-caldesmon. In conclusion, oral LM/LMS are uncommon neoplasms with the latter usually presenting as metastatic disease. H&E evaluation may be very suggestive of oral LMs, but h-caldesmon staining is strongly recommended to confirm LMS diagnosis.
- Patient's perceptions of oral and oropharyngeal cancer diagnosis disclosure: communication aspects based on SPIKES protocol(2023) ALVES, Carolina G. B.; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; TONAKI, Juliana O.; PEDROSO, Caique Mariano; RIVERA, Cesar; EPSTEIN, Joel B.; MIGLIORATI, Cesar Augusto; KOWALSKI, Luiz Paulo; MAK, Milena Perez; CASTRO, Gilberto; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan RogerObjective. Breaking bad medical news is a complex task of clinical practice. The manner in which this is done has a significant impact on patients. This study aimed to assess patient's perceptions regarding oral and oropharyngeal cancer diagnosis disclosure according to the ""SPIKES"" protocol. Study Design. This cross-sectional study used a questionnaire with 21 SPIKES-based items. The questionnaire was administered to 100 patients with recently diagnosed oral and oropharyngeal squamous cell carcinoma who evaluated each item according to their preference and experience. Results. Nineteen items showed a significant difference between patient's preference and recalled experience. Eighteen of these items showed lower experience scores primarily related to the amount of information desired by patients, presence of a compan-ion, time to express feelings, and summary of information. Most patients preferred receiving as much information as possible about the diagnosis. However, only 35% reported that they had obtained sufficient information. Patients who were aware of can-cer diagnostic suspicion had better communication experiences. Conclusions. Protocols may be useful to guide health professionals to support patient-centered strategies to disclose oral cancer diagnoses. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;135:518-529)
- Patterns of oral mucositis in advanced oral squamous cell carcinoma patients managed with prophylactic photobiomodulation therapy-insights for future protocol development(2021) PAGLIONI, Mariana de Pauli; FARIA, Karina Morais; PALMIER, Natalia Rangel; PRADO-RIBEIRO, Ana Carolina; DIAS, Reinaldo Brito e; PINTO, Henrique da Graca; TREISTER, Nathaniel Simon; EPSTEIN, Joel B.; MIGLIORATI, Cesar Augusto; SANTOS-SILVA, Alan Roger; BRANDAO, Thais BiancaTo characterize oral sites affected by radiation-induced oral mucositis (OM) and related clinical outcomes in oral cancer patients subjected to prophylactic photobiomodulation therapy (PBMT). This study included advanced oral squamous cell carcinoma (OSCC) patients treated with prophylactic PBMT for OM. The site distribution of OM, OM grading (CTCAE NCI, Version 4.0, 2010), OM-related pain (VAS), analgesic protocol (WHO Analgesic Ladder), and use of enteral nutrition were evaluated weekly during treatment. Data analysis was performed using descriptive statistics expressed as median values and percentages. A total of 145 OSCC patients were included. OM most frequently affected the lateral border of the tongue (44.1%), buccal mucosa (37.2%), and labial mucosa (33.8%). Keratinized oral mucosa sites, including the tongue dorsum (6.21%), retromolar trigone (8.3%), and hard palate (2.76%), were less frequently affected. Peak OM scores were observed at weeks 5, 6, and 7, with severe OM (NCI grades 3 and 4) rates of 11%, 20%, and 25%, respectively. The cumulative occurrence of severe OM was 23%, which developed as early as week 3 and as late as week 7. The highest mean value of OM-related pain (2.7) was observed at the sixth week, and 13.8% of the patients required feeding support. This study showed, compared with studies that did not provide PBMT, reduced severity of mucositis, reduced pain and analgesic use, and reduced tube feeding in patients treated with PBMT. OM involving keratinized and non-keratinized surfaces should be included in the prophylactic PBMT to reduce severe OM in future studies.
