CAIO SERGIO RIZKALLAH NAHAS

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 1 Citação(ões) na Scopus
    Outcomes of surgical treatment for patients with distal rectal cancer: A retrospective review from a single university hospital
    (2020) NAHAS, S. C.; NAHAS, C. S. R.; BUSTAMANTE-LOPEZ, L. A.; PINTO, R. A.; MARQUES, C. F. S.; CECCONELLO, I.
    introduction and aim: Surgery for distal rectal cancer (DRC) can be performed with or without sphincter preservation. The aim of the present study was to analyze the outcomes of two surgical techniques in the treatment of DRC patients: low anterior resection (LAR) and abdominoperineal resection (APR). Methods: Patients with advanced DRC that underwent surgical treatment between 2002 and 2012 were evaluated. We compared the outcomes of the type of surgery (APR vs LAR) and analyzed the associations of survival and recurrence with the following factors: age, sex, tumor location, lymph nodes obtained, lymph node involvement, and rectal wall involvement. Patients with distant metastases were excluded. Results: A total of 148 patients were included, 78 of whom were females (52.7%). The mean patient age was 61.2 years. Neoadjuvant chemoradiation therapy was performed in 86.5% of the patients. APR was performed on 86 (58.1%) patients, and LAR on 62 (41.9%) patients. No differences were observed between the two groups regarding clinical and oncologic characteristics. Eighty-seven (62%) patients had pT3-4 disease, and 41 patients (27.7%) had lymph node involvement. In the multivariate analysis, only poorly differentiated tumors (P=.026) and APR (P=.009) correlated with higher recurrence rates. Mean follow-up time was 32 (16-59.9) months. Overall 5 -year survival was 58.1%. The 5 -year survival rate was worse in patients that underwent APR (46.5%) than in the patients that underwent LAR (74.2%) (P=.009). Conclusions: Patients with locally advanced DRC that underwent APR presented with a lower survival rate and a higher local recurrence rate than patients that underwent LAR. In addition, advanced T/stage, lymph node involvement, and poor tumor differentiation were associated with recurrence and a lower survival rate, regardless of the procedure. 2020 Asociacion Mexicana de Gastroenterologia.
  • article 57 Citação(ões) na Scopus
    Transient Ischemic Rectitis as a Potential Complication after Prostatic Artery Embolization: Case Report and Review of the Literature
    (2013) MOREIRA, Airton Mota; MARQUES, Carlos Frederico Sparapan; ANTUNES, Alberto Azoubel; NAHAS, Caio Sergio Rizkallah; NAHAS, Sergio Carlos; ARIZA, Miguel Angel de Gregorio; CARNEVALE, Francisco Cesar
    Prostatic artery embolization (PAE) is an alternative treatment for benign prostatic hyperplasia. Complications are primarily related to non-target embolization. We report a case of ischemic rectitis in a 76-year-old man with significant lower urinary tract symptoms due to benign prostatic hyperplasia, probably related to nontarget embolization. Magnetic resonance imaging revealed an 85.5-g prostate and urodynamic studies confirmed Inferior vesical obstruction. PAE was performed bilaterally. During the first 3 days of follow-up, a small amount of blood mixed in the stool was observed. Colonoscopy identified rectal ulcers at day 4, which had then disappeared by day 16 post PAE without treatment. PAE is a safe, effective procedure with a low complication rate, but interventionalists should be aware of the risk of rectal nontarget embolization.
  • article 7 Citação(ões) na Scopus
    Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic?
    (2022) SULBARAN, Marianny; BUSTAMANTE-LOPEZ, Leonardo; BERNARDO, Wanderley; SAKAI, Christiano M.; SAKAI, Paulo; NAHAS, Sergio; MOURA, Eduardo G. H. de
    Aim To determine the diagnostic accuracy of colon capsule endoscopy for colorectal cancer screening. Methods Studies that compared the diagnostic performance of colonoscopy and second-generation colon capsule endoscopy (CCE-2) for screening of asymptomatic patients aged 50-75 years were included. The primary outcomes were sensitivity, specificity, and positive and negative likelihood ratios for polyps and adenomas measuring at least 6 mm or 10 mm. Results Eight full-text studies that evaluated 1602 patients were included for systematic review. Of these, 840 (52.43%) patients participated in an opportunistic screening program. The pooled outcomes of CCE-2 for polyps at least 6 mm / 10 mm were (CI = confidence interval): sensitivity: 88% (95% CI: 0.84-0.91) / 88% (95% CI: 0.82-0.93), specificity: 94% (95% CI: 0.92-0.95) / 95.5% (95% CI: 0.94-0.97); positive likelihood ratio: 11.86 (95% CI: 5.53-25.46) / 23.07 (95% CI: 6.163-86.36); negative likelihood ratio: 0.14 (95% CI: 0.1-0.21) / 0.14 (95% CI: 0.09-0.21). The area under the summary receiver operating characteristic curve for polyps at least 6 and 10 mm was 96.3% and 96.7%, respectively. The only cancer missed by complete CCE-2 was shown at multiple frames in the unblinded review. In total, 125 (7.8%) patients presented mild adverse events mostly related to bowel preparation. Conclusion CCE-2 is demonstrated to be an effective and safe alternative method for colorectal cancer screening. Diagnostic performance of CCE-2 for polyps of at least 6 and 10 mm was similar. Completion rates still need to be improved.
