GIULIANO BETONI GUGLIELMETTI
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
19 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 19
- A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy(2022) GUGLIELMETTI, Giuliano B.; ANJOS, Gabriel C. dos; SAWCZYN, Guilherme; RODRIGUES, Gilberto; CARDILI, Leonardo; CORDEIRO, Mauri Prime Cio D.; NEVES, Luiz C. O.; PONTES JUNIOR, Jose; FAZOLI, Arnaldo; COELHO, Rafael F.; SROUGI, Miguel; NAHAS, William C.Purpose: Partial nephrectomy is the standard treatment for renal tumors <7 cm, and the trend toward minimally invasive surgery has increased. However, data that could support its use and benefits are still lacking. Materials and Methods: We conducted a prospective, randomized controlled trial comparing surgical, functional and oncologic outcomes in patients undergoing open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN). Randomization was 1:1 to OPN or LPN for the treatment of renal tumors <7 cm. The primary endpoint was surgical complications up to 90 days after surgery. Secondary outcomes were comparison of surgical, oncologic and functional results. Results: We randomized 208 patients between 2012 and 2020 (110 with OPN vs 98 with LPN). Operative data showed no differences in operative time, warm ischemia time, estimated blood loss, transfusions or length of hospital stay. Zero ischemia was more frequent in the OPN (35.4% vs 15.5%, p=0.02). OPN was associated with more abdominal wall complications (31.2% vs 13.1%, p=0.004). Regarding oncologic outcomes, no differences were noted. The LPN group had less kidney function reduction at 3 (-5.2% vs -10%, p=0.04; CI 0.09 to 9.46) and 12 months after surgery (-0.8% vs -6.3%, p=0.02; CI 1.18 to 12.95), and a lower rate of downstaging on the chronic kidney disease classification at 12 months (14.1% vs 32.6%, p=0.006). Conclusions: Surgical and oncologic outcomes of LPN were similar to OPN. Minimally invasive surgery may provide better preservation of kidney function. More studies, especially those involving robotic surgery, are necessary to confirm our findings.
conferenceObject CAN MAGNETIC RESONANCE IMAGING REDUCE POSITIVE SURGICAL MARGINS IN RADICAL PROSTATECTOMY?(2016) PADOVANI, Guilherme; ANJOS, Gabriel; GUGLIELMETTI, Giuliano; FRANCA, Regis; VIANA, Publio; CORDEIRO, Mauricio; COELHO, Rafael; NAHAS, William- Effectiveness of Intrarectal Povidone-iodine Cleansing Plus Formalin Disinfection of the Needle Tip in Decreasing Infectious Complications After Transrectal Prostate Biopsy: A Randomized Controlled Trial(2022) PONTES-JUNIOR, Jose; FREIRE, Tiago Magalhaes; PUGLIESI, Felipe Guimaraes; COSTA, Felipe Machado de Moura; SOUZA, Vinicius Meneguette Gomes De; GALUCCI, Fabio Pescarmona; ALBERTINI, Aline; COUTO, Adriano Borba; MURTA, Claudio Bovolenta; GUGLIELMETTI, Giuliano Betoni; NAHAS, William C.; JUNIOR, Adalberto Andriolo; NETO, Alcides Mosconi; CLARO, Joaquim Francisco de AlmeidaPurpose:Prostate biopsy is mostly performed through the transrectal route worldwide and infectious complications may occur in up to 7% of cases. Therefore, alternative strategies to decrease infectious complications are needed. Our aim was to evaluate the effectiveness of intrarectal povidone-iodine cleansing plus formalin disinfection of the needle tip in decreasing infectious complications after transrectal ultrasound guided prostate biopsy.Materials and Methods:We conducted a prospective, single-center, phase III trial in patients undergoing transrectal ultrasound guided prostate biopsy randomized 1:1 to rectal mucosa cleansing with gauze soaked in 10% povidone-iodine solution wrapped around the gloved index finger and needle tip disinfection by immersion in a 10% formalin solution before each puncture vs control group. The primary end point was the rate of infectious complications defined as 1 or more of the following events: fever, urinary tract infection, or sepsis.Results:Overall, 633 patients were randomized to the intervention group and 623 to the control group. The infectious complication rate was 3.9% in the intervention group and 6.4% in the control group (RR 0.61; 95% CI 0.36-0.99; P = .049). The rates of sepsis, urinary tract infection, and fever were 0.3% vs 0.5% (P = .646), 2.3% vs 4.1% (P = .071), and 1.3% vs 1.9% (P = .443), respectively. The positive urine culture rate was 5.2% in the intervention group and 9% in the control group (RR 0.57; P = .015). There was no statistically significant difference between the groups regarding the occurrence of noninfectious adverse events.Conclusions:Intrarectal povidone-iodine cleansing plus formalin disinfection of the biopsy needle tip was associated with a reduction in infectious complications after transrectal prostate biopsy.
