MAURICIO DENER CORDEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
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- Robotic-assisted approaches to urachal carcinoma: A comprehensive systematic review of the safety and efficacy outcomes(2024) SUARTZ, Caio Vinicius; MARTINEZ, Lucas Motta; BRITO, Pedro Henrique; NETO, Carlos Victori; CORDEIRO, Mauricio Dener; BOTELHO, Luiz Antonio Assan; GALLUCCI, Fabio Pescarmona; MOTA, Jose Mauricio; NAHAS, William Carlos; RIBEIRO-FILHO, Leopoldo AlvesIntroduction Surgical intervention is the treatment of choice in patients with urachal carcinoma. Due to complications and to reduce hospital stay from open surgery, minimally invasive approaches are desirable. Nowadays, robotic-assisted surgery has become increasingly popular, and robot-assisted cystectomy can be performed in patients with urachal carcinoma with low complication rates. Methods We performed a systematic review to search for studies that evaluated patients who underwent robotic-assisted surgery for urachal carcinoma. The outcomes of interest were the type of cystectomy performed, whether there was umbilicus resection, total operative time, console time, intraoperative complications, estimated blood loss, postoperative complications, time of hospitalisation, positive surgical margins and the presence of documented tumour recurrence. Results In this study, we evaluated three cohorts comprising a total of 21 patients. The median follow-up period ranged from 8 to 40 months. Medium age was between 51 and 54 years, with a majority (63.1%) being male. One patient (5.2%) underwent a radical cystectomy, and 19 patients (94.7%) underwent to partial cystectomy. Umbilical resections were performed in all cases, and pelvic lymphadenectomy in 14 cases (73.6%). Recurrence occurred in three patients at a median of 17 months postoperation, two cases in the trocar insertion site. Additionally, there was one death, which was attributed to postoperative cardiovascular complications. Conclusion Robotic-assisted partial cystectomy has a low incidence of adverse outcomes in patients with urachal carcinoma. Controlled studies, ideally randomised, are warranted to establish the comparative efficacy and safety of the robotic-assisted cystectomy approach relative to open surgery.
- Scoring system for prediction of overall survival in patients with renal cell carcinoma T3aN0M0(2024) SUARTZ, Caio Vinicius; CORDEIRO, Mauricio Dener; CARVALHO, Paulo Afonso de; GALLUCCI, Fabio Pescarmona; RIBEIRO-FILHO, Leopoldo Alves; CARDILI, Leonardo; SIVARAMAN, Arjun; AUDENET, Francois; MOTA, Jose Mauricio; NAHAS, William CarlosObjectiveWe aim to create a new score to predict postoperative overall survival in patients with nonmetastatic T3aN0 renal cell carcinoma.MethodsWe reviewed the clinical data of adult patients who underwent radical nephrectomy for renal cell carcinoma between December 2007 and January 2022 in a single tertiary oncological institution. Clinical characteristics, clinical-pathological staging and histopathological characteristics were analysed. Survival analyses were determined using the Kaplan-Meier curve. A nomogram was established using Cox proportional hazard regression to identify the prognostic factors affecting the overall survival. The area under the curve, calibration curves and decision curve analysis were used to evaluate prognostic efficacy.ResultsWe analyzed 362 patients classified as pT3aN0M0 stage with a median follow-up of 40 months. According to Cox univariate and multivariate analyses, weight loss greater than 5% in 6 months before surgery, stage V chronic kidney disease after radical nephrectomy, sarcomatoid pattern, and coagulative tumor necrosis were identified as predictors of overall survival. We developed a score and performed internal and external validation. The time-dependent receiver operating characteristic curve, area under the curve value and calibration curve analysis showed good prediction ability of the score. The nomogram can effectively predict and stratify overall survival after radical nephrectomy in patients with pT3aN0M0 renal cell carcinoma.ConclusionPatients with pT3aN0MO renal cell carcinoma exhibited different characteristics, and those with unfavourable characteristics deserve greater attention during follow-up. This nomogram provides an accurate prediction of overall survival after radical nephrectomy.
- A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy. Reply.(2023) ANJOS, Gabriel C. Dos; GUGLIELMETTI, Giuliano B.; JUNIOR, Jose P.; CORDEIRO, Mauricio; COELHO, Rafael F.; NAHAS, William C.