  • article
    Use of an electromagnetic-guided device to assist with post-pyloric placement of a nasoenteral feeding tube: A systematic review and meta-analysis
    (2022) MANCINI, Fabio Catache; MOURA, Diogo Turiani Hourneaux de; FUNARI, Mateus Pereira; RIBEIRO, Igor Braga; NETO, Fernando Lopes Ponte; MENDIETA, Pastor Joaquin Ortiz; MCCARTY, Thomas R.; BERNARDO, Wanderley Marques; NAHAS, Sergio Carlos; MOURA, Eduardo Guimaraes Hourneaux de
    Background and study aims While endoscopic-guided placement (EGP) of a post-pyloric nasoenteral feeding tube may improve caloric intake and reduce the risk of bronchoaspiration, an electromagnetic-guided placement (EMGP) method may obviate the need for endoscopic procedures. Therefore, the primary aim of this study was to perform a systematic review and meta-analysis of randomized trials comparing the efficacy and safety of EMGP versus EGP of a post-pyloric feeding tube. Methods Protocolized searches were performed from the inception through January 2021 following PRISMA guidelines. Only randomized controlled trials were included comparing EMGP versus EGP. Study outcomes included: technical success (defined as appropriate post-pyloric positioning), tube and patient associated adverse events (AEs), time to enteral nutrition, procedure-associated cost, and procedure time. Pooled risk difference (RD) and mean difference (MD) were calculated using a fixed-effects model and heterogeneity evaluated using Higgins test (I-2). Results Four randomized trials (n =536) were included. A total of 287 patients were included in the EMGP group and 249 patients in the EGP group. There was no difference between EMGP versus EGP regarding technical success, tube-related AEs, patient-related AEs, procedure time, and time in the right position. Time to enteral nutrition favored EMGP (MD: -134.37 [-162.13, -106.61]; 1 2 =35%); with significantly decreased associated cost (MD: -127.77 (5) [-135.8-119.73]; I-2 =0%). Conclusions Based on this study, EMGP and EGP were associated with similar levels of technical success and safety as well as time to complete the procedure. Despite this, EMGP was associated with reduced cost and time to initiation of nutrition.
  • article 108 Citação(ões) na Scopus
    Characteristics of Early-Onset vs Late-Onset Colorectal Cancer A Review
    (2021) ZABOROWSKI, Alexandra M.; ABDILE, Ahmed; ADAMINA, Michel; AIGNER, Felix; D'ALLENS, Laura; ALLMER, Caterina; ALVAREZ, Andrea; ANULA, Rocio; ANDRIC, Mihailo; ATALLAH, Sam; BACH, Simon; FAES, Seraina; FAIZ, Omar; FLEMING, Fergal; FOPPA, Caterina; FOWLER, George; FRASSON, Matteo; FIGUEIREDO, Nuno; FORGAN, Tim; FRIZELLE, Frank; KRONBERGER, Irmgard; SCHNEIDER, Martin; GADAEV, Shamil; GELLONA, Jose; GLYN, Tamara; GONG, Jianping; GORAN, Barisic; GREENWOOD, Emma; GUREN, Marianne G.; GUILLON, Stephanie; GUTLIC, Ida; HAHNLOSER, Dieter; SEISHIMA, Ryo; KROON, Hidde Maarten; HAMPEL, Heather; HANLY, Ann; HASEGAWA, Hirotoshi; IVERSEN, Lene Hjerrild; HILL, Andrew; HILL, James; HOCH, Jiri; HOFFMEISTER, Michael; HOMPES, Roel; SEKULIC, Aleksandar; HURTADO, Luis; BALA, Miklosh; IAQUINANDI, Fabiano; IMBRASAITE, Ugne; ISLAM, Rumana; JAFARI, Mehrenah Dorna; KANEMITSU, Yukihide; KARACHUN, Aleksei; KARIMUDDIN, Ahmer