LEANDRO LUONGO DE MATOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina
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- Active Surveillance of Thyroid Microcarcinomas: a Critical View(2022) CERNEA, Claudio R.; MATOS, Leandro Luongo; EUGENIO, Cecilia; FERREIRA, Giovanna Mattos; CERQUEIRA, Yasmin Sa; LEITE, Ana Kober N.; VANDERLEI, Felipe A. B.; CARLUCCI, Dorival de; GOTODA, Renato N.; HOJAIJ, Flavio C.; ARAUJO-FILHO, Vergilius J. F.Purpose of the Review There has been an increasing interest on active surveillance for papillary thyroid microcarcinomas (PTMC) in the literature. We will analyze the contributions of those authors who support this approach in most patients with low-risk tumors. Recent Findings The development of molecular methods to effectively detect aggressive PTMC at the fine-needle aspiration biopsy will enable the sound indication of immediate surgery in those patients, assuring the other individuals with the far more frequent indolent PTMC will undergo active surveillance with less anxiety. Several studies compared the quality of life between patients with PTMC who underwent active surveillance with immediate total thyroidectomy. However, thyroid lobectomy is a quite acceptable intermediate alternative for most patients with PTMC, with less surgical morbidity. Summary It is important to wait for worldwide validation, with reports from low- and middle-income areas, before recommending the routine adoption of active surveillance for patients with PTMC, due to difficult logistic obstacles in those environments.
- Incidental Node Metastasis as an Independent Factor of Worse Disease-Free Survival in Patients with Papillary Thyroid Carcinoma(2023) PINHEIRO, Renan Aguera; LEITE, Ana Kober; CAVALHEIRO, Beatriz Godoi; MELLO, Evandro Sobroza de; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoSimple Summary Papillary thyroid cancer is treated mainly by thyroidectomy surgery. The surrounding lymph nodes are not usually resected unless it is known before surgery that they are metastatic, and then all adjacent lymph nodes are resected (named the central compartment neck dissection). However, some lymph nodes could be incidentally resected with the thyroid, sometimes containing metastasis, but this does not mean that the central compartment neck dissection was performed properly. This study aimed to test whether these patients with incidental metastatic nodes had higher treatment failure rates. We found that they indeed had higher rates of treatment failure, even when compared to patients with clinically evident central compartment node metastasis that were submitted to proper neck dissection. We suggest that these patients must be closely followed to detect signs of treatment failure early and to provide prompt treatment. Introduction: Papillary thyroid carcinoma (PTC) have high node metastasis rates. Occasionally after thyroidectomy, the pathological report reveals node metastasis unintentionally resected. The present study aimed to evaluate the prognosis of these patients. Methods: A retrospective cohort of patients submitted to thyroidectomy with or without central compartment neck dissection (CCND) due to PTC with a minimum follow-up of five years. Results: A total of 698 patients were included: 320 Nx, 264 pN0-incidental, 37 pN1a-incidental, 32 pN0-CCND and 45 pN1a-CCND. Patients with node metastasis were younger, had larger tumors, higher rates of microscopic extra-thyroidal extension, and angiolymphatic invasion and most received radioiodine therapy. Treatment failure was higher in patients pN1a-incidental and pN1a-CCND (32% and 16%, respectively; p < 0.001-Chi-square test). Disease-free survival (DFS) was lower in patients pN1a-incidental compared to patients Nx and pN0-incidental (p < 0.001 vs. Nx and pN0-incidental and p = 0.005 vs. pN0-CCND) but similar when compared to patients pN1a-CCND (p = 0.091)-Log-Rank test. Multivariate analysis demonstrated as independent risk factors: pT4a (HR = 5.524; 95%CI: 1.380-22.113; p = 0.016), pN1a-incidental (HR = 3.691; 95%CI: 1.556-8.755; p = 0.003), microscopic extra-thyroidal extension (HR = 2.560; 95%CI: 1.303-5.030; p = 0.006) and angiolymphatic invasion (HR = 2.240; 95%CI: 1.077-4.510; p = 0.030). Conclusion: Patients that were pN1a-incidental were independently associated with lower DFS.