conferenceObject CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY FOLLOWING ANDROGEN DEPRIVATION THERAPY CESSATION - RESULTS FROM A PROSPECTIVE ANALYSIS(2023) NASCIMENTOL, B. C. G.; NETOL, R. Pedrenho; ZANDONAL, P.; BESSA, J. De; BASTOS, D.; CORDEIROL, M.; COELHOL, R.; NAHAS, W.; HALLAK, J.; MULHALL, J.; GOMES, C.conferenceObject CORRELATION BETWEEN MICRORNAS AND MRNA EXPRESSION PROFILES WITH THE PROGNOSIS OF CLINICALLY LOCALIZED PENILE CANCER(2019) MURTA, Claudio; PONTES JR., Jose; FURUYA, Tatiane; UNO, Miyuki; CARRASCO, Alexis; COELHO, Rafael; GUGLIELMETTI, Giuliano; CORDEIRO, Mauricio; FARAJ, Sheila; LEITE, Katia; SICHERO, Laura; VILLA, Luisa; SROUGI, Miguel; CHAMMAS, Roger; NAHAS, WilliamconferenceObject Association of primary tumor radiomic phenotypes and outcomes in patients (pts) with metastatic renal cell clear cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CN).(2023) CUNHA, Mateus Trinconi; STANGLER, Lucas; FREIRE, Pedro; PINTO, Paulo Victor Alves; COELHO, Fernando Morbeck Almeida; VIANA, Publio; CORDEIRO, Mauricio; NAHAS, William Carlos; MOTA, Jose Mauricio- Perioperative Morbidity of Radical Prostatectomy After Intensive Neoadjuvant Androgen Blockade in Men With High-Risk Prostate Cancer: Results of Phase II Trial Compared to a Control Group(2023) ILARIO, Eder N.; BASTOS, Diogo A.; GUGLIELMETTI, Giuliano B.; MURTA, Claudio B.; CARDILI, Leonardo; CORDEIRO, Mauricio D.; JUNIOR, Jose P.; COELHO, Rafael F.; NAHAS, William C.In this study, we investigated whether intense neoadjuvant therapy could increase the risk of complications in radical prostatectomy. After analyzing 124 patients we concluded that intense neoadjuvant therapy doesn't increase morbidity of radical prostatectomy and reduces positive surgical margins. The association of neoad-juvant therapy with extended pelvic lymphadenectomy may increase the risk of perioperative thromboembolic events.Introduction: Recent studies about intense neoadjuvant therapy followed by Radical Prostatectomy (RP) lack standard-ized cr iter ia regarding surgical complications and comparison to a group of patients who underwent RP without the use of neoadjuvant therapy. The aim of this study is to describe and compare the perioperative complication rates. Materials and Methods: This was a prospective, single-center phase II trial in patients with high-risk prostate cancer (HRPCa). The control group included HRPCa patients who underwent RP outside the clinical trial during the same study recruit-ment period. The interventional group was randomized (1:1) to receive neoadjuvant androgen deprivation therapy plus abiraterone with or without apalutamide followed by RP. Complications observed up to 30 days of surgery were classi-fied based on the Clavien-Dindo classification. Uni-and multivariate analyses were carried out to assess predictive factors associated with perioperative complications. Results: In total, 124 patients with HRPCa were underwent to RP between May 27, 2019 and August 6, 2021, including 61 patients in the intervention group and 63 patients in the control group. The general and major complications in the intervention group reached 29.6% and 6.6%, respectively, and 39.7% and 7.9% in the control group, respectively. There was no significant difference between groups. We observed 4.9% of thromboembolic event in the neoadjuvant group. Conclusions: There was no significant increase in morbidity rate in RP after intense neoadjuvant therapy. The association of intense androgen deprivation neoadjuvant therapy with RP and extended pelvic lymphadenectomy may increase the risk of a perioperative thromboembolic events.
conferenceObject Ureteral obstruction in advanced malignancies: Prognostic factors(2012) CORDEIRO, M. D.; OGLIO, M. F. Dall; SANTANA, A. Crippa; PESSOA, R. R.; CHADE, D.; MURTA, C. B.; SROUGI, M.INTRODUCTION & OBJECTIVES: Ureteral obstruction may occur as a secondary event in patients with end-stage abdominopelvic malignancies. Ureteral decompression procedures are performed in order to relief symptons and avoid progression to renal failure, however they may not result in patient increased survival. The objectives was to conduct a prospective study to assess the prognostic factors after ureteral decompression aiming to detect the patients who would benefit from such procedures. MATERIAL & METHODS: One hundred and twenty-three patients who underwent ureteral de sobstruction procedures by ureteral stent or nephrostomy, were analized in the Cancer Institute of the State of São Paulo from January 2009 to September 2010. The collected data included: sex, age , body mass index (BMI), type of primary tumor, clinical symptoms, events related to dissemination (metastases, ascites, pleural effusion), prior therapies (chemotherapy, radiotherapy and surgery), Charlson co-morbidity index, degree of hydronephrosis, type of ureteral desobstruction (ureteral stent or nephrostomy) and preoperative serum albumin, preoperative serum creatinine and preoperative hemoglobin. RESULTS: Univariate Analysis: With the clinical and laboratory data identified in the study, the Kaplan-Meier method was used to assess survival rates and the log-rank tests were performed to identified the relationship between clinical variables and survival time. We detected as significant prognostic associations preoperative serum albumin (<3mg/dL), degree of hydronephrosis (grade 1 and 2), presence of metastases, number of sites of metastases and the Charlson co-morbidity index (Charlson> 10 ). Multivariate Analysis: The Cox proportional hazards model detected that the preoperative serum albumin level, the degree of hydronephrosis and the Charlson index were significantly related to a poor survival. Patients were divided into four groups to create a model of risk stratification: favorable (0 risk factors), lower intermediate (1 risk factor), upper Intermediate (2 risk factors) unfavorable (3 risk factors). The 6-month survival rates were 83.3% for the favorable group, 59.4% for the lower intermediate group, 19% for upper intermediate group and 0% for unfavorable group. CONCLUSIONS: Our model of stratification may be a useful tool before deciding on ureteral desobstruction procedures since the survival of patients in the unfavorable group was 0% in 6 months. We hope that our study can modify the current approach of patients with advanced abdominopelvic malignancies complicated by ureteral obstruction.