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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- Morphological Evaluation of Thyroid Cartilage Invasion in Early Glottic Tumors Involving the Anterior Commissure(2018) SAVA, Henrique Wendling; DEDIVITIS, Rogerio Aparecido; GAMEIRO, Gustavo Rosa; PFUETZENREITER, Elio Gilberto; ALMEIDA, Ricardo Camillo de; MATOS, Leandro Luongo; CERNEA, Claudio RobertoIntroduction: The anterior commissure is an area of glottic cancer infiltration, even in early stages. Objective: To evaluate the invasion by tumors into the anterior commissure cartilage in surgical specimens of frontolateral laryngectomy. Methods: Forty-eight patients who had undergone frontolateral laryngectomy for T1b/T2 squamous cell carcinoma were included. Epidemiological and clinical aspects as well as morphological histopathological analysis were evaluated. Results: Of the 48 patients, 42 (87.5%) had T1b lesions and 6 (12.5%) had T2. Thirty-four cases (70.8%) showed healthy tissue between the tumor and the thyroid cartilage, 10 cases (20.8%) had a tumor in close proximity to the cartilage, and in 4 cases (8.3%) there was cartilage invasion. There was no major risk of adverse outcome in the groups with infiltration or tumor adjacent to the cartilage. Level of differentiation, mitotic index, nuclear irregularity, and the presence of nucleolus and tumor necrosis were not related to cartilage invasion. Conclusion: The infiltration of thyroid cartilage occurred in 8.3% of tumors and did not change the outcome in patients submitted to frontolateral laryngectomy. The morphological characteristics did not present any statistical significance. (C) 2018 S. Karger AG, Basel
- Comparison between magnetic resonance and computed tomography in detecting mandibular invasion in oral cancer: A systematic review and diagnostic meta-analysis MRI x CT in mandibular invasion(2018) BRANDAO NETO, Jose de Souza; AIRES, Felipe Toyama; DEDIVITIS, Rogerio Aparecido; MATOS, Leandro Luongo; CERNEA, Claudio RobertoBackground: Suspicion of mandibular invasion directly influences perioperative strategy, requiring marginal or segmental mandibulectomy, or reconstruction in some cases. This has a considerable impact on outcome and quality of life. The aim of this study was to evaluate the accuracy of magnetic resonance and computed tomography in the prediction of mandibular invasion in patients with oral cavity cancer. Method: A systematic review was conducted, including diagnostic studies comparing magnetic resonance imaging with computed tomography in the prediction of bone invasion. Sensitivity, specificity, positive and negative likelihood values and summary receiver operating characteristic (sROC) curves were calculated. Results: The electronic and manual search identified 346 articles. Of these, 11 studies were included in the systematic review for a total of 477 patients. The sensitivity, specificity, and positive and negative likelihood values for MRI were 78%, 86%, 5.29 and 0.23, respectively. For CT, they were 76%, 89%, 6.00 and 0.28, respectively. The sROC curves for MRI and CT were 82.3% and 82.5%, respectively. Conclusion: No superiority was observed between the diagnostic methods regarding mandibular invasion detection.
