LEONARDO GOMES DA FONSECA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Outcome of liver cancer patients with SARS-CoV-2 infection: An International, Multicentre, Cohort Study(2022) MUNOZ-MARTINEZ, Sergio; SAPENA, Victor; FORNER, Alejandro; BRUIX, Jordi; SANDUZZI-ZAMPARELLI, Marco; RIOS, Jose; BOUATTOUR, Mohamed; EL-KASSAS, Mohamed; LEAL, Cassia R. G.; MOCAN, Tudor; NAULT, Jean-Charles; ALVES, Rogerio C. P.; REEVES, Helen L.; FONSECA, Leonardo da; GARCIA-JUAREZ, Ignacio; PINATO, David J.; VARELA, Maria; ALQAHTANI, Saleh A.; ALVARES-DA-SILVA, Mario R.; BANDI, Juan C.; RIMASSA, Lorenza; LOZANO, Mar; SANTIAGO, Jesus M. Gonzalez; TACKE, Frank; SALA, Margarita; ANDERS, Maria; LACHENMAYER, Anja; PINERO, Federico; FRANCA, Alex; GUARINO, Maria; ELVEVI, Alessandra; CABIBBO, Giuseppe; PECK-RADOSAVLJEVIC, Markus; ROJAS, Angela; VERGARA, Mercedes; BRACONI, Chiara; PASCUAL, Sonia; PERELLO, Christie; MELLO, Vivianne; RODRIGUEZ-LOPE, Carlos; ACEVEDO, Juan; VILLANI, Rosanna; HOLLANDE, Clemence; VILGRAIN, Valerie; TAWHEED, Ahmed; THEODORO, Carmem Ferguson; SPARCHEZ, Zeno; BLAISE, Lorraine; VIERA-ALVES, Daniele E.; WATSON, Robyn; CARRILHO, Flair J.; MOCTEZUMA-VELAZQUEZ, Carlos; D'ALESSIO, Antonio; IAVARONE, Massimo; REIG, MariaBackground & Aims Information about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with liver cancer is lacking. This study characterizes the outcomes and mortality risk in this population. Methods Multicentre retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February and December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered. Results Two hundred fifty patients from 38 centres were included, 218 with hepatocellular carcinoma (HCC) and 32 with intrahepatic cholangiocarcinoma (iCCA). The median age was 66.5 and 64.5 years, and 84.9% and 21.9% had cirrhosis in the HCC and iCCA cohorts respectively. Patients had advanced cancer stage at SARS-CoV-2 diagnosis in 39.0% of the HCC and 71.9% of the iCCA patients. After a median follow-up of 7.20 (IQR: 1.84-11.24) months, 100 (40%) patients have died, 48% of the deaths were SARS-CoV-2-related. Forty (18.4%) HCC patients died within 30-days. The death rate increase was significantly different according to the BCLC stage (6.10% [95% CI 2.24-12.74], 11.76% [95% CI 4.73-22.30], 20.69% [95% CI 11.35-31.96] and 34.52% [95% CI 17.03-52.78] for BCLC 0/A, B, C and D, respectively; p = .0017). The hazard ratio was 1.45 (95% CI 0.49-4.31; p = .5032) in BCLC-B versus 0/A, and 3.13 (95% CI 1.29-7.62; p = .0118) in BCLC-C versus 0/A in the competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, and 12 deaths were related to SARS-CoV-2 infection. Conclusions This is the largest cohort of liver cancer patients infected with SARS-CoV-2. It characterizes the 30-day mortality risk of SARS-CoV-2 infected patients with HCC during this period.
