ROGERIO APARECIDO DEDIVITIS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, 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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- Extracranial neurogenic tumors of the head and neck(2015) CURIONI, Otavio Alberto; SOUZA, Ricardo Pires de; MERCANTE, Ana Maria da Cunha; JESUS, Ana Carolina de; PAVELEGENI, Alysson; DEDIVITIS, Rogerio Aparecido; RAPOPORT, AbraoIntroduction: Peripheric nerve tumors typically derive from Schwann cells of the peripheral nerve sheet. Since these tumors are uncommon, they should be considered in preoperative differential diagnosis. Objective: To report the experience of a tertiary care department. Methods: Forty-two patients with head and neck peripheral neurogenic tumors were retrospectively analyzed and evaluated from 1977 to 2013. The preoperative diagnosis was confirmed by biopsy or imaging study. Results: The mean age was 41.7 and 15 patients (36%) were male. The mean size was 5.5 cm and 26 (61%) were located laterally in the neck. Most tumors (39.9%) presented as an asymptomatic neck mass. Most (39.9%) were resected through a neck approach. Cranial nerves were the commonest site of origin. Conclusions: Extracranial neurogenic tumors presented with a mean size of 5.5 cm, were located laterally in the neck, normally had their origin from cranial nerves, and their resection approach is cervical.
- 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
- Implication of the New AJCC pT Classification of SCC of the Lip Comparing With Other Oral Subsites(2021) TOLEDO, Loic Monginet; OLIVEIRA, Adriana Santos de; PINHEIRO, Renan Aguera; LEITE, Ana Kober Nogueira; MELLO, Evandro Sobroza de; MOYSES, Raquel Ajub; KULCSAR, Marco Aurelio V.; DEDIVITIS, Rogerio Aparecido; KOWALSKI, Luiz Paulo; MATOS, Leandro LuongoObjective To determine the implication of the new AJCC staging system for pT classification in a cohort of patients with SCC of the lip mucosa and compare it to other oral cavity sites. Methods Retrospective cohort of 744 patients treated between 2002 and 2017, by the Head and Neck Surgery Department of the University of Sao Paulo. Results Of 95 lip patients, 42 had pT upstage (58.1% of pT1 to pT2-3 and 50% of pT2 to pT3). Similar DFS/OS observed for those pT1 maintained or upstaged to pT2-3, pT2 patients upstaged to pT3 presented worse OS (49.4% versus 92.3%, P = .032). The comparison between lip and other mouth topographies, denoted better prognosis for pT1-2, but not for pT3-4a. Lip tumors had lower DOI, rates of perineural/angiolymphatic invasion, nodal metastasis, recurrence, and death. Conclusion The inclusion of DOI to the new pT classification better stratifies patients with SCC of the lip mucosa upstaged to pT3 by assessing inferior OS. Level of Evidence 3 Laryngoscope, 2021
article 0 Citação(ões) na Scopus Evaluation of a Training Model for Cervical Trauma Using Cadavers(2019) SIMOES, Cesar Augusto; JR, Marcelo A. F. Ribeiro; PORTILHO, Ana Sara; FAVARO, Murillo; SANTIN, Stephanie; FERRADA, Paula; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto- Sialendoscopy for treatment of major salivary glands diseases: a comprehensive analysis of published systematic reviews and meta-analyses(2023) -SILVA, Lucas Kallas; AZEVEDO, Maria Fernanda Dias; MATOS, Fatima Cristina Mendes de; PETRARROLHA, Silvia Picado; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; MATOS, Leandro LuongoObjectives: Sialendoscopy is a minimally invasive procedure used to diagnose and treat obstructive salivary gland diseases. Previous studies in the topic have shown mixed results. The present study aimed to evaluate the efficacy and safety of sialendoscopy through previous systematic reviews for different outcomes of several diseases. We also aimed to assess studies' methodological quality and heterogeneity.Methods: We conducted a comprehensive systematic literature search of Pubmed, Embase, Lilacs and Cochrane Library. We included systematic reviews and meta-analyses that used sialendoscopy to treat both lithiasic and alithiasic salivary glands diseases. Data extraction included studies' characteristics and results. We assessed studies' methodological quality using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews 2) tool. Results: 13 studies were included in the review, being 9 in adult populations and 4 in pedi-atric populations. Sialendoscopy proved to be effective at the treatment of different lithiasic and other obstructive diseases, but with important heterogeneity. The technique was also considered highly safe in most studies. However, studies had a critically low quality of evidence. Conclusions: Most studies demonstrated high efficacy and safety of sialendoscopy, but with critically low quality of evidence. We still lack randomized studies in this field, and future systematic reviews on the topic should follow current guidelines to improve conduction and reporting. (c) 2023 Associacao Brasileira de Otorrinolaringologia e Cirurgia C ' ervico-Facial.
