CLAUDIO ROBERTO CERNEA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
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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- 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
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- Quantitative analysis of lymph nodes in neck dissection specimens. Morphologic study(2016) CAPELLI, Fabio de Aquino; PAES, Vitor Ribeiro; MACHADO, Mariangela Marinheiro; MENEZES, Camila Lohmann; SILVA, Pablo Rodrigo Andrade da; SIQUEIRA, Sheila Aparecida Coelho; ALVES, Venancio Avancini Ferreira; MATOS, Leandro Luongo; CERNEA, Claudio RobertoPURPOSE: To quantify the amount of lymph nodes harvested in modified radical neck dissection. METHODS: Cross-sectional anatomical study conducted in 28 non-preserved cadavers. RESULTS: The mean number of lymph nodes found in each nodal level of the 56 modified radical neck dissections performed were: level IA - 1.5 (95% CI: 1.1 - 1.8), level IB - 2.5 (95% CI: 2.1 - 2.9), level IIA - 7.2 (95% CI: 6.0 - 8.5), IIB level - 6.5 (95% CI: 5.5 - 7.4), level III - 6.6 (95% CI: 5.7 - 7.4), level IV - 8.6 (95% CI: 7.1 - 10.1), level V - 11 (95% CI: 9.2 - 12.7), totalizing 43.8 lymph nodes (95% CI: 40.3 - 47.4). CONCLUSION: The results defined a parameter in relation to the minimum recommended nodal yield in a modified radical neck dissection, as well as the number of lymph nodes in each level of this dissection, performed in clinical practice.
- GTSP1 expression in non-smoker and nondrinker patients with squamous cell carcinoma of the head and neck(2017) SOARES, Pamela de Oliveira; CURY, Patricia Maluf; LOPEZ, Rossana Veronica Mendoza; CERNEA, Claudio Roberto; FUKUYAMA, Erika Erina; FIGUEIREDO, David Livingstone Alves; NOBREGA, Francisco Gorgonio da; CURIONI, Otavio Alberto; NUNES, Fabio Daumas; MOYSES, Raquel Ajub; GARCIA, Maria Lucia BuenoIntroduction The main risk factors for head and neck squamous cell carcinoma (HNSCC) are tobacco and alcohol consumption and human papillomavirus (HPV) infection. However, in a subset of patients, no risk factors can be identified. Glutathione S-transferase p (GTSP1) is a carcinogen-detoxifying enzyme that is activated by exposure to carcinogens, and it is associated with a reduction in response to toxic therapies. We studied the expression of GTSP1 in tumor and non-tumor tissue samples from patients with and without these risks to identify whether GTSP1 expression differs according to exposure to carcinogens. Materials and methods Non-smoker/non-drinker (NSND) and smoker/drinker (SD) patients were matched according to age, gender, tumor site, TNM stage, grade and histological variants to establish 47 pairs of patients who have been previously tested for HPV. GTSP1 immunostaining was analyzed using a semi-quantitative method with scores ranging from 0 to 3 according to the area of immunostaining. Results GTSP1 expression was detected in the tumors of both groups. GTSP1 expression was higher in the non-tumor margins of SD patients (p = 0.004). There was no association between GTSP1 expression and positivity for HPV. No differences in survival were observed according to GTSP1 staining in tumors and non-tumor margins. Conclusion This study showed that GTSP1 was expressed in tumors of HNSCC patients regardless of smoking, drinking or HPV infection status. The difference in GTSP1 expression in non-tumor margins between the two groups may have been due to two possible reasons. First, elevated GTSP1 expression in SD patients might be the result of activation of GTSP1 in response to exposure to carcinogens. Second, alternatively, impairment in the detoxifying system of GTSP1, as observed by the reduced expression of GTSP1, might make patients susceptible to carcinogens other than tobacco and alcohol, which may be the underlying mechanism of carcinogenesis in the absence of risk factors.
- Hypomagnesemia associated with hypocalcemia after total thyroidectomy: an observational study(2016) MAHMOUD, Renata Regina da Graca Lorencetti; ARAUJO NETO, Vergilius Jose Furtado de; ALVES, Wellington; LIN, Chin Shien; LEITE, Ana Kober Nogueira; MATOS, Leandro Luongo; ARAUJO FILHO, Vergilius Jose Furtado de; CERNEA, Claudio RobertoIntroduction: Serum magnesium is frequently low in patients with hypocalcemia after total thyroidectomy. The aim of the present study was to analyze the variations in serum magnesium and calcium concentrations after total thyroidectomy, and the relationship between both ions. Materials and methods: We conducted an observational study of 142 patients who had undergone total thyroidectomy, measuring serum calcium and magnesium levels preoperatively and on the day following surgery. The incidence of postoperative hypocalcemia was compared with that of postoperative hypomagnesemia. Results: A total of 142, total thyroidectomies were performed: 54 patients (38%) presented with hypocalcemia on the first postoperative day. A marked decrease in blood magnesium in the group of patients with hypocalcemia was observed when compared to those with normal calcemia on the first postoperative day (mean variation respectively, 0.125 +/- 0.065 mmol/L versus 0.035 +/- 0.020 mmol/L; P = 0.0002). Conclusion: Hypomagnesemia is significantly associated with early hypocalcemia following thyroidectomy.
bookPart Infecções cervicais(2021) UEHARA, Thalita Mara; CERNEA, Claudio Roberto; ARAUJO FILHO, Vergilius José Furtado de- Tumor thickness as a predictive factor of lymph node metastasis and disease recurrence in T1N0 and T2N0 squamous cell carcinoma of the oral tongue(2014) MATOS, Leandro Luongo de; MANFRO, Gabriel; SANTOS, Ricardo Vieira dos; STABENOW, Elaine; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini F.; PINTO, Fabio Roberto; KULCSAR, Marