CARLOS EDUARDO JACOB
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
28 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 28
- Characterization of oncogene suppressor marker expression in patients with submucosal gastric carcinoma(2018) MORON, Roberson A.; JACOB, Carlos Eduardo; BRESCIANI, Claudio Jose Caldas; SIMOES, Kleber; ALVES, Venancio Avancini Ferreira; IRYA, Kyoshi; GAMA-RODRIGUES, Joaquim; CECCONELLO, Ivan; LONGATTO-FILHO, Adhemar; ZILBERSTEIN, BrunoThe aim of the present study was to determine the clinical significance of p53 and p21(ras) p21(wafl), p27(kip1) and p16(ink4a) expression in cases of early gastric cancer. A total of 81 patients who had undergone gastrectomy with D2 lymphadenectomy between 1971 and 2004 were retrospectively investigated. The immunohistochemical expression of p21ras, p53, p21waf1.cip1, p27kip1 and p16ink4a in the tissues was evaluated. In normal, metaplastic and tumoral mucosa, p53 was positive in 53, 87.3, and 87.1% of the cases, respectively. In the same tissues, p21ras was positive in 85.3, 86 and 96.8%, respectively. Positivity for p16ink4a was detected in 46.3, 91.1 and 86% of the cases, respectively, whereas p27kip1 was positive in 60, 94.7 and 95.3%, and p21wafl/ cip1 was positive in 32.4, 72.7 and 71.4% of the cases, respectively. All the tumors were positive for p53. Tumors with lymph node invasion presented with overexpression (+ 4) of p53 in 47% of the cases vs. 17% of patients who did not have lymph node involvement. Therefore, higher expression of p53, p21ras and p21wafl/ cip1 in the tumor exhibited a statistically significant association with lymph node involvement.
- Robotic digestive tract reconstruction after total gastrectomy for gastric cancer: a simple way to do it(2016) BARCHI, Leandro Cardoso; JACOB, Carlos Eduardo; FRANCISS, Maurice Youssef; KAPPAZ, Guilherme Tommasi; RODRIGUES FILHO, Edison Dias; ZILBERSTEIN, BrunoBackground Intracorporeal digestive tract reconstruction after minimally invasive total gastrectomy may be challenging, even when using the da Vinci (R) Surgical System. This may be due to intrinsic difficulties during oesophagojejunal anastomosis (EJA). The aim of this study was to describe a simple way to perform digestive tract reconstruction after robotic total gastrectomy (RTG) for gastric cancer and the results of its application in a small series of cases. Methods In the last 2 years, six patients with gastric adenocarcinoma have been treated by RTG, four male and two female, with mean age of 59.8 (range 48-74) years. The tumour was located in the gastric body in three patients, the gastric antrum in two patients and the fundus in one patient with no need of splenectomy. In all cases, D2 lymphadenectomy was completed. A modified robotic reconstruction technique proposed by the authors was used in these operations, which consists in a latero-lateral EJA using a linear stapler. An entero-enterostomy is also performed in the upper abdomen. Results The mean operative time was 408 (range 340-481) min. The mean time for digestive tract reconstruction was 57 (range 47-68) min. There were no conversions to open or laparoscopic surgery. The number of lymph nodes removed varied in the range 28-52 (average 40). There was no mortality. Postoperative staging showed three T1N0M0s, one T2N0M0, one T3N0M0 and one T3N2M0. Conclusion This series, which despite being small, demonstrates that this robotic reconstruction technique is safe, with no major complications, demands a relatively short time for its accomplishment, even when dealing with initial experience.
