ALEXANDRE SILVA E SILVA

(Fonte: Lattes)
Índice h a partir de 2011
6
Lattes
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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 23
  • conferenceObject
    In Bag Morcellation: details and logistics of the technique
    (2016) FERNANDES, R.; ARAUJO, M.; SILVA, A. Silva e; CARVALHO, P. Mancusi de; ANTON, C.; GENTA, M. L. Nogueira Dias; RIBEIRO JR., A. Dias; SAMPAIO, D.; MIGLINO, G.; SADALLA, J. C.; CARVALHO, J. Paula
  • conferenceObject
    VAGINAL-ASSISTED LAPAROSCOPIC RADICAL HYSTERECTOMY (VALRH): INITIAL EXPERIENCE OF A GYNECOLOGICAL CANCER CENTER IN BRAZIL
    (2013) FAVERO, G.; SILVA, A. Silva e; ANTON, C.; RIBEIRO, A.; ARAUJO, M. Pereira; SADALLA, J.; MIGLINO, G.; BARACAT, E.; CARVALHO, J.
  • conferenceObject
    BORDERLINE OVARIAN TUMORS-10 YEARS SINGLE CENTER EXPERIENCE
    (2019) FERNANDES, R.; ANTON, C.; SILVA, A. Silva e; CARVALHO, J. P. Mancusi; ARAUJO, M.; GENTA, M. L. Dias; SAMPAIO, D.; MIGLINO, G.; DIAS JR., A.; SADALLA, J. C.; CARVALHO, J. Paula
  • conferenceObject
    BORDERLINE OVARIAN CANCER: 6 YEAR EXPERIENCE FROM A SINGLE INSTITUTE
    (2015) FERNANDES, R.; ANTON, C.; NOBREGA, F. S.; FARIA, M. B. S.; SILVA, A. Silva E; CARVALHO, J. P.
  • article 9 Citação(ões) na Scopus
    A novel model to estimate lymph node metastasis in endometrial cancer patients
    (2017) ANTON, Cristina; SILVA, Alexandre Silva e; BARACAT, Edmund Chada; DOGAN, Nasuh Utku; KOHLER, Christhardt; CARVALHO, Jesus Paula; FAVERO, Giovanni Mastrantonio di
    OBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration > 50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value > 21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy.
  • conferenceObject
    VAGINAL MORCELLATION INSIDE PROTECTIVE POUCH AND UTERINE EXTRATION IN CASES OF BULKY ENDOMETRIAL CANCERS: REPORT OF 30 CASES
    (2015) FAVERO, G.; MIGLINO, G.; KOEHLER, C.; PFIFFER, T.; SILVA, A.; RIBEIRO, A.; DOGAN, N. U.; ANTON, C.; BARACAT, E.; CARVALHO, J.
  • article 1 Citação(ões) na Scopus
    Persistent postoperative ascites successfully identified and treated with laparoscopic indocyanine green fluorescence
    (2020) FERNANDES, Rodrigo; ANTON, Cristina; LOPES, Andre; SILVA, Alexandre Silva e; LEBLANC, Eric; JR, Ulysses Ribeiro; CARVALHO, Jesus Paula
  • conferenceObject
    IATROGENIC INJURY OF THE OBTURATOR NERVE DURING PELVIC LAPAROSCOPIC LYMPHADENECTOMY: ANALYSIS OF THE CORRECTION 5 YEARS LATER
    (2016) DIAS, A. J. Ribeiro; SILVA, A. Silva e; FERNANDES, R. Pinto; ANTON, C.; ARAUJO, M.; MORAES, A.; BARROS, L.; CARVALHO, J. P.; BARACAT, E. C.
