KATIA RAMOS MOREIRA LEITE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Change in the risk stratification of prostate cancer after Slide Review by a uropathologist: the experience of a reference center for the treatment of prostate cancer(2014) CAMARA-LOPES, George; MARTA, Gustavo Nader; LEITE, Elton Trigo Teixeira; SIQUEIRA, Gabriela Silva Moreira de; HANNA, Samir Abdallah; SILVA, Joao Luis Fernandes da; CAMARA-LOPES, L. H.; LEITE, Katia R. M.Introduction: Brachytherapy is an option for treating low-risk prostate cancer (PC). Biochemical control of low-risk disease can reach 95%. The practice advocated is that a review of prostate biopsies should be mandatory before choosing the best treatment for patients with PC. Our objective was to evaluate the change in PC risk after review of a prostate biopsy by an experienced uropathologist at a reference hospital. Materials and Methods: Between December 2003 and August 2012, 182 men were referred to our institution for brachytherapy to treat PC. Their slides were reviewed by the same uropathologist. Results and Discussion: Classification risk disagreement occurred in 71 (39%) cases, including one in which no tumor was observed. The main cause of risk change was related to the Gleason score (GS), with 57 (81.4%) cases upgraded to GS 7 or 8. Tumor volume was also compared, although only the number of fragments was reported in most original reports. The concordance of the number of cores affected by tumor was 43.9%, and in 49% of the cases, the number was decreased by the uropathologist. Perineural invasion (PNI) was reported in one quarter of original reports, and the agreement was 58%. Conclusion: Slide review by an uropathologist remains essential at reference radiotherapy centers for the treatment of PC. The change in PC risk evaluation is mainly due to the GS, but tumor volume and PNI, which are important for the characterization of tumor aggressiveness, are also misinterpreted and could drive a change in the therapy choice.
- Brazilian Expert Consensus for NTRK Gene Fusion Testing in Solid Tumors(2023) MACEDO, Mariana Petaccia de; NASCIMENTO, Ellen Caroline Toledo; SOARES, Fernando Augusto; SANTINI, Fernando Costa; COSTA, Felipe D'Almeida; CUNHA, Isabela Werneck da; MUNHOZ, Rodrigo Ramella; MARCHI, Pedro De; JORGE, Thiago William Carnier; LEITE, Katia Ramos MoreiraOncogenic neurotrophic tropomyosin receptor kinase gene fusions occur in less than 1% of common cancers. These mutations have emerged as new biomarkers in cancer genomic profiling with the approval of selective drugs against tropomyosin receptor kinase fusion proteins. Nevertheless, the optimal pathways and diagnostic platforms for this biomarker's screening and genomic profiling have not been defined and remain a subject of debate. A panel of national experts in molecular cancer diagnosis and treatment was convened by videoconference and suggested topics to be addressed in the literature review. The authors proposed a testing algorithm for oncogenic neurotrophic tropomyosin receptor kinase gene fusion screening and diagnosis for the Brazilian health system. This review aims to discuss the latest literature evidence and international consensus on neurotrophic tropomyosin receptor kinase gene fusion diagnosis to devise clinical guidelines for testing this biomarker. We propose an algorithm in which testing for this biomarker should be requested to diagnose advanced metastatic tumors without known driver mutations. In this strategy, Immunohistochemistry should be used as a screening test followed by confirmatory next-generation sequencing in immunohistochemistry-positive cases.
- Intraductal carcinoma of the prostate is an aggressive form of invasive carcinoma and should be graded(2020) SAMARATUNGA, Hemamali; DELAHUNT, Brett; EGEVAD, Lars; SRIGLEY, John R.; BILLIS, Athanase; BOSTWICK, David G.; CAMPARO, Philippe; CHENG, Liang; CLOUSTON, David; DENHAM, James; FURUSATO, Bungo; HARTMANN, Arndt; JUFE, Laura; KENCH, James; KENWRIGHT, Diane N.; KRISTIANSEN, Glen; LEITE, Katia R. M.; MACLENNAN, Gregory T.; MERRIMEN, Jennifer; MOCH, Holger; OXLEY, Jon; PAN, Chin-Chen; PANER, Gladell; RO, Jae; SESTERHENN, Isabell A. M.; SHANKS, Jonathan; THUNDERS, Michelle; TSUZUKI, Toyonori; WHEELER, Thomas; YAXLEY, John W.; VARMA, MuraliInfiltration of the prostatic ducts by prostatic adenocarcinoma occurs relatively frequently, being most commonly associated with high grade disease. It is now recognised that intraductal carcinoma of the prostate (IDCP) has an associated poor prognosis and this is reflected in its histological, molecular and immunohistochemical features. The current recommendation of the World Health Organization is that IDCP not be taken into consideration when grading prostate adenocarcinoma. It is apparent that Gleason did not differentiate between IDCP and stromal invasive carcinoma when developing and validating his grading system, and recent studies suggest that the incorporation of IDCP grading into the overall grading of the specimen provides additional prognostic information.
