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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- Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis(2022) PAGLIONI, Mariana de Pauli; KHURRAM, Syed Ali; RUIZ, Blanca Iciar Indave; LAUBY-SECRETAN, Beatrice; NORMANDO, Ana Gabriela; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; PALMIER, Natalia Rangel; LOPES, Marcio Ajudarte; GUERRA, Eliete Neves da Silva; MELETI, Marco; MIGLIORATI, Cesar Augusto; CARVALHO, Andre Lopes; MATOS, Leandro Luongo de; KOWALSKI, Luiz Paulo; SANTOS-SILVA, Alan RogerObjective. We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]). Study Design. We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT. Results. Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT). Conclusions. Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD.
- Epithelial-mesenchymal transition related to bone invasion in oral squamous cell carcinoma(2022) VANINI, Jaqueline Vaz; KOYAMA, Leonardo Kenji Sakaue; MATOS, Leandro Luongo de; FIGUEREDO JUNIOR, Jose Martins; CERNEA, Claudio Roberto; NAGANO, Cibele Pidorodeski; COUTINHO-CAMILLO, Claudia Malheiros; HSIEH, Ricardo; LOURENCO, Silvia VanessaIntroduction: Bone invasion is an important prognostic factor in oral squamous cell carcinoma, leading to a lower survival rate and the use of aggressive treatment approaches. Epithelial-mesenchymal transition (EMT) is possibly involved in this process, because it is often related to mechanisms of cell motility and invasiveness. This study examined whether a panel of epithelial-mesenchymal markers are present in cases of oral squamous cell carcinoma with bone invasion and whether these proteins have any relationship with patients' clinical-pathological parameters and prognostic factors. Methods: Immunohistochemical analysis of E-cadherin, twist, vimentin, TGF beta 1, and periostin was performed in paraffin-embedded samples of 62 oral squamous cell carcinoma cases. Results: The analysis revealed that most cases (66%) presented with a dominant tumor infiltrative pattern in bone tissue, associated with lower survival rates, when compared with cases with a dominant erosive invasion pattern (P = 0.048). Twenty-seven cases (43%) expressed markers that were compatible with total or partial EMT at the tumor-bone interface. There was no association between evidence of total or partial EMT and other demographic or prognostic features. E-cadherin-positive cases were associated with tobacco smoking (P = 0.022); vimentin-positive cases correlated with tumors under 4 cm (P = 0.043). Twistexpression was observed in tumors with a dominant infiltrative pattern (P = 0.041) and was associated with the absence of periostin (P = 0.031). Conclusion: We observed evidence of total or partial EMT in oral squamous cell carcinoma bone invasion. The transcription factor twist appears to be involved in bone invasion and disease progression. (C) 2022 The Authors.
bookPart Epidemiologia e prevenção do câncer de laringe(2022) MATOS, Leandro Luongo de- Nutritional and immunological parameters as prognostic factors in patients with advanced oral cancer(2022) TREVISANI, Lorenzo Fernandes Moça; KULCSAR, Isabelle Fernandes; LEITE, Ana Kober Nogueira; KULCSAR, Marco Aurélio Vamondes; LIMA, Graziele Aparecida Simões; DEDIVITIS, Rogerio Aparecido; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoAbstract Objective: The aim of the present study was to analyze the prognostic relationship of weight loss and preoperative hematological indexes in patients surgically treated for pT4a squamous cell carcinoma of the oral cavity. Methods: A retrospective cohort study. Results: Percent weight loss greater than 10% was identified in 49 patients (28.2%), and any weight loss in relation to the usual weight occurred in 140 patients (78.7%). Percent weight loss greater than 10% (HR = 1.679), Red cell distribution width (RDW) values greater than 14.3% (HR = 2.210) and extracapsular spread (HR = 1.677) were independent variables associated with risk of death. Conclusion: Patients with advanced squamous cell carcinoma of the oral cavity present significant weight loss and as significantly immunocompromised. Increased values of RDW and higher percentages of weight loss in relation to the individual’s usual weight, together with extracapsular spread of metastatic lymph nodes, were risk factors for lower survival, regardless of other clinical and anatomopathological characteristics. Level of evidence: 3.