A.; KELLER, Deborah S.; SEPPALA, Toni; KELLY, Justin; KENNELLY, Rory; KRYZAUSKAS, Marius; KHRYKOV, Gleb; KURAL, Said; KUSTERS, Miranda; LAKKIS, Zaher; LANKOV, Timur; LARSON, Dave; LAZAR, Gyorgy; SHEAHAN, Kieran; LEE, Kai-Yin; LEE, Suk Hwan; LEFEVRE, Jeremie H.; BARUSSAUD, Marie; LEPISTO, Anna; LIEU, Christopher; LOI, Lynette; LYNCH, Craig; MAILLOU-MARTINAUD, Helene; MAROLI, Annalisa; SHINE, Rebecca; MARTIN, Sean; MARTLING, Anna; MATZEL, Klaus E.; MAYOL, Julio; BAUSYS, Augustinas; MCDERMOTT, Frank; MEURETTE, Guillaume; MILLAN, Monica; MITTEREGGER, Martin; MOISEENKO, Andrei; SHLOMINA, Alexandra; MONSON, John R. T.; MORARASU, Stefan; MORITANI, Konosuke; MOSLEIN, Gabriela; MUNINI, Martino; BEBINGTON, Brendan; NAHAS, Caio; NAHAS, Sergio; NEGOI, Ionut; NOVIKOVA, Anastasia; SICA, Guiseppe S.; OCARES, Misael; OKABAYASHI, Koji; OLKINA, Alexandra; ONATE-OCANA, Luis; OTERO, Jaime; OZEN, Cihan; BEGGS, Andrew; PACE, Ugo; JULIAO, Guilherme Pagin Sao; PANAIOTTI, Lidiia; SINGNOMKLAO, Tongplaew; PANIS, Yves; PAPAMICHAEL, Demetris; PARK, Jason; PATEL, Swati; URIBURU, Juan Carlos Patron; PERA, Miguel; PEREZ, Rodrigo O.; BELLOLIO, Felipe; PETROV, Alexei; PFEFFER, Frank; BEVAN, Vicki; PHANG, P. Terry; POSKUS, Tomas; PRINGLE, Heather; PROUD, David; RAGUZ, Ivana; RAMA, Nuno; RASHEED, Shahnawaz; RAVAL, Manoj J.; BENNETT, Melissa-Rose; REGA, Daniela; KOCIAN, Peter; REISSFELDER, Christoph; MENESES, Juan Carlos Reyes; RIS, Frederic; RISS, Stefan; RODRIGUEZ-ZENTNER, Homero; ROXBURGH, Campbell S.; SAKLANI, Avanish; SALIDO, Andrea Jimenez; SAMMOUR, Tarik; BERDINSKIKH, Anton; SIRAGUSA, Leandro; SARASTE, Deborah; SMART, Neil; SOLIS, Alejandro; SPINELLI, Antonino; STAIGER, Roxane D.; STAMOS, Michael J.; STEELE, Scott; SUNDERLAND, Michael; TAN, Ker-Kan; TANIS, Pieter J.; KOH, Cherry; BIONDO, Sebastiano; TEKKIS, Paris; TEKLAY, Biniam; TENGKU, Sabrina; JIMENEZ-TOSCANO, Marta; TSARKOV, Petr; TURINA, Matthias; ULRICH, Alexis; VAILATI, Bruna B.; HARTEN, Meike van; KOK, Neils; VERHOEF, Cornelis; BISLENGHI, Gabriele; WARRIER, Satish; WEXNER, Steve; WILT, Hans de; WEINBERG, Benjamin A.; WELLS, Cameron; WOLTHUIS, Albert; XYNOS, Evangelos; YOU, Nancy; KNIGHT, Katrina A.; ZAKHARENKO, Alexander; ZEBALLOS, Justino; BLUDAU, Marc; WINTER, Des C.; BOUTALL, Adam; BROUWER, Nelleke; BROWN, Carl; BRUNS, Christiane; BUCHANAN, Daniel D.; BUCHWALD, Pamela; KNOL, Joep; BURGER, Jacobus W. A.; BURLOV, Nikita; CAMPANELLI, Michela; CAPDEPONT, Maylis; CARVELLO, Michele; CHEW, Hwee-Hoon; CHRISTOFORIDIS, Dimitri; CLARK, David; CLIMENT, Marta; COLOGNE, Kyle G.; KONTOVOUNISIOS, Christos; CONTRERAS, Tomas; CRONER, Roland; DANIELS, Ian R.; DAPRI, Giovanni; DAVIES, Justin; DELRIO, Paolo; DENOST, Quentin; DEUTSCH, Michael; DIAS, Andre; D'HOORE, Andre; KORNER, Hartwig; DROZDOV, Evgeniy; DUEK, Daniel; DUNLOP, Malcolm; DZIKI, Adam; EDMUNDSON, Aleksandra; EFETOV, Sergey; EL-HUSSUNA, Alaa; ELLIOT, Brodie; EMILE, Sameh; ESPIN, Eloy; KRIVOKAPIC, Zoran; EVANS, Martyn
    IMPORTANCE The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. OBSERVATIONS Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include aWesternized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. CONCLUSIONS AND RELEVANCE The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.