- Delayed postoperative radiation therapy in local control of squamous cell carcinoma of the tongue and floor of the mouth(2014) AMAR, Ali; CHEDID, Helma Maria; CURIONI, Otávio Alberto; DEDIVITIS, Rogério Aparecido; RAPOPORT, Abrão; CERNEA, Claudio Roberto; BRANDÃO, Lenine GarciaObjective To evaluate the effect of time between surgery and postoperative radiation therapy on local recurrence of squamous cell carcinoma of the tongue and floor of the mouth. Methods A total of 154 patients treated between 1996 and 2007 were selected considering local recurrence rate and time of the adjuvant radiotherapy. Results Local recurrence was diagnosed in 54 (35%) patients. Radiation therapy reduced the rate of local recurrences, although with no statistical significance. The time between surgery and initiation of postoperative radiotherapy did not significantly influence the risk of local recurrence in patients referred to adjuvant treatment (p=0.49). Conclusion In the presence of risk factors for local recurrence, a short delay in starting the adjuvant radiation therapy does not contraindicate its performance.
- How to Avoid Injury of the External Branch of Superior Laryngeal Nerve(2012) CERNEA, Claudio R.; DEDIVITIS, Rogerio A.; FERRAZ, Alberto R.; BRANDAO, Lenine G.
- Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth(2013) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. Objective: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. Method: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. Results: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. Conclusion: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.
- The role of E-cadherin and β-catenin in laryngeal cancer(2018) NARDI, C. E.; DEDIVITIS, R. A.; ALMEIDA, R. C. de; MATOS, L. L. de; CERNEA, C. R.Epithelial cadherins with catenins form the E-cadherin-catenin complex that acts on cell-to-cell adhesion. The loss of these complex lead to the reduction or absence of epithelial cadherin expression in the cell membrane, cytoplasmic accumulation of β-catenin and its translocation to the nucleus, contributing to carcinogenic events. The objective of this study was to evaluate the expression of epithelial cadherin and β-catenin in patients with laryngeal tumor. A retrospective study of 52 patients with glottic or supraglottic squamous cell carcinoma was conducted and evaluated according to the tumor site, histological differentiation, TNM stage, survival analysis and compared with the immunohistochemical expression of epithelial cadherin and β-catenin. We observed statistically significant association between the epithelial cadherin expression reduction and supraglottic localization of the lesion, the presence of cervical metastasis, poorly differentiated tumors and locally advanced tumors when in glottic topography. Related to the expression of β-catenin, statistical significance was also found to the presence of cervical metastasis and tumor of low differentiation with the decreased expression of this marker. Regarding survival analysis, the low expression of β-catenin is related to worse overall survival and the reduction of expression of both markers to worse disease-free survival. We concluded that the reduction in expression of the markers studied leads to a prognostic impact as they are related to tumors with greater local aggressiveness and presence of cervical metastasis. © Nardi et al.
- Does the Intensity of IGG4 Immunostaining Have a Correlation with the Clinical Presentation of Riedel's Thyroiditis?(2018) SIMOES, C. A.; TAVARES, M. R.; ANDRADE, N. M. M.; UEHARA, T. M.; DEDIVITIS, R. A.; CERNEA, C. R.Riedel's thyroiditis (RT) represents one type of IgG4-related thyroid disease (IgG4RTD) and the diagnosis involves quantitative immunohistochemistry showing dense lymphoplasmacellular inflammatory infiltrate consisting of IgG4- positive plasma cells with storiform fibrosis and obliterative phlebitis. We report a case of RT with progressive enlargement of the anterior neck, severe dysphagia, odynophagia, and dyspnea. The patient underwent surgical decompression of the airway, protection tracheotomy, and gastrostomy for nutritional intake 6 months after first symptoms. Complete resolution occurred after surgical treatment combined with prednisolone. Immunostaining revealed IgG4-positive plasma cells 12/HPF (high-power field) and the IgG4/IgG ratio 25%, values that were disproportionate to the intensity of the patient's symptoms. As to this case and the few cases described and analyzed in the literature, our impression is that there is no relation between the intensity of symptoms in RT with the total number of IgG4positive plasma cells and the IgG4/IgG ratio, but more studies are needed.