conferenceObject THE PHENOMENON OF EPITHELIAL-MESENCHYMAL TRANSITION IS ASSOCIATED WITH THE PROGRESSION OF PROSTATE CANCER(2016) PONTES JR., Jose; COELHO, Rafael; CORDEIRO, Mauricio; BETONI, Giuliano; OLIVEIRA, Luiz; REIS, Sabrina; LEITE, Katia; SROUGI, Miguel; NAHAS, WilliamconferenceObject PROSPECTIVE RANDOMIZED TRIAL COMPARING OPEN TO LAPAROSCOPIC PARTIAL NEPHRECTOMY, INTERIM ANALYSIS. (NCT01809119)(2016) GUGLIELMETTI, Giuliano; ADONIAS, Sanarelly; COELHO, Rafael; CORDEIRO, Mauricio; BORGES, Leonardo; COLOMBO, Jose Roberto; PESSOA, Rodrigo; NEVES, Luiz; PONTES, Jose; NESRALLAH, Adriano; SROUGI, Miguel; NAHAS, William- 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.
- Impact of Statin Use on Oncologic Outcomes in Patients with Urothelial Carcinoma of the Bladder Treated with Radical Cystectomy(2013) SILVA, Rodrigo Donalisio da; XYLINAS, Evanguelos; KLUTH, Luis; CRIVELLI, Joseph J.; CHRYSTAL, James; CHADE, Daher; GUGLIELMETTI, Giuliano Betoni; PYCHA, Armin; LOTAN, Yair; KARAKIEWICZ, Pierre I.; SUN, Maxine; FAJKOVIC, Harun; ZERBIB, Marc; SCHERR, Douglas S.; SHARIAT, Shahrokh F.Purpose: Statins are cholesterol lowering agents used to prevent cardiovascular disease. Evidence suggests a dichotomous effect of statins with cancer inhibiting and promoting properties. To our knowledge the effect of statins on the prognosis of muscle invasive urothelial carcinoma of the bladder remains uninvestigated to date. We tested the hypothesis that statin use impacts oncological outcomes in patients treated with radical cystectomy for urothelial carcinoma of the bladder. Materials and Methods: We retrospectively evaluated the records of 1,502 patients treated with radical cystectomy and pelvic lymphadenectomy without neoadjuvant therapy at a total of 4 institutions. Cox regression models were used to determine the association of statins with disease recurrence and cancer specific mortality. Results: A total of 642 patients (42.7%) were on statins. At a median followup of 34 months 509 patients (33.9%) experienced disease recurrence and 402 (26.8%) had died of urothelial carcinoma of the bladder. Statin users were older (p = 0.003), had a higher body mass index (median 32 vs 28 kg/m(2), p < 0.001) and were more likely to have positive soft tissue surgical margins (9% vs 4%, p < 0.001). On univariable Cox regression analysis statins, female gender, advanced age, higher body mass index, smoking status, tumor stage, tumor grade, soft tissue surgical margin status, lymphovascular invasion, lymph node metastasis and adjuvant chemotherapy were associated with disease recurrence (p <= 0.05) and cancer specific mortality (p <= 0.02). On multivariable Cox regression analysis statin use was not associated with either outcome. Conclusions: Statin users were at higher risk for disease recurrence and cancer specific mortality on univariable but not multivariable analysis. These data do not support modification of statin use in patients with high risk urothelial carcinoma of the bladder who will be treated with radical cystectomy.
conferenceObject CONVENTIONAL LAPAROSCOPIC RADICAL NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY(2017) GUGLIELMETTI, Giuliano; NONEMACHER, Henrique; ALBUQUERQUE, George Lins de; COELHO, Rafael; CORDEIRO, Mauricio; NAHAS, Willian- Reply by Authors(2022) GUGLIELMETTI, G. B.; ANJOS, G. C. Dos; SAWCZYN, G.; RODRIGUES, G.; CARDILI, L.; CORDEIRO, M. D.; NEVES, L. C. O.; PONTES JUNIOR, J.; FAZOLI, A.; COELHO, R. F.; SROUGI, M.; NAHAS, W. 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, William