ADRIANA VAZ SAFATLE RIBEIRO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    LONG-TERM SURVIVAL ANALYSIS AFTER ENDOSCOPIC STENTING AS A BRIDGE TO SURGERY FOR MALIGNANT COLONIC OBSTRUCTION: COMPARISON WITH EMERGENCY SURGERY
    (2019) SCOMPARIN, Rodrigo Corsato; MARTINS, Bruno da Costa; MARQUES, Carlos F.; NAHAS, Caio Sergio R.; KAWAGUTI, Fabio S.; LENZ, Luciano; SAFATLE-RIBEIRO, Adriana V.; PAULO, Gustavo A. de; RIBEIRO, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze
  • article 9 Citação(ões) na Scopus
    Frequency of CDH1 germline variants and contribution of dietary habits in early age onset gastric cancer patients in Brazil
    (2019) GUINDALINI, Rodrigo Santa Cruz; CORMEDI, Marina Candido Visontai; MAISTRO, Simone; PASINI, Fatima Solange; BRANAS, Priscila Cristina Abduch Adas; SANTOS, Liliane dos; PEREIRA, Glaucia Fernanda de Lima; BOCK, Geertruida Hendrika de; SACCARO, Daniela Marques; KATAYAMA, Maria Lucia Hirata; FARAJ, Sheila Friedrich; SAFATLE-RIBEIRO, Adriana; RIBEIRO JUNIOR, Ulysses; DIZ, Maria Del Pilar Estevez; GOUVEA, Ana Carolina Ribeiro Chaves de; CHAMMAS, Roger; FOLGUEIRA, Maria Aparecida Azevedo Koike
    Introduction The contribution of CDH1 germline variants to gastric cancer burden among young adults is unknown in Brazil. We aimed to evaluate the frequency of CDH1 germline variants and the diet/lifestyle habits in early age onset gastric cancer (EOGC, <= 55 years old) patients. Methodology From 2013 to 2015, a total of 88 unrelated and consecutive patients diagnosed with EOGC were enrolled. All CDH1 exons and intronic boundaries were sequenced, and large genomic rearrangements were screened by MLPA. CDH1 transcription analysis was performed for variants that could potentially induce an effect on splicing. The diet and lifestyle habits of EOGC patients were compared to Brazilian population diet and lifestyle, obtained from governmental databases. Results Of 88 patients, the mean age at EOGC diagnosis was 39 years and 55% fulfilled the criteria for hereditary diffuse gastric cancer. The majority of the tumors were diffuse (74%) and poorly differentiated (80%). In total, 4 novel missense variants of uncertain significance (VUS) were identified: c.313T>A, c.387G>T, c.1676G>A, and c.1806C>A. The MLPA results revealed no rearrangements and CDH1 transcription analysis for variants of interest were inconclusive. EOGC patients had a higher red (OR:2.6, 95%CI:1.4-4.9) and processed (OR:3.1, 95%CI:1.6-6.0) meat intake and higher fruit consumption (OR:0.4, 95%IC:0.3-0.7) compared to eating habits of the Brazilian population. Conclusions No unequivocal pathogenic germline CDH1 variants were identified in Brazilian EOGC patients. Dietary habits may be associated with the EOGC development.
  • conferenceObject
    ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) VERSUS TRANSANAL ENDOSCOPIC MICROSURGERY (TEM) FOR THE TREATMENT OF EARLY RECTAL CANCER: COMPARISON OF LONG TERM OUTCOMES
    (2019) KAWAGUTI, Fabio S.; KIMURA, Cintia Mayumi S.; MARQUES, Carlos F.; NAHAS, Caio Sergio R.; SEGATELI, Vanderlei; MARTINS, Bruno; OKAZAKI, Ossamu; SAFATLE-RIBEIRO, Adriana V.; RIBEIRO, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze
  • conferenceObject
    COMPARISON OF TWO CUT-OFF VALUES OF THE FECAL IMMUNOCHEMICAL TEST DURING AN ORGANIZED COLORECTAL CANCER SCREENING
    (2019) SAFATLE-RIBEIRO, Adriana V.; SORBELLO, Mauricio P.; PFUETZENREITER, Vinicius; BASTOS, Victor R.; COHEN, Diane D.; SOUZA, Afonso H. Silva e; HASHIMOTO, Claudio L.; FRANCO, Joel L.; GOMES, Jackeline O.; ALVES, Venancio A.; CECCONELLO, Ivan; NAHAS, Sergio C.; ELUF NETO, Jose; RIBEIRO, Ulysses
  • conferenceObject
    Double balloon enteroscopy in paediatric Crohn's disease and 10 years follow-up
    (2019) OBA, J.; CARLOS, A.; AZEVEDO, M.; MILANI, L.; FREITAS, N.; TOMA, R.; BIBAS, M.; DAMIAO, A.; SAFATLE-RIBEIRO, A.