- Liver decompensation is a frequent cause of treatment discontinuation and prognostic factor in intermediate-advanced HCC(2023) PINEROA, Federico; ANDERS, Margarita; BERMUDEZ, Carla; DEMIRDJIAN, Ezequiel; VARON, Adriana; PALAZZO, Ana; RODRIGUEZ, Jorge; BELTRAN, Oscar; FONSECA, Leonardo Gomes da; RIDRUEJO, Ezequiel; CABALLINI, Pablo; TAMAGNONE, Norberto; REGGIARDO, Virginia; CHEINQUER, Hugo; ARAUJO, Alexandre; ARUFE, Diego; MARIN, Juan Ignacio; RATUSNU, Natalia; MANERO, Estela; PEREZ, Daniela; VILLA, Marina; OROZCO, Federico; MURGA, Dolores; MARCIANO, Sebastian; BESSONE, Fernando; SILVA, Marcelo; MENDIZABAL, ManuelIntroduction and Objectives: With the advent of new therapeutic options for patients with hepatocellular car-cinoma (HCC) for intermediate or advanced stages of the Barcelona Clinic Liver Cancer (BCLC), regional real -world data regarding prognostic survival factors are of significant importance. Patients and Methods: A multicenter prospective cohort study was conducted in Latin America including BCLC B or C patients since 15th May 2018. We report here the second interim analysis focusing on prognostic varia-bles and causes of treatment discontinuation. Cox proportional hazard survival analysis was performed, esti-mating hazard ratios (HR) and 95% confidence intervals (95% CI). Results: Overall, 390 patients were included, 55.1% and 44.9% were BCLC B and C at the time of study enroll-ment. Cirrhosis was present in 89.5% of the cohort. Among the BCLC-B group, 42.3% were treated with TACE with a median survival since the first session of 41.9 months. Liver decompensation before TACE was inde-pendently associated with increased mortality [HR 3.22 (CI 1.64;6.33); P<.001]. Systemic treatment was initi-ated in 48.2% of the cohort (n=188), with a median survival of 15.7 months. Of these, 48.9% presented first -line treatment discontinuation (44.4% tumor progression, 29.3% liver decompensation, 18.5% symptomatic deterioration, and 7.8% intolerance), and only 28.7% received second-line systemic treatments. Liver decom-pensation [HR 2.9 (1.64;5.29); P<.0001], and symptomatic progression [HR 3.9 (1.53;9.78); P=0.004] were independently associated with mortality after first-line systemic treatment discontinuation. Conclusions: The complexity of these patients, with one-third presenting liver decompensation after systemic therapies, underlines the need for multidisciplinary team management and the central role of hepatologists. (c) 2023 Fundacion Clinica Medica Sur, A.C.
conferenceObject A multicenter international study of sorafenib treatment in patients with hepatocellular carcinoma and chronic kidney disease undergoing hemodialysis(2019) DIAZ-GONZALEZ, Alvaro; SANDUZZI-ZAMPARELLI, Marco; FONSECA, Leonardo Gomes da; COSTANZO, Giovan Giuseppe Di; ALVES, Rogerio; IAVARONE, Massimo; LEAL, Cassia Regina G.; SACCO, Rodolfo; MATILLA, Ana M.; GUERRA, Manuel Hernandez; SOTERAS, Gabriel Alejandro Aballay; MARCUS, Worns; PINTER, Matthias; VARELA, Maria; LADEKARL, Morten; CHAGAS, Aline Lopes; MINGUEZ, Beatriz; RUIZ-TAPIADOR, Juan Ignacio Arenas; GRANITO, Alessandro; SANCHEZ, Yolanda; ROJAS, Angela; LOPE, Carlos Rodriguez De; ALVARES-DA-SILVA, Mario Reis; PASCUAL, Sonia; RIMASSA, Lorenza; LLEDO, Jose Luis; HUERTAS, Carlos; SANGRO, Bruno; GIANNINI, Edoardo Giovanni; DELGADO, Manuel; GOMEZ, Mercedes Vergara; PERELLO, Christie; LUE, Alberto; SALA, Margarita; MOYA, Adolfo Gallego; COLL, Susana; ALSINA, Tania Hernaez; PINERO, Federico; PEREIRA, Gustavo; FRANCA, Alex Vianey Callado; MARIN, Juan; ANDERS, Maria Margarita; MELLO, Vivianne; LOZANO, Maria Del Mar; NAULT, Jean Charles; MENENDEZ, Jose Maria; JUAREZ, Ignacio Garcia; BRUIX, Jordi; REIG, MariaconferenceObject Early SARS-CoV-2-related mortality of liver cancer patients: Cancer stage matters(2021) MUNOZ-MARTINEZ, Sergio; SAPENA, Victor; FORNER, Alejandro; BRUIX, Jordi; ZAMPARELLI, Marco Sanduzzi; BOUATTOUR, Mohamed; LEAL, Cassia Regina Guedes; THEODORO, Carmem Ferguson; EL-KASSAS, Mohammed; NAULT, Jean Charles; BLAISE, Lorraine; MOCAN, Tudor; FONSECA, Leonardo Gomes da; REEVES, Helen L.; ALVES, Rogerio; JUAREZ, Ignacio Garcia; VARELA, Maria; PINATO, David J.; GARDINI, Andrea Casadei; ALVARES-DA-SILVA, Mario Reis; SANTIAGO, Jesus Gonzalez; LOZANO, Maria del Mar; BANDI, Juan Carlos; RIMASSA, Lorenza; SALA, Margarita; ALQAHTANI, Saleh; ANDERS, Maria Margarita; PINERO, Federico; LACHENMAYER, Anja; TACKE, Frank; RODERBURG, Christoph; GOMEZ, Manuel Romero; PECK-RADOSAVLJEVIC, Markus; CABIBBO, Giuseppe; ELVEVI, Alessandra; GUARINO, Maria; FRANCA, Alex Vianey Callado; VILLANI, Rosanna; GOMEZ, Mercedes Vergara; ACEVEDO, Juan; LOPE, Carlos Rodriguez de; MELLO, Vivianne; PERELLO, Christie; PASCUAL, Sonia; BRACONI, Chiara; IAVARONE, Massimo; REIG, Maria