  • article
    Functional Reconstruction of Temporomandibular Joint after Resection of Pigmented Villonodular Synovitis with Extension to Infratemporal Fossa and Skull Base: A Case Report
    (2016) VELLUTINI, Eduardo de Arnaldo Silva; ALONSO, Nivaldo; ARAP, Sergio Samir; GODOY, Luis Felipe Silva; SOUZA, Ricardo Antenor de Souza e; MATTEDI, Romulo Loss; OLIVEIRA, Matheus Fernandes de
    Introduction Pigmented villonodular synovitis (PVNS) is a benign but aggressive lesion arising from sinovia. The temporomandibular joint (TMJ) is hardly ever involved. Methods We describe a case of PVNS arising in the left TMJ involving infratemporal fossa soft tissue and the skull base; we also present the reconstruction. Results A 37-year-old woman had progressive mandibular swelling for 6 months. Computed tomography of the skull revealed an osteolytic lesion in the left TMJ, involving the upper mandible, condyle, and glenoid fossa and extending to the infratemporal fossa and fossa media through a defect in temporal bone. Surgical management included a left pterional craniotomy to reach the temporal skull base and resect the intracranial tumor and a facial approach with partial leftmandibulectomy and resection of left condyle, glenoid fossa, and tumor removal in infratemporal fossa. Mandible function was restored with prosthetic reconstruction of the condyle. She progressively started to eat solid foods after 3 months, becoming increasingly functional and asymptomatic. At 30 months' follow-up, she had no sign of tumoral recurrence and showed asymptomatic and normal TMJ function. Conclusion PVNS should be considered in the differential diagnosis of bone neoplasms affecting young patients. In such cases, radical excision is mandatory and TMJ prosthesis for local reconstruction may be used to preserve functionality.
  • article 4 Citação(ões) na Scopus
    Ten years of experience with endometrial cancer treatment in a single Brazilian institution: Patient characteristics and outcomes
    (2020) ANTON, Cristina; KLEINE, Rodolpho Truffa; MAYERHOFF, Eric; DIZ, Maria del Pilar Esteves; FREITAS, Daniela de; CARVALHO, Heloisa de Andrade; CARVALHO, Joao Paulo Mancusi de; SILVA, Alexandre Silva e; GENTA, Maria Luiza Nogueira Dias; SILVA, Andre Lopes de Faria e; SALIM, Rafael Calil; ARANHA, Andrea; LOPEZ, Rossana Veronica Mendoza; CARVALHO, Filomena Marino; BARACAT, Edmund Chada; CARVALHO, Jesus Paula
    Few reports have described the clinical and prognostic characteristics of endometrial cancer, which is increasing worldwide, in large patient series in Brazil. Our objective was to analyze the clinicopathological characteristics, prognostic factors, and outcomes of patients with endometrial cancer treated and followed at a tertiary Brazilian institution over a 10-year period. This retrospective study included 703 patients diagnosed with endometrial cancer who were treated at a public academic tertiary hospital between 2008 and 2018. The following parameters were analyzed: age at diagnosis, race, body mass index, serum CA125 level before treatment; histological type and grade, and surgical stage. Outcomes were reported relative to histological type, surgical staging, serum CA125, lymph-vascular space involvement (LVSI), and lymph-node metastasis. The median patient age at diagnosis was 63 (range, 27-93) years (6.4% were < 50 years). Minimally invasive surgeries were performed in 523 patients (74.4%). Regarding histological grade, 468 patients (66.5%) had low-grade endometrioid histology and 449 patients (63.9%) had stage I tumors. Tumors exceeded 2.0 cm in 601 patients (85.5%). Lymphadenectomy was performed in 551 cases (78.4%). LVSI was present in 208 of the patients' tumors (29.5%). Ninety-three patients (13.2%) had recurrent tumors and 97 (13.7%) died from their malignant disease. The robust prognostic value of FIGO stage and lymph node status were confirmed. Other important survival predictors were histological grade and LVSI [overall survival: hazard ratio (HR) = 3.75, p < 0.001 and HR = 2.01, p = 0.001; recurrence: HR = 2.49, p = 0.004 and HR = 3.22, p = 0.001, respectively). Disease-free (p = 0.087) and overall survival (p = 0.368) did not differ significantly between patients with stage II and III disease. These results indicate that prognostic role of cervical involvement should be explored further. This study reports the characteristics and outcomes of endometrial cancer in a large population from a single institution, with systematic surgical staging, a predominance of minimally invasive procedures, and well-documented outcomes. Prognostic factors in the present study population were generally similar to those in other countries, though our patients' tumors were larger than in studies elsewhere due to later diagnosis. Our unexpected finding of similar prognoses of stage II and III patients raises questions about the prognostic value of cervical involvement and possible differences between carcinomas originating in the lower uterine segment versus those originating in the body and fundus. The present findings can be used to guide public policies aimed at improving the diagnosis and treatment of endometrial cancer in Brazil and other similar countries.