  • article 14 Citação(ões) na Scopus
    Upper gastrointestinal neoplasia in familial adenomatous polyposis: prevalence, endoscopic features and management
    (2019) CAMPOS, Fabio Guilherme; MARTINEZ, Augusto Real; SULBARAN, Marianny; BUSTAMANTE-LOPEZ, Leonardo Alfonso; SAFADE-RIBEIRO, Adriana Vaz
    Background: To evaluate the prevalence of upper gastrointestinal (GI) polyps in familial adenomatous polyposis (FAP), and to discuss current therapeutic recommendations. Methods: Clinical, endoscopic, histological and treatment data were retrieved from charts of 102 patients [1958-2016]. Duodenal adenomatosis was classified according to Spigelman stages. Results: this series comprised 59 women (57.8%) and 43 men (42.1%) with a median age of 32.3 years. Patients underwent 184 endoscopic procedures, the first at a median age of 35.9 years (range, 13-75 years). Fundic gastric polyps (n=31; 30.4%) prevailed in the stomach. While only 5 adenomas were found in the stomach, 33 patients (32.4%) presented duodenal ones. Advanced lesions (n=13; 12.7%) were detected in the stomach (n=2) and duodenum (n=11). During follow-up, Spigelman stages improved in 6 (12.2%) patients, remained unchanged in 25 (51.0%) and worsened in 18 (36.7%). Carcinomas were diagnosed in the stomach and duodenum (4 lesions each, 3.9%), at median ages of 50.2 and 55.0 years, respectively. Advanced lesions and carcinomas were managed through local or surgical resections. Severe complications occurred in only 2 patients (one death). Enteroscopy in 21 patients revealed jejunal adenomas in 12, 11 of whom also presented duodenal adenomas. Conclusions: There is a high prevalence of upper GI adenomas and cancer in FAP. There were diagnosed fundic gastric polyps (30.4%), duodenal (32.4%) and jejunal adenomas (11.8%), respectively. One third of duodenal polyps progressed slowly throughout the study. The rates of advanced gastroduodenal lesions (12.7%) and cancer (7.8%) raise the need for continuous surveillance during follow-up.
  • conferenceObject
    THE ROLE OF MAGNIFICATION CHROMOENDOSCOPY IN THE MANAGEMENT OF COLORECTAL NEOPLASTIC LESIONS SUSPICIOUS FOR SUBMUCOSAL INVASION
    (2019) KAWAGUTI, Fabio S.; FRANCO, Matheus C.; SEGATELI, Vanderlei; MARTINS, Bruno; OKAZAKI, Ossamu; MARQUES, Carlos F.; NAHAS, Caio Sergio R.; PINTO, Rodrigo A.; SAFATLE-RIBEIRO, Adriana V.; RIBEIRO, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze
  • article 13 Citação(ões) na Scopus
    Clinical and endoscopic aspects of metastases to the gastrointestinal tract
    (2019) BENTO, Luiza Haendchen; MINATA, Mauricio Kazuyoshi; BATISTA, Clelma Pires; MARTINS, Bruno da Costa; TOLENTINO, Luciano Henrique Lenz; SCOMPARIM, Rodrigo Corsato; KAWAGUTI, Fabio Shiguehissa; OLIVEIRA, Carla Cristina Gusmon de; LIMA, Marcelo Simas de; GEIGER, Sebastian Naschold; BABA, Elisa Ryoka; SAFATLE-RIBEIRO, Adriana; RIBEIRO JR., Ulysses; MALUF-FILHO, Fauze
    Background Studies that describe metastases to the gastrointestinal (GI) tract are restricted to small case series. An increase in the frequency of this condition is expected, so it would be useful to better characterize the endoscopic aspects of metastasis to the GI tract. The aims of this study were to describe the frequency and endoscopic features of the lesions, and to analyze the survival rate after diagnosis of metastasis. Methods This was a retrospective, single-center, observational study, conducted between 2009 and 2017. Patients with metastasis to the GI tract were included. Results 95 patients were included. Melanoma (25.3%), lung (15.8%), and breast (14.7%) were the most frequent primary tumors. The most common endoscopic presentation was a