ANDRE LOPES DE FARIAS E SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Brazilian Society of Surgical Oncology consensus on fertility-sparing surgery for cervical cancer(2022) BAIOCCHI, Glauco; TSUNODA, Audrey Tieko; GUITMANN, Gustavo; VIEIRA, Marcelo Andrade; ZANVETTOR, Paulo Henrique; SILVESTRE, Janiceli Blanca Carlotto Hablich; SANTOS, Marcelo Henrique; SACRAMENTO, Raquel de Maria Maues; ARAUJO, Eliel Oliveira de; LOPES, Roberto Heleno; FALCAO, Deraldo; LOPES, Andre; SCHMIDT, Ronaldo; LYRA, Jorge Soares; ALMEIDA, Herbert Ives Barretto; CASTELEINS, William Augusto; CINTRA, Georgia Fontes; ZANINI, Lucas Adalberto Geraldi; REIS, Rosilene Jara; COELHO, Eid Goncalves; FIN, Fabio Roberto; REZENDE, Viviane; PANCAN, Thais Dvulatk Marques; VIEIRA, Sabas Carlos; SILVA, Jeancarllo Sousa; ANDRADE, Manoel Rodrigues de; CARNEIRO, Vandre Cabral Gomes; FOIATO, Tariane Friedrich; RITT, Guilherme Fonteles; IANAZE, Gustavo Castro; MORETTI-MARQUES, Renato; ANDRADE, Carlos Eduardo Mattos Cunha; MACIEL, Luiza Freitas; LIRA, Daniel Lourenco; MEDEIROS, Gustavo Mendes; LEITE, Amanda Lira Santos; CUCOLICCHIO, Guilherme Oliveira; TAYEH, Muhamed Read Ali; CRUZ, Ricardo Pedrini; GUTH, Gustavo Ziggiatti; LEAL, Renato Mazon Lina Verde; MAGNO, Valentino Antonio; LOPES, Francisco Carlos Oliveira; LAPORTE, Gustavo Andreazza; PUPO-NOGUEIRA, Alexandre; BARROS, Aldo Vieira; CUNHA, Juliano Rodrigues da; PESSINI, Suzana Arenhart; BRAGANCA, Joana Froes; FIGUEIREDO, Higino Felipe; LOUREIRO, Carlos Manoel Bulcao; BOCANEGRA, Ronald Enrique Delgado; AFFONSO, Renato Jose; FERNANDES, Paulo Henrique de Souza; RIBEIRO, Heber Salvador Castro; BATISTA, Thales Paulo; OLIVEIRA, Alexandre Ferreira; RIBEIRO, ReitanObjective Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer. Methods The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. Results The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition). Conclusions As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
- Pregnancy after sugery and brachytherapy for vaginal cancer(2023) GERBASI, Giovana Junqueira; DECKERS, Paula; KANAGUCHI, Giuliana; PASTORE, Caroline B. P.; CINTRA, Georgia Fontes; MAIA, Maria Aparecida Conte; LOPES, AndreIntroduction: Primary vaginal cancer is infrequent, corresponding to 1-2% of all female genital tract cancer diagnoses.Treatment for vaginal cancer varies depending on tumor histology, size, location and staging, and may include one or more of the following: surgical excision, radiation therapy and/or chemotherapy. All treatments negatively affect fertility/pregnancy outcomes.Pelvic radiation therapy, even in doses < 2 Gy, may extinguish up to 50% of immature oocytes. In addition, radiotherapy may cause modifications in cervical length, loss of uterine junctional zone anatomy and lead to myometrial atrophy and fibrosis, increasing the risk for adverse pregnancy outcomes.Methods: Case report of a patient who carried a pregnancy to term after surgery and brachytherapy for vaginal cancer.Results: A 28 year-old woman, presented with a 3 cm right midvagina wall tumor, diagnosed as grade 2, vaginal squamous cell carcinoma - FIGO 2009, stage IB. Computed tomography showed no evidence of lymph node involvement or distant metastasis. The patient underwent surgery followed by 4 fractions of vaginal brachytherapy, once a week, with a dose of 6 Gy at a 5 mm depth, amounting to a total dose of 24 Gy. One year and 9 months after treatment, the patient gave birth to a healthy child at 39 weeks pregnancy. A Csection was needed due functional dystocia during labor. Conclusion: This case report recounts a successful pregnancy carried to term after surgery and brachytherapy for squamous cell vaginal cancer.
- Expanding Cervical Cancer Screening in Mozambique: Challenges Associated With Diagnosing and Treating Cervical Cancer(2023) BATMAN, Samantha; RANGEIRO, Ricardina; MONTEIRO, Eliane; CHANGULE, Dercia; DAUD, Siro; RIBEIRO, Magda; TSAMBE, Edgar; BILA, Celso; OSMAN, Nafissa; CARRILHO, Carla; NEVES, Andrea; ATIF, Hira; JESUS, Celda De; MARIANO, Arlete; MORETTI-MARQUES, Renato; VIEIRA, Marcelo; FONTES-CINTRA, Georgia; LOPES, Andre; BATWARE, Jean Claude; LUIS, Elvira; GROVER, Surbhi; BAKER, Ellen; MONTEALEGRE, Jane; CASTLE, Philip E.; JERONIMO, Jose; CHIAO, Elizabeth; LORENZONI, Cesaltina; SCHMELER, Kathleen; SALCEDO, Mila P.PURPOSE Mozambique has one of the highest burdens of cervical cancer globally. Treatment options are few as most women present with advanced disease, and there are limited trained health professionals and health care resources. The objective of this study was to describe the outcomes of women diagnosed with invasive cancer as part of the Mozambican women undergoing cervical cancer screening with human papillomavirus (HPV) testing in conjunction with family planning services (MULHER) study. MATERIALS AND METHODS Women age 30-49 years were prospectively enrolled in the MULHER study and offered screening with primary HPV testing followed by treatment of screenpositive women with thermal ablation or excision as appropriate. Women with cervical examination findings suspicious for cancer were referred to one of the three gynecologic oncologists in the country. RESULTS Between January 2020 and January 2023, 9,014 women underwent cervical cancer screening and 30 women were diagnosed with cervical cancer. In this cohort, four patients (13.3%) had early-stage disease, 18 (60.0%) had locally advanced disease, one (3.3%) had distant metastatic disease, and seven (23.3%) did not have staging information available. Five patients (16.6%) died without receiving oncologic treatment, and seven patients (23.3%) are still awaiting treatment. Of the remaining 18 patients, three (17.6%) underwent surgery and four (23.5%) received radiotherapy. Eleven (36.7%) patients received only chemotherapy. CONCLUSION As cervical screening programs are implemented in low-resource settings, there will likely be an increase in the number of women diagnosed with invasive cervical cancer. Our results in Mozambique demonstrate the need to increase access to advanced surgery, radiation, and palliative care services.