- Locally advanced oral squamous cell carcinoma patients treated with photobiomodulation for prevention of oral mucositis: retrospective outcomes and safety analyses(2018) BRANDAO, Thais Bianca; MORAIS-FARIA, Karina; RIBEIRO, Ana Carolina Prado; RIVERA, Cesar; SALVAJOLI, Joao Victor; LOPES, Marcio Ajudarte; EPSTEIN, Joel B.; ARANY, Praveen R.; CASTRO JR., Gilberto de; MIGLIORATI, Cesar Augusto; SANTOS-SILVA, Alan RogerThe well-established clinical efficacy of photobiomodulation (PBM) therapy in management of oral mucositis (OM) is leading to increasing use in oncology care. This protection and enhanced repair of damage to mucosal tissue have led to the question of the potential effects of PBM therapy on pre-malignant and malignant cells. The purpose of this study was to examine the outcome of cancer therapy and incidence of tumor recurrence in locally advanced oral squamous cell carcinoma (OSCC) patients treated with PBM therapy for OM. A retrospective clinical analysis of 152 advanced OSCC patients treated with prophylactic PBM therapy for radiotherapy-induced OM from January 2009 to December 2014 was conducted. Of the 152 OSCC patients treated with PBM therapy in this study, 19 (12.5%) had stage III and 133 (87.5%) had stage IV tumors. Of these, 52 (34.2%) received initial treatment with surgery followed by adjuvant radiotherapy, 94 (61.8%) with exclusive chemoradiation, and 6 (4%) with induction chemotherapy followed by surgery and radiotherapy. After a mean follow-up of 40.84 (+/- 11.71) months, the overall survival and disease-free survival rates were 46.7 and 51.8%, respectively. Forty-five (29.6%) patients developed local-regional recurrence, 10 (6.57%) patients developed distant relapse, and 19 (12.5%) developed new (second) primary tumors. Clinicopathological features and survival outcomes in the PBM-treated patients were similar to previously published data for conventional treatments in patients with advanced OSCC. In this study, prophylactic use of PBM therapy did not impact treatment outcomes of the primary cancer, recurrence or new primary tumors, or survival in advanced OSCC patients.
- Global prevalence of human papillomavirus-driven oropharyngeal squamous cell carcinoma following the ASCO guidelines: A systematic review and meta-analysis(2020) MARIZ, Bruno Augusto Linhares Almeida; KOWALSKI, Luiz Paulo; JR, William Nassib William; CASTRO, Gilberto de; CHAVES, Aline Lauda Freitas; SANTOS, Marcos; OLIVEIRA, Thiago Bueno de; ARAUJO, Anna Luiza Damaceno; NORMANDO, Ana Gabriela Costa; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; VARGAS, Pablo Agustin; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan RogerObjectives: to provide accurate information about the global prevalence of human papillomavirus (HPV) in oropharyngeal squamous cell carcinomas (OPSCC). Material and methods: a systematic review was performed using three main electronic databases. Studies were independently assessed by two reviewers based on established eligibility criteria, to identify the prevalence of HPV-driven OPSCC following criteria defined by the American Society of Clinical Oncology. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Statistical software MedCalc was used to perform meta-analyses. Results: from 2215 records found, 15 were included, reporting data from 6009 patients (time period range: 1980-2016), distributed in 11 countries. Eleven studies were considered as presenting low risk, and four as moderate risk of bias. Using proportion meta-analysis, pooled prevalence of HPV-driven OPSCC was 44.8 % (95 %CI: 36.4-53.5 %; i(2) = 97.6 %), with the highest rates in New Zealand (74.5 %; 95 %CI: 60.9-85.3 %), and the lowest in Brazil (11.1 %; 95 %CI: 4.5-21.5 %). HPV prevalence was similar between males (45.7 %; 95 %CI: 36.5-55.0 %; i(2) = 96.4 %) and females (42.2 %; 95 %CI: 34.3- 50.5 %; i(2) = 85.4 %). Mean/median age ranged from 59.1-67.1 years in the HPV-negative group, and from 55.7-63.5 years in the HPV-positive group. There was an overall discordance between testing by p16 (49.4 %; 95 %CI, 38.2-60.5 %; i(2) = 96.2 %) and p16+ISH/PCR (44.7 %; 95 %CI, 33.5-56.2 %; i(2) = 96.4 %). Conclusion: Overall pooled prevalence of HPV-driven OPSCC was approximately 45 %, with similar distribution among males and females. Double p16/HPV-DNA/RNA testing may be considered to increase specificity and prognostic accuracy.