solitary, ulcerated lesion in the gastric body. Conventional biopsy was diagnostic in 98.9% of the cases. The mean and median survival rates were 13.3 months (95% confidence interval [CI] 8.2 - 18.3) and 4.7 months (95%CI 3.7 - 5.6), respectively. Palliative treatment with chcmo and/or radiotherapy after the diagnosis of the metastasis was related to a higher survival rate. Conclusions Melanoma, lung, and breast cancer were the most common primary tumors to metastasize to the Cl tract. The endoscopic features could not predict the primary site of the tumor. The finding of metastasis in the GI tract is related to the final stage of the cancer disease but patients who received palliative treatment with chemo and/or radiotherapy after diagnosis of Cl metastasis had higher survival rates.
  • article 13 Citação(ões) na Scopus
    Role of Magnification Chromoendoscopy in the Management of Colorectal Neoplastic Lesions Suspicious for Submucosal Invasion
    (2019) KAWAGUTI, Fabio S.; FRANCO, Matheus C.; MARTINS, Bruno C.; SEGATELI, Vanderlei; MARQUES, Carlos F. S.; NAHAS, Caio S. R.; PINTO, Rodrigo A.; SAFATLE-RIBEIRO, Adriana V.; RIBEIRO-JUNIOR, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze
    BACKGROUND: Correctly predicting the depth of tumor invasion in the colorectal wall is crucial for successful endoscopic resection of superficial colorectal neoplasms. OBJECTIVE: The aim of this study was to assess the accuracy of magnifying chromoendoscopy in a Western medical center to predict the depth of invasion by the pit pattern classification in patients with colorectal neoplasms with a high risk of submucosal invasion. DESIGN: This single-center retrospective study, from a prospectively collected database, was conducted between April 2009 and June 2015. SETTINGS: The study was conducted at a single academic center. PATIENTS: Consecutive patients with colorectal neoplasms with high risk of submucosal invasion were included. These tumors were defined by large (>= 20 mm) sessile polyps (nonpedunculated), laterally spreading tumors, or depressed lesions of any size. INTERVENTIONS: Patients underwent magnifying chromoendoscopy and were classified according to the Kudo pit pattern. The therapeutic decision, endoscopic or surgery, was defined by the magnification assessment. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive values of magnifying chromoendoscopy for assessment of these lesions were determined. RESULTS: A total of 123 lesions were included, with a mean size of 54.0 +/- 37.1 mm. Preoperative magnifying chromoendoscopy with pit pattern classification had 73.3% sensitivity, 100% specificity, 100% positive predictive value, 96.4% negative predictive value, and 96.7% accuracy to predict depth of invasion and consequently to guide the appropriate treatment. Thirty-three rectal lesions were also examined by MRI, and 31 were diagnosed as T2 lesions. Twenty two (70.1%) of these lesions were diagnosed as noninvasive by magnifying colonoscopy, were treated by endoscopic resection, and met the curative criteria. LIMITATIONS: This was a single-center retrospective study with a single expert endoscopist experience. CONCLUSIONS: Magnifying chromoendoscopy is highly accurate for assessing colorectal neoplasms suspicious for submucosal invasion and can help to select the most appropriate treatment. See Video Abstract at http://links. lww. com/DCR/A920.
  • conferenceObject
    Double Balloon Enteroscopy in Pediatric Crohn's Disease for Decision Therapy and 10 Years Follow up
    (2019) OBA, Jane; DEBONI, Mariana; TOMA, Ricardo; AZEVEDO, Matheus; CARLOS, Alexandre; MILANI, Luciane; DAMIAO, Aderson; RIBEIRO, Adriana Saflatle