- Surgical treatment for thyroid carcinoma: retrospective study with 811 patients in a Brazilian tertiary hospital(2016) CAVALHEIRO, Beatriz G.; MATOS, Leandro L.; LEITE, Ana Kober N.; KULCSAR, Marco Aurelio V.; CERNEA, Claudio R.; BRANDAO, Lenine G.Objective: The aim of the present study was to describe the epidemiologic data, histological type, treatment and follow-up of the 811 patients treated for thyroid cancer in Instituto do Cancer do Estado de Sao Paulo (ICESP) over 5 years. Materials and methods: Retrospective analyses of electronic chart information. Results: There were 679 cases (83.7%) of papillary thyroid cancer, 61 (7.5%) of follicular carcinoma, 54 (6.7%) of medullary carcinoma, 11 (1.4%) of poorly differentiated carcinoma and 6 of anaplastic carcinoma (0.7%). The majority of patients were female (82.2%), and the mean age was 50.5 +/- 15 years. Two hundred forty-two patients had disease persistence or recurrence. At the last follow-up, 629 (77.6%) patients were alive and disease free, 141 (17.4%) were alive with disease, and 41 (5.1%) were deceased, with 37 deaths related to thyroid cancer. Conclusion: This study was able to outline the profile, disease type and evolution of patients treated for thyroid cancer at a single tertiary hospital.
- The impact of sentinel lymph node biopsy on the quality of life in patients with oral cavity squamous cell carcinoma(2022) SEFERIN, Marco Roberto; PINTO, Fabio Roberto; LEITE, Ana Kober Nogueira; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; CERNEA, Claudio Roberto; MATOS, Leandro Luongo deIntroduction Sentinel lymph node biopsy is a proven method for staging the neck in patients with early oral cavity squamous cell carcinoma because it results in less comorbidity than the traditional method of selective neck dissection, with the same oncological results. However, the real effect of that method on the quality of life of such patients remains unknown. Objective The present study aimed to evaluate the quality of life of patients with oral cavity squamous cell carcinoma T1/T2N0 submitted to sentinel lymph node biopsy compared to those that received selective neck dissection. Methods Cross-sectional study including 24 patients, after a 36 month follow-up, 15 of them submitted to the sentinel lymph node biopsy and 9 to selective neck dissection. All patients answered the University of Washington quality of life questionnaire. Results The evaluation of the questionnaires showed a late worsening of the domains appearance (p = 0.035) and chewing (p = 0.041), as well as a decrease of about 10% of general quality of life (p = 0.025) in patients undergoing selective neck dissection in comparison to those undergoing sentinel lymph node biopsy. Conclusion Patients with early-stage oral cavity squamous cell carcinoma undergoing sentinel lymph node biopsy presented better late results of general quality of life, mainly regarding appearance and chewing, when compared to patients submitted to selective neck dissection.
- Survival in differentiated thyroid carcinoma: A comparison between the 7th and 8th editions of the AJCC/UICC TNM staging system and the ATA initial risk stratification system(2021) CAVALHEIRO, Beatriz Godoi; MATOS, Leandro Luongo de; LEITE, Ana Kober Nogueira; KULCSAR, Marco Aurelio Vamondes; CERNEA, Claudio Roberto; KOWALSKI, Luiz PauloBackground The AJCC/UICC TNM staging system evaluates the risk of death from cancer. Its 8th edition aimed to increase its accuracy. In turn, the American Thyroid Association proposed an initial risk stratification system (IRSS) focusing on the risk of recurrence in differentiated thyroid carcinoma. The present study intended to analyze their prediction abilities. Methods Six hundred and eighty-five consecutive surgical patients (mean follow-up 71.6 months) were staged. Correlations with disease-free survival (DFS) and overall survival (OS) were carried out. Results IRSS was discriminative for DFS but not for OS. Applying TNM 8th, 36.9% of the cohort was downstaged. Their DFS was shorter, compared with other patients in the same stage, but with no impact on OS. However, all those who died of the disease had been downstaged. Conclusions IRSS was more effective to predict DFS, but not OS. TNM 8th was more appropriate for OS analysis than TNM 7th and IRSS.