- Strategies for communicating oral and oropharyngeal cancer diagnosis: why talk about it?(2020) ALVES, Carolina Guimaraes Bonfim; TREISTER, Nathaniel Simon; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; TONAKI, Juliana Ono; LOPES, Marcio Ajudarte; RIVERA, Cesar; SANTOS-SILVA, Alan RogerObjective. This review aimed to explore the paradigms of disclosing a cancer diagnosis with a focus on oral and oropharyngeal cancer and patient-related considerations. Study Design. A search of MEDLINE, Embase, and Scopus was conducted using the following keywords: oral cancer; mouth lesions; oncology; breaking bad news; truth disclosure; and communication skills training. English and Spanish language studies published through October 2019 were included. Results. The way bad news is conveyed to patients with cancer may affect their comprehension of information, emotional distress, treatment adherence, and health outcomes. Models of communication that are focused on patients' preferences may result in better treatment outcomes. Available protocols, such as SPIKES and ABCDE, have useful recommendations for health care professionals communicating an oral cancer diagnosis. However, it is important to be attentive to the particular information needs of patients. Conclusions. When communicating a cancer diagnosis, providers should employ validated methods of information delivery and support for oncology patients. Further studies are needed to evaluate the experiences and preferences of patients with oral cancer during these communications.
- Different methods of cell quantification can lead to different results: a comparison of digital methods using a pilot study of dendritic cells in HIV-positive patients(2020) FERNANDES, Diego Tetzner; HEERDEN, Willie F. P. van; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; MELLO, Evandro Sobroza de; RIVERA, Cesar; HEERDEN, Marlene B. van; GONDAK, Rogerio; SANTOS-SILVA, Alan Roger; VARGAS, Pablo Agustin; LOPES, Marcio AjudarteBackground: Although new digital pathology tools have improved the positive cell quantification, there is a heterogeneity of the quantification methods in the literature. The aim of this study was to evaluate and propose a novel dendritic cells quantification method in squamous cell carcinoma comparing it with a conventional quantification method. Material and Methods: Twenty-six squamous cell carcinomas HIV-positive cases affecting the oropharynx, lips and oral cavity were selected. Immunohistochemistry for CD1a, CD83, and CD207 was performed. The immunohistochemical stains were evaluated by automated examination using a positive pixel count algorithm. A conventional quantification method (unspecific area method; UA) and a novel method (specific area method; SA) were performed obtaining the corresponding density of positive dendritic cells for the intratumoral and peritumoral regions. The Mann-Whitney U test was used to verify the influence of the quantification methods on the positive cell counting according to the evaluated regions. Data were subjected to the ANOVA and Student's t-test to verify the influence of the tumour location, stage, histological grade, and amount of inflammation on the dendritic cells density counting. Results: The cell quantification method affected the dendritic cells counting independently of the evaluated region (P-value < 0.05). Significant differences between methods were also observed according to the tumour features evaluations. Conclusions: The positive cell quantification method influences the dendritic cells density results. Unlike the conventional method (UA method), the novel SA method avoids non-target areas included in the hotspots improving the reliability and reproducibility of the density cell quantification.
- Are intraoral stents effective in reducing oral toxicities caused by radiotherapy? A systematic review and meta-analysis(2022) BRANDAO, Thais Bianca; PINTO, Henrique da Graca; VECHIATO FILHO, Aljomar Jose; FARIA, Karina Morais; OLIVEIRA, Maria Cecilia Querido de; PRADO-RIBEIRO, Ana Carolina; DIAS, Reinaldo Brito; SANTOS-SILVA, Alan Roger; BATISTA, Victor Eduardo de SouzaStatement of problem. Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness. Purpose. The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation. Material and methods. Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents. Results. The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P<.001), salivary changes (P=.003), and trismus (P<.02). A funnel plot showed asymmetry among the differences of means in all selected studies. Conclusions. Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.
- Over 300 Radiation Caries Papers: Reflections From the Rearview Mirror(2022) PEDROSO, Caique Mariano; MIGLIORATI, Cesar Augusto; EPSTEIN, Joel B.; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; LOPES, Marcio Ajudarte; GOES, Mario Fernando de; SANTOS-SILVA, Alan RogerRadiation caries (RC) is an aggressive oral toxicity in head and neck cancer survivors, which develops 6 to 12 months after head and neck radiotherapy. It initially affects the tooth cervical/incisal surfaces, and if not promptly diagnosed/managed, progresses to dental crown amputation and risk of osteoradionecrosis. It results from a multidimensional cluster of treatment-induced oral symptoms, including hyposalivation, dietary changes, and oral hygiene impairment. Although recognized as a frequent complication of radiotherapy and extensively assessed by a myriad of retrospective, in vitro, and in situ studies, RC patients are still orphans of clinically validated methods for risk prediction, prevention, and treatment of early lesions. This review provides a historical overview of science-based concepts regarding RC pathogenesis and treatment, emphasizing the growing demand for interventional clinical studies (randomized trials).