- Biomarkers of human papillomavirus (HPV)-driven head and neck cancer in Latin America and Europe study: Study design and HPV DNA/p16(INK4a) status(2022) SICHERO, Laura; TAGLIABUE, Marta; MOTA, Giana; FERREIRA, Silvaneide; NUNES, Rafaella A. L.; CASTANEDA, Carlos Arturo; CASTILLO, Miluska; CORREA, Rita Mariel; PERDOMO, Sandra; RODRIGUEZ-URREGO, Paula A.; MATOS, Leandro Luongo; MOHSSEN, Ansarin; GHEIT, Tarik; TOMMASINO, Massimo; CHIOCCA, Susanna; VILLA, Luisa LinaBackground Human papillomavirus (HPV)-driven head/neck squamous cell carcinomas (HNSCC) prevalence varies globally. We evaluated HPV DNA and p16(INK4a) in formalin fixed paraffin embedded (FFPE) HNSCC from Argentina, Brazil, Colombia, and Peru. Methods HPV was genotyped by PCR-hybridization. All HPV DNA positive and some HPV DNA negative cases underwent p16(INK4a) immunohistochemistry. Results HPV DNA was detected in 32.8%, 11.1%, and 17.8% of oropharyngeal (OPC), oral cavity (OCC) and laryngeal (LC) cancers, respectively. OPC HPV prevalence was higher in Colombia (94.7%), and Argentina (42.6%) compared to Brazil (10.6%) and Peru (0.0%). HPV-16 was the most detected. Other HPVs were found in LC. Higher rates of p16(INK4a) positivity were observed among HPV positive OPC/OCC cases compared to LC cases. Conclusions Our results support a role for HPV-16 in a subset of HNSCC, corroborate the heterogeneity observed in samples from different countries, and contribute additional etiological and biomarkers information in tumors of significant impact worldwide.
- Risk factors associated with disease-specific mortality in papillary thyroid cancer patients with distant metastases(2022) NUNES, Kamilla Schmitz; MATOS, Leandro Luongo; CAVALHEIRO, Beatriz Godoi; MAGNABOSCO, Felipe Ferraz; TAVARES, Marcos Roberto; KULCSAR, Marco Aurelio; HOFF, Ana Oliveira; KOWALSKI, Luiz Paulo; LEITE, Ana KoberPurpose Papillary thyroid carcinoma (PTC) is among the most curable cancer types. Even though uncommon, some patients present distant metastatic disease at diagnosis or during the follow-up and most of them have long-term survival. However, there continues to be controversies regarding what clinicopathological features are associated with mortality in these patients. This paper evaluates the factors related to poor disease-specific survival (DSS) in patients with metastatic PTC. Methods A retrospective cohort study included PTC patients with distant metastasis from a tertiary public oncological center. Clinicopathological features, treatment modalities, and outcome were reviewed. Results Between 1986 and 2014, 108 patients were diagnosed with metastatic PTC. In the multivariate analysis male sex (HR = 2.65; 95%CI: 1.08-6.53; P = 0.033), radioiodine refractory disease (HR = 9.50; 95%CI: 1.23-73.38; P = 0.031) and metastasis at multiple sites (HR = 5.91; 95%CI: 1.80-19.32; P = 0.003) were independent risk factors for death in patients with metastatic PTC. Conclusion Male patients with metastatic PTC, with radioiodine refractory disease and metastasis at multiple sites have a high risk of death.
- 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.
- Sentinel lymph node biopsy for early squamous cell carcinoma of the lip and oral cavity: Real-world experience in Brazil(2022) MATOS, Leandro Luongo; CAPUZZO, Renato Castro; PEDRUZZI, Paola Andrea Galbiatti; FARIAS, Terence; FARIAS, Jose Wilson Mourao de; CHONE, Carlos Takahiro; KOHLER, Hugo Fontan; VARTANIAN, Jose Guilherme; DIAS, Fernando Luiz; COUTO, Eduardo Vieira; PINTO, Fabio Roberto; CARVALHO, Andre Lopes; KOWALSKI, Luiz PauloBackground This study aimed to evaluate the accuracy and oncological results of sentinel lymph node biopsy in patients with early lip and oral cavity squamous cell carcinoma (SCC) in a real-world scenario. Methods Retrospective study including seven Brazilian centers. Results Four-hundred and seven cN0 patients were accrued for 20 years. The rate of occult metastasis was 23.1% and 22 patients (5.4%) had regional failure. We found, for 5 years of follow-up, 85.3% of regional recurrence-free survival; 77.1% of disease-free survival; 73.7% of overall survival; and 86.7% of disease-specific survival. The rate of false-negative cases was 5.4%. Conclusion In a real-world scenario, sentinel lymph node biopsy for patients with SCC of the lip and oral cavity proved feasible in different settings and to be oncologically safe, with similar rates of occult lymph node metastasis and false-negative cases, when compared to elective neck dissection, and with similar long-term survival to that reported historically.