- External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients(2017) MATOS, Leandro Luongo; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini F.; CERNEA, Claudio RobertoObjectives: To evaluate the new American Joint Committee on Cancer (AJCC) cancer staging manual (8th edition) in an independent cohort of patients surgically treated for oral squamous cell carcinoma in order to determine whether the upstaging of pT and pN classification was indicative of a worse prognosis. Methods: A cohort of 298 patients was analyzed retrospectively. Results: Of these patients, 22.8% received an upstaging when the depth of invasion was included into the pT classification. Similarly, 29.2% of them were upstaged when extracapsular extension was added to pN classification. Twenty-eight of 68 patients (41.2%) that received an upstaging of pT classification died, and 23 (33.8%) experienced disease recurrence compared to 98/229 (42.8%) and 68/229 (29.7%), respectively, for those with the same pT during follow-up. With regard to pN classification, 70.6% of upstaged patients (60/85) died, and 50.6% (43/85) developed recurrence of the disease compared to 63/205 (30.7%) and 42/205 (20.5%), respectively, for those with the same pN during follow-up. Patients who were upstaged in pT classification presented a worse DFS (51.1% versus 80.4%, P = 0.007) and OS (31.5% versus 58.6%, P = 0.017). Similarly, those that were upstaged in pN classification presented a worse DFS (17.1% versus 61.2%, P = 0.001) and OS (8.5% versus 37.9%, P < 0.001). Conclusion: The new AJCC cancer staging manual (8th edition) allows a better stratification of oral SCC patients. By including the depth of invasion to the pT classification and extranodal extension to the pN classification, a worse disease-free and overall survival was assessed for these patients.
- Lymph node density as a predictive factor for worse outcomes in laryngeal cancer(2020) PETRAROLHA, Silvia; DEDIVITIS, Rogerio; MATOS, Leandro; RAMOS, Daniel; KULCSAR, MarcoBackground The lymph node density (LND) is the number of positive metastatic lymph nodes divided by the total number of dissected lymph nodes. The purpose of this study was to evaluate LND as a prognostic factor in patients with laryngeal squamous cell carcinoma (SCC). Methods The study included 186 patients with laryngeal SCC submitted to laryngeal surgical treatment with neck dissection between January 2009 and December 2016. Clinical-pathological variables were assessed, as well as the cut-off point for LND. Results LND value was calculated considering pN+ (LND = 0.060). The Kaplan-Meier curve (log-rank) related to cumulative survival demonstrated that patients with LND >= 0.060 had a higher mortality rate than those with LND < 0.060, presenting a more aggressive form of the disease, with earlier recurrence. However, only the LND >= 0.060 group had impact on both disease-free survival and overall survival. Conclusion The LND proved to be an important index in the prognostic evaluation of larynx SCC patients having a direct relationship with disease recurrence. Patients with LND >= 0.060 should be considered for adjuvant therapy.
- Tumor volume as a prognostic factor of locally advanced laryngeal cancer(2021) ANDRADE, Natalia Martins Magacho de; DEDIVITIS, Rogerio Aparecido; RAMOS, Daniel Marin; MATOS, Leandro Luongo; GARCIA, Marcio Ricardo Taveira; CONTI, Gustavo Goncalves; KOWALSKI, Luiz PauloPurpose The TNM tumor staging system is the most widely used for laryngeal cancer. However, in the same T stage, lesions with different primary tumor volumes (TV) can be found, impacting treatment outcomes. Methods 145 patients with T3 and T4a laryngeal cancer, according to Union for International Cancer Control, who underwent surgical treatment from 2008 to 2017, were analyzed. TV measurements were collected and compared to different outcomes. Results The mean TV was 23.0 +/- 16.4 cm(3). A cutoff point for TV of 14.2 cm(3) was established. Cumulative sample 5-year overall survival (OS) was 62.1%, while 5-years disease-free survival (DFS) was 65.5%. In univariate analysis, TV >= 14.2 cm(3) was associated with a higher risk of distant metastases (p = 0.045), and worse rates of OS (p = 0.009) and DFS (p = 0.035). In multivariate analysis, TV was not an independent risk factor of worse DFS (p = 0.569) or OS (p = 0.094). Conclusion Primary lesion TV showed significant association, in univariate analysis, with worse rates of recurrence and survival in advanced laryngeal cancer undergoing surgical treatment and can be a promising prognostic for these patients.
- Comparison between transoral laser surgery and radiotherapy in the treatment of early glottic cancer: A systematic review and meta-analysis(2018) GUIMARAES, Andre Vicente; DEDIVITIS, Rogerio Aparecido; MATOS, Leandro Luongo; AIRES, Felipe Toyama; CERNEA, Claudio RobertoA therapeutic decision in the treatment of Tis/T1a glottic carcinoma with radiotherapy (RT) or transoral laser surgery (TOS) is still an open issue. Oncologic outcome and voice quality may support the choice for the latter To conduct a systematic review and meta-analysis to compare oncologic and functional outcomes of TOS and RT as treatment options for Tis/T1a glottic cancer. Literature research on online databases was carried out. Potentially eligible articles were reviewed. Relevant articles were selected and evaluated. There was statistical significance favoring patients initially treated with TOS when it comes to overall survival, disease-specific survival and larynx preservation. No difference in local control was found. TMF, Jitter and Shimmmer measurements presented statistically significant results in favor of RT. Self-assessment of voice quality (VHI) and f0 showed no statistically significant differences. Maximum Phonation Time (MPT) had a better response to RT. There is a trend in favor of RT. Tis/T1a glottic cancer patients submitted to TOS had significant overall and disease specific survival and had fewer risks of having a total laryngectomy, when compared to the radiotherapy group. The self-assessment of voice quality and f0 did not show any difference; however, Jitter, Shimmer and MPT measurements favored radiotherapy.
- Total laryngectomy vs. non-surgical organ preservation in advanced laryngeal cancer: a metanalysis(2024) JR, Elio Gilberto Pfuetzenreiter; FERRERON, Gabriela Feltrini; SADKA, Julia Zumerkorn; SOUZA, Ana Beatriz Padua de; MATOS, Leandro Luongo; KOWALSKI, Luiz Paulo; DEDIVITIS, Rogerio AparecidoObjective: To compare the oncological results and the functional outcomes of patients undergoing Total Laryngectomy (TL) with the non-surgical treatment (organ preservation protocol) in the treatment of advanced laryngeal carcinomas through systematic review and meta-analysis. Methods: A literature survey strategy was employed in order to perform a systematic review of the available evidence. Success rate and functional outomes after oncological treatment of patients with advanced laryngeal carcinomas was evaluated through systematic review and metanalysis, comparing TL and organ preservation protocol. Results: The surgical treatment was associated with better survival outcomes. When stratifying by T stage, while patients with T4 staging have less risk of mortality with TL, there is no difference between the different treatments for patients with T3 tumors. Surgery is related to a lower chance of recurrence, late dysphagia and feeding tube dependence.
- Association of the Specimen and Tumor Bed Margin Status with Local Recurrence and Survival in Open Partial Laryngectomy(2024) DEDIVITIS, Rogerio Aparecido; MATOS, Leandro Luongo de; CASTRO, Mario Augusto Ferrari de; KOWALSKI, Luiz PauloBackground/Objectives: Positive margins are associated with locoregional recurrence in early laryngeal cancer. The aim of this study was to evaluate the impacts of specimen-driven (ex vivo) positive margins on patients with early-stage laryngeal cancer whose tumor bed (defect-driven) margins had been negative. Methods: A retrospective study was performed on 60 consecutive T1b/T2 glottic cancer patients who underwent open frontolateral laryngectomy. The intraoperative margins were obtained from the tumor bed. Their recurrence and disease-free survival were evaluated. In all cases, negative margins were obtained from the surgical bed. The impact of positive margins from the specimen was evaluated in a paraffin study. Results: Among 10 patients with positive margins in the specimen, six experienced local relapse, and among 50 patients with negative margins in the specimen, three developed recurrence. The 5-year disease-free survival rates were 37.5% and 93.9%, respectively (p < 0.001; log-rank). Even with negative margins in the surgical bed, patients with positive margins in the specimen at the final histopathological examination had a 3.5-fold higher chance of developing local recurrence than those with negative margins (HR = 13.993; 95% CI: 3.479-56.281; p < 0.001; univariate Cox regression). Conclusions: Specimen-driven positive margins represent a significant risk factor for local recurrence, even under negative margins at the tumor bed.