- Controversial issues in Gleason and International Society of Urological Pathology (ISUP) prostate cancer grading: proposed recommendations for international implementation(2019) SRIGLEY, John R.; DELAHUNT, Brett; SAMARATUNGA, Hemamali; BILLIS, Athanase; CHENG, Liang; CLOUSTON, David; EVANS, Andrew; FURUSATO, Bungo; KENCH, James; LEITE, Katia; MACLENNAN, Gregory; MOCH, Holger; PAN, Chin-Chen; RIOUX-LECLERCQ, Nathalie; RO, Jae; SHANKS, Jonathan; SHEN, Steven; TSUZUKI, Toyonori; VARMA, Murali; WHEELER, Thomas; YAXLEY, John; EGEVAD, LarsThe Gleason Grading system has been used for over 50 years to prognosticate and guide the treatment for patients with prostate cancer. At consensus conferences in 2005 and 2014 under the guidance of the International Society of Urological Pathology (ISUP), the system has undergone major modifications to reflect modern diagnostic and therapeutic practices. The 2014 consensus conference yielded recommendations regarding cribriform, mucinous, glomeruloid and intraductal patterns, the most significant of which was the removal of any cribriform pattern from Gleason grade 3. Furthermore, a Gleason score grouping system was endorsed which consisted of five grades where Gleason score 6 (3+3) was classified as grade 1 which better reflected the mostly indolent behaviour of these tumours. Another issue discussed at the meeting and subsequently endorsed was that in Gleason score 7 cases, the percentage pattern 4 should be recorded. This is especially important in situations where modern active surveillance protocols expand to include men with low volume pattern 4. While major progress was made at the conference, several issues were either not resolved or not discussed at all. Most of these items relate to details of assignment of Gleason score and ISUP grade in specific specimen types and grading scenarios. This detailed review looks at the 2014 ISUP conference results and subsequent literature from an international perspective and proposes several recommendations. The specific issues addressed are percentage pattern 4 in Gleason score 7 tumours, percentage patterns 4 and 5 or 4/5 in Gleason score 8-10 disease, minor (<= 5%) high grade patterns when either 2 or 3 patterns are present, level of reporting (core, specimen, case), dealing with grade diversity among site (highest and composite scores) and reporting scores in radical prostatectomy specimens with multifocal disease. It is recognised that for many of these issues, a strong evidence base does not exist, and further research studies are required. The proposed recommendations mostly reflect consolidated expert opinion and they are classified as established if there was prior agreement by consensus and provisional if there was no previous agreement or if the item was not discussed at prior consensus conferences. For some items there are reporting options that reflect the local requirements and diverse practice models of the international urological pathology community. The proposed recommendations provide a framework for discussion at future consensus meetings.
- Penile cancer: a Brazilian consensus statement for low- and middle-income countries(2020) SOARES, Andrey; CARVALHO, Icaro Thiago de; FONSECA, Aluizio Goncalves da; ALENCAR JR., Antonio Machado; LEITE, Carlos Heli Bezerra; BASTOS, Diogo Assed; SOARES, Joao Paulo Holanda; LEITE, Katia Ramos Moreira; BRANDAO FILHO, Mario Ronalsa; COELHO, Ronald Wagner Pereira; CAVALLERO, Sandro Roberto de A.; ZEQUI, Stenio de Cassio; CALIXTO, Jose de Ribamar RodriguesPurpose Penile cancer is highly prevalent in low- and middle-income countries, with significant morbidity and mortality rates. The first Brazilian consensus provides support to improve penile cancer patients' outcomes, based on expert's opinion and evidence from medical literature. Methods Fifty-one Brazilian experts (clinical oncologists, radiation oncologists, urologists, and pathologists) assembled and voted 104 multiple-choice questions, confronted the results with the literature, and ranked the levels of evidence. Results Healthcare professionals need to deliver more effective communication about the risk factors for penile cancer. Staging and follow-up of patients include physical examination, computed tomography, and magnetic resonance imaging. Close monitoring is crucial, because most recurrences occur in the first 2-5 years. Lymph-node involvement is the most important predictive factor for survival, and management depends on the location (inguinal or pelvic) and the number of lymph nodes involved. Conservative treatment may be helpful in selected patients without compromising oncological outcomes; however, surgery yields the lowest rate of local recurrence. Conclusion This consensus provides an essential decision-making orientation regarding this challenging disease.