- Achieving negative resection margins in oral cavity cancer with masticator space involvement-Is it feasible? An international collaborative study(2022) HOROWITZ, Gilad; ALMEIDA, John R. De; BERANIA, Ilyes; GOLDSTEIN, David P.; KOEHLER, Hugo Fontan; KOWALSKI, Luiz Paulo; MATOS, Leandro Luongo; BRENNER-ULLMAN, Adi; FLISS, Dan M.; MUHANNA, Nidal; HALPERN, Daniel; NARD-CARMEL, Narin; UNGAR, Omer J.; WARSHAVSKY, AntonBackground Masticator space involvement in oral cavity squamous cell carcinoma (OCSCC) is considered an unresectable disease. Nevertheless, achieving negative resection margins is feasible in limited masticatory space involvement. Materials and Methods A multi-institutional study on OCSCC patients with masticator space invasion who underwent surgical resection. Margin status was assessed according to anatomic tumor involvement of the inframandibular and supra-mandibular notch. Results One-hundred and thirty-two patients met the inclusion criteria. Then, 67 patients (50.8%) were diagnosed with a supra-notch tumor and 65 (49.2%) with an infra-notch disease. Negative margins were more common in the infra-notch group (43.3 vs. 23.1%, p = 0.014), and positive margins were more common in the supra-notch group (41.5 vs. 23.9%, p = 0.041). Multivariable analysis demonstrated that supra-notch tumors had an increased likelihood for involved resection margins (odds ratio = 2.46, p = 0.036). Conclusion OCSCC patients with masticator space involvement are prone for positive surgical margins in tumors extending above the supra-mandibular notch.
- Sphingolipids signature in plasma and tissue as diagnostic and prognostic tools in oral squamous cell carcinoma(2022) FAEDO, Raquel Roman; SILVA, Gabriel da; SILVA, Rodrigo Moreira da; USHIDA, Tatiane Resende; SILVA, Ricardo Roberto da; LACCHINI, Riccardo; MATOS, Leandro Luongo; KOWALSKI, Luiz Paulo; LOPES, Noberto Peporine; LEOPOLDINO, Andreia MachadoEnzymes related to sphingolipids metabolism has been suggested as altered in oral squamous cell carcinoma (OSCC). However, clinical relevance of diverse sphingolipids in OSCC is not fully known. Here, we evaluated sphingolipidomics in plasma and tumor tissues as a tool for diagnosis/prognosis in OSCC patients. Plasma was obtained from 58 controls and 56 OSCC patients, and paired tumor and surgical margin tissues (n = 42). The levels of 28 sphingolipids molecules were obtained by mass spectrometry. Furthermore, sphingolipids were analyzed with clinical and pathological characteristics to search the potential for diagnosis and prognosis. Lower levels of 17 sphingolipids was found in the plasma of OSCC patients compared to controls while four were elevated in tumor tissues. C18:0 dyhidroceramide and C24:0 lactosylceramide in plasma were associated with perineural invasion, while tissue levels of ceramide and dyhidroceramide were associated with advanced tumor stage and perineural invasion. High plasma levels of C24:0 ceramide (HR = 0.10, p = 0.0036) and C24:1 glucosylceramide (HR = 6.62, p = 0.0023), and tissue levels of C24:0 dyhidroceramide (HR = 3.95, p = 0.032) were identified as independent prognostic factors. Moreover, we identified signatures composed by i) sphinganine-1-phosphate and C16 ceramide-1-phosphate in plasma with significant diagnostic accuracy, while ii) C24:0 ceramide, C24:0 dyhidroceramide, and C24:1 glucosylceramide plasma levels, and iii) C24:0 dyhidrosphingomyelin and C24:0 ceramide tissue levels showed value to predict survival in patients aged 60 years or older. We proposed the sphingolipids signatures in plasma and tumor tissues as biomarkers candidates to diagnosis and prognosis in OSCC.