- GASTRIC NEUROENDOCRINE TUMOR: REVIEW AND UPDATE(2017) DIAS, Andre Roncon; AZEVEDO, Beatriz Camargo; ALBAN, Luciana Bastos Valente; YAGI, Osmar Kenji; RAMOS, Marcus Fernando Kodama Pertille; JACOB, Carlos Eduardo; BARCHI, Leandro Cardoso; CECCONELLO, Ivan; RIBEIRO-JR, Ulysses; ZILBERSTEIN, BrunoABSTRACT Introduction: The frequency of gastric neuroendocrine tumors is increasing. Reasons are the popularization of endoscopy and its technical refinements. Despite this, they are still poorly understood and have complex management. Aim: Update the knowledge on gastric neuroendocrine tumor and expose the future perspectives on the diagnosis and treatment of this disease. Method: Literature review using the following databases: Medline/PubMed, Cochrane Library and SciELO. Search terms were: gastric carcinoid, gastric neuroendocrine tumor, treatment. From the selected articles, 38 were included in this review. Results: Gastric neuroendocrine tumors are classified in four clinical types. Correct identification of the clinical type and histological grade is fundamental, since treatment varies accordingly and defines survival. Conclusion: Gastric neuroendocrine tumors comprise different subtypes with distinct management and prognosis. Correct identification allows for a tailored therapy. Further studies will clarify the diseases biology and improve its treatment.
conferenceObject OUTCOME OF GASTRIC CANCER PATIENTS SUBMITTED TO D1 LYMPH NODE DISSECTION DUE TO UNFAVORABLE MEDICAL CONDITIONS(2017) RAMOS, Marcus Kodama; PEREIRA, Marina; DIAS, Andre R.; YAGI, Osmar K.; BARCHI, Leandro C.; JACOB, Carlos E.; MUCERINO, Donato R.; LOPASSO, Fabio; MESTER, Marcelo; BRESCIANI, Claudio C.; CHARRUF, Amir Z.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO, Ulysses- Resultados da gastrectomia D2 para o câncer gástrico: dissecção da cadeia linfática ou ressecção linfonodal múltipla?(2012) ZILBERSTEIN, Bruno; MUCERINO, Donato Roberto; YAGI, Osmar Kenji; RIBEIRO-JUNIOR, Ulysses; LOPASSO, Fabio Pinatel; BRESCIANI, Claudio; JACOB, Carlos Eduardo; COIMBRA, Brian Guilherme Monteiro Marta; CECCONELLO, IvanBACKGROUND: Eastern literature is remarkable for presenting survival rates for surgical treatment of gastric adenocarcinoma superior to those presented in western countries. AIM: To analyze the long-term result after D2 gastrectomy for gastric cancer. METHODS: Two hundred seventy four underwent gastrectomy with D2 lymph node dissection as exclusive treatment. The inclusion criteria were: 1) lymph node removal according to Japanese standardized lymphatic chain dissection; 2) potentially curative surgery described in medical records as D2 or more lymph node dissection; 3) tumoral invasiveness of gastric wall restricted to the organ (T1 - T3); 4) absence of distant metastasis (N0-N2/M0); 5) a minimum of five years follow-up. Clinical pathological data included sex, age, tumor location, Borrmann's macroscopic tumor classification, type of gastrectomy, mortality rates, hystological type, TNM classification and staging according to UICC TNM 1997. RESULTS: Total gastrectomy was performed in 77 cases (28.1%) and subtotal gastrectomy in 197 (71.9%). The tumor was located in the upper third in 28 cases (10.2%), in the middle third in 53 (19.3%), and in the lower third in 182 (66.5%). Among patients that had their Borrmann's classification assigned, five cases (1.8%) were BI, 34 (12.4%) BII, 230 (84.0%) BIII and 16 (5.9%) BIV. Tumors were histologically classified as Laurén intestinal type in 119 cases (43.4%) and as diffuse type in 155 (56.6%). According to UICC TNM 1997 classification, early gastric cancer (T1) was diagnosed in 68 cases (24.8 %); 51 (18.6%) were T2, and 155 (56.6%) were T3. No lymph node involvement (N0) was observed in 129 cases (47.1%), whereas 100 (36.5%) were N1 (1-6 lymph nodes), and 45 (16.4%) were N2 (7-15 lymph nodes).The median number of lymph nodes dissected was 35. The overall long-term (five-year) survival rate, for stages I to IIIb was 70.4%. CONCLUSION: Digestive surgeons must be stimulated in performing D2 gastrectomies to avoid wasting the only treatment to gastric adenocarcinoma that has proven to be efficient up to this days. It must be emphasized that standardized lymph nodes dissection according to tumor location is more important that only the number of removed nodes
article Surgical outcome of Gastric Cancer in patients older than 80 years(2016) OLIVEIRA, Rodrigo José de; CHARRUF, Amir Zeide; JACOB, Carlos Eduardo; RAMOS, Marcus Kodama P.; DIAS, André Roncon; YAGI, Osmar K.; MUCERINO, Donato R.; BARCHI, Leandro; MESTER, Marcelo; BRESCIANI, Cláudio J. C.; LOPASSO, Fábio P.; ZILBERSTEIN, Bruno; CECCONELLO, Ivanarticle Clinicopathologic features and surgical outcome of Gastric Stump Cancer(2016) OLIVEIRA, Rodrigo José de; CHARRUF, Amir Zeide; JACOB, Carlos Eduardo; DANTAS, Anna Carolina B.; RAMOS, Marcus Kodama P.; DIAS, André Roncon; YAGI, Osmar; MUCERINO, Donato; MESTER, Marcelo; BRESCIANI, Cláudio; LOPASSO, Fábio; ZILBERSTEIN, Bruno; CECONELLO, Ivanarticle Morbimortality of extended local resection for advanced gastric cancer(2016) OLIVEIRA, Rodrigo José de; CHARRUF, Amir Zeide; JACOB, Carlos Eduardo; RAMOS, Marcus Kodama P.; DIAS, André Roncon; YAGI, Osmar K.; MUCERINO, Donato R.; BARCHI, Leandro; MESTER, Marcelo; BRESCIANI, Cláudio J. C.; LOPASSO, Fábio P.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan- Absence of RKIP expression is an independent prognostic biomarker for gastric cancer patients(2013) MARTINHO, Olga; SIMOES, Kleber; LONGATTO-FILHO, Adhemar; JACOB, Carlos Eduardo; ZILBERSTEIN, Bruno; BRESCIANI, Claudio; GAMA-RODRIGUES, Joaquim; CECCONELLO, Ivan; ALVES, Venancio; REIS, Rui ManuelGastric cancer is a leading cause of cancer-related mortality, and the presence of lymph node metastasis an important prognostic factor. Downregulation of RKIP has been associated with tumor progression and metastasis in several types of neoplasms, being currently categorized as a metastasis suppressor gene. Our aim was to determine the expression levels of RKIP in gastric tissues and to evaluate its impact in the clinical outcome of gastric carcinoma patients. RKIP expression levels were studied by immunohistochemistry in a series of gastric tissues. Overall, we analysed 222 non-neoplastic gastric tissues, 152 primary tumors and 42 lymph node metastasis samples. We observed that RKIP was highly expressed in similar to 83% of non-neoplastic tissues (including normal tissue and metaplasia), was lost in similar to 56% of primary tumors and in similar to 90% of lymph node metastasis samples. Loss of RKIP expression was significantly associated with several markers of poor clinical outcome, including the presence of lymph node metastasis. Furthermore, the absence of RKIP protein constitutes an independent prognostic marker for these patients. In conclusion, RKIP expression is significantly lost during gastric carcinoma progression being almost absent in lymph node metastasis samples. Of note, we showed that the absence of RKIP expression is associated with poor outcome features of gastric cancer patients, this being also an independent prognostic marker.
bookPart Avanço de Retalho Cutâneo/Mucoso na Fissura Anal. Aspectos Técnicos e Critérios para Indicação(2013) JACOB, Carlos Eduardo; HABR-GAMA, Angelita; LYNN, Patrício; GAMA-RODRIGUES, Joaquim
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