RODRIGO OLIVA PEREZ
Índice h a partir de 2011
25
Projetos de Pesquisa
Unidades Organizacionais
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Alternative treatment to surgery for rectal cancer(2018) HABR-GAMA, Angelita; FERNANDEZ, Laura Melina; JULIAO, Guilherme Pagin Sao; VAILATI, Bruna Borba; PEREZ, Rodrigo OlivaThe traditional concept of rectal cancer management has changed significantly over the last few years. Although surgical resection remains central the treatment of distal rectal cancer by proctectomy and total mesorectal excision (TME), there has been increased interest in organ preservation strategies. Neoadjuvant chemoradiation (nCRT) may result in significant tumor regression and complete pathological response may be observed in up to 42% of patients. In order to avoid the morbidity, mortality and functional consequences of major surgery, selected patients with clinical and radiological evidence of significant tumor regression after nCRT have been managed non-operatively with strict follow-up (Watch & Wait Strategy-WW) with acceptable outcomes and minimal functional consequences. In addition, close surveillance may allow early detection of local recurrences and salvage alternatives with no oncological compromise.
- Strategies to improve clinical research in surgery through international collaboration(2013) SOREIDE, Kjetil; ALDERSON, Derek; BERGENFELZ, Anders; BEYNON, John; CONNOR, Saxon; DECKELBAUM, Dan L.; DEJONG, Cornelis H.; EARNSHAW, Jonathan J.; KYAMANYWA, Patrick; PEREZ, Rodrigo O.; SAKAI, Yoshiharu; WINTER, Desmond C.More than 235 million patients undergo surgery every year worldwide, but less than 1% are enrolled in surgical clinical trials-few of which are international collaborations. Several levels of action are needed to improve this situation. International research collaborations in surgery between developed and developing countries could encourage capacity building and quality improvement, and mutually enhance care for patients with surgical disorders. Low-income and middle-income countries increasingly report much the same range of surgical diseases as do high-income countries (eg, cancer, cardiovascular disease, and the surgical sequelae of metabolic syndrome); collaboration is therefore of mutual interest. Large multinational trials that cross cultures and levels of socioeconomic development might have faster results and wider applicability than do single-country trials. Surgeons educated in research methods, and aided by research networks and trial centres, are needed to foster these international collaborations. Barriers to collaboration could be overcome by adoption of global strategies for regulation, health insurance, ethical approval, and indemnity coverage for doctors.
- Shifting concepts in rectal cancer management A Review of Contemporary Primary Rectal Cancer Treatment Strategies(2012) KOSINSKI, Lauren; HABR-GAMA, Angelita; LUDWIG, Kirk; PEREZ, RodrigoThe management of rectal cancer has transformed over the last 3 decades and continues to evolve. Some of these changes parallel progress made with other cancers: refinement of surgical technique to improve organ preservation, selective use of neoadjuvant (and adjuvant) therapy, and emergence of criteria suggesting a role for individually tailored therapy. Other changes are driven by fairly unique issues including functional considerations, rectal anatomic features, and surgical technical issues. Further complexity is due to the variety of staging modalities (each with its own limitations), neoadjuvant treatment alternatives, and competing strategies for sequencing multimodal treatment even for nonmetastatic disease. Importantly, observations of tumor response made in the era of neoadjuvant therapy are reshaping some traditionally held concepts about tumor behavior. Frameworks for prioritizing and integrating complex data can help to formulate treatment plans for patients. CA Cancer J Clin 2012;. (C) 2012 American Cancer Society.
- Role of magnetic resonance imaging in organ-preserving strategies for the management of patients with rectal cancer(2019) ORTEGA, Cinthia D.; PEREZ, Rodrigo O.Total mesorectal excision has been the most effective treatment strategy adopted to reduce local recurrence rates among patients with rectal cancer. The morbidity associated with this radical surgical procedure led surgeons to challenge the standard therapy particularly when dealing with superficial lesions or good responders after neoadjuvant radiotherapy, to which radical surgery may be considered overtreatment. In this subset of patients, less invasive procedures in an organ-preserving strategy may result in good oncological and functional outcomes. In order to tailor the most appropriate treatment option, accurate baseline staging and reassessment of tumor response are relevant. MRI is the most robust tool for the precise selection of patients that are candidates for organ preservation; therefore, radiologists must be familiar with the criteria used to guide the management of these patients. The purpose of this article is to review the relevant features that radiologists should know in order to provide valuable information during the multidisciplinary discussion and ultimate management decision.
- The Future of Rectal Cancer Surgery: A Narrative Review of an International Symposium(2018) LACY, F. Borja de; CHADI, Sami A.; BERHO, Mariana; HEALD, Richard J.; KHAN, Jim; MORAN, Brendan; PANIS, Yves; PEREZ, Rodrigo; TEKKIS, Paris; MORTENSEN, Neil J.; LACY, Antonio M.; WEXNER, Steven D.; CHAND, ManishSurgery remains the mainstay of curative treatment for primary rectal cancer. For mid and low rectal tumors, optimal oncologic surgery requires total mesorectal excision (TME) to ensure the tumor and locoregional lymph nodes are removed. Adequacy of surgery is directly linked to survival outcomes and, in particular, local recurrence. From a technical perspective, the more distal the tumor, the more challenging the surgery and consequently, the risk for oncologically incomplete surgery is higher. TME can be performed by an open, laparoscopic, robotic or transanal approach. There is a lack of consensus on the gold standard approach with each of these options offering specific advantages. The International Symposium on the Future of Rectal Cancer Surgery was convened to discuss the current challenges and future pathways of the 4 approaches for TME. This article reviews the findings and discussion from an expert, international panel.