ANDRE LUIS MONTAGNINI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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  • article 20 Citação(ões) na Scopus
    BRAZILIAN CONSENSUS ON INCIDENTAL GALLBLADDER CARCINOMA
    (2020) COIMBRA, Felipe Jose F.; TORRES, Orlando Jorge M.; ALIKHANOV, Ruslan; AGARWAL, Anil; PESSAUX, Patrick; FERNANDES, Eduardo de Souza M.; QUIREZE-JUNIOR, Claudemiro; ARAUJO, Raphael Leonardo C.; GODOY, Andre Luis; WAECHTER, Fabio Luis; RESENDE, Alexandre Prado de; BOFF, Marcio Fernando; COELHO, Gustavo Rego; REZENDE, Marcelo Bruno de; LINHARES, Marcelo Moura; BELOTTO, Marcos; MORAES-JUNIOR, Jose Maria A.; AMARAL, Paulo Cezar G.; PINTO, Rinaldo Danesi; GENZINI, Tercio; LIMA, Agnaldo Soares; RIBEIRO, Heber Salvador C.; RAMOS, Eduardo Jose; ANGHINONI, Marciano; PEREIRA, Lucio Lucas; ENNE, Marcelo; SAMPAIO, Adriano; MONTAGNINI, Andre Luis; DINIZ, Alessandro; JESUS, Victor Hugo Fonseca de; SIROHI, Bhawna; V, Shailesh Shrikhande; PEIXOTO, Renata D. Alpino; KALIL, Antonio Nocchi; JARUFE, Nicolas; SMITH, Martin; HERMAN, Paulo
    Background: Incidental gallbladder cancer is defined as a cancer discovered by histological examination after cholecystectomy. It is a potentially curable disease. However, some questions related to their management remain controversial and a defined strategy is associated with better prognosis. Aim: To develop the first evidence-based consensus for management of patients with incidental gallbladder cancer in Brazil. Methods: Sixteen questions were selected, and 36 Brazilian and International members were included to the answer them. The statements were based on current evident literature. The final report was sent to the members of the panel for agreement assessment. Results: Intraoperative evaluation of the specimen, use of retrieval bags and routine histopathology is recommended. Complete preoperative evaluation is necessary and the reoperation should be performed once final staging is available. Evaluation of the cystic duct margin and routine 16b1 lymph node biopsy is recommended. Chemotherapy should be considered and chemoradiation therapy if microscopically positive surgical margins. Port site should be resected exceptionally. Staging laparoscopy before reoperation is recommended, but minimally invasive radical approach only in specialized minimally invasive hepatopancreatobiliary centers. The extent of liver resection is acceptable if R0 resection is achieved. Standard lymph node dissection is required for T2 tumors and above, but common bile duct resection is not recommended routinely. Conclusions: It was possible to prepare safe recommendations as guidance for incidental gallbladder carcinoma, addressing the most frequent topics of everyday work of digestive and general surgeons.
  • article 7 Citação(ões) na Scopus
    TP53 mutation p.R337H in gastric cancer tissues of a 12-year-old male child - evidence for chimerism involving a common mutant founder haplotype: case report
    (2011) SILVA, Edaise M. da; ACHATZ, Maria Isabel W.; MARTEL-PLANCHE, Ghyslaine; MONTAGNINI, Andre L.; OLIVIER, Magali; PROLLA, Patricia A.; HAINAUT, Pierre; SOARES, Fernando A.
    Background: Gastric adenocarcinoma is rare in children and adolescents, with about 17 cases under age 21 in the world's literature. We report a case of invasive well-differentiated metastatic gastric cancer in a Brazilian 12-year-old boy without documented familial history of cancer. Case presentation: The patient, diagnosed with metastatic disease, died seven months after surgery. DNA from intra-surgical specimens revealed a TP53 mutation at codon 337 (p. R337H) in samples with neoplastic cells (dysplasia, tumor and metastasis) but not in non-transformed cells (incomplete intestinal metaplasia and non-involved celiac lymph node). In all mutation-positive tissues, p. R337H occurred on the same background, a founder allele identified by a specific haplotype previously described in Brazilian Li-Fraumeni syndrome patients. The same mutant haplotype, corresponding to a founder mutation present in 0.3% of the general population in Southern Brazil, was found in the genome of the father. Presence of this inherited haplotype in the tumor as well as in the father's germline, suggests a rare case of microchimerism in this patient, who may have harbored a small number of mutant cells originating in another individual, perhaps a dizygotic twin that died early in gestation. Conclusion: This case represents one of the earliest ages at diagnosis of gastric cancer ever reported. It shows that cancer inheritance can occur in the absence of an obvious germline mutation, calling for caution in assessing early cancers in populations with common founder mutations such as p. R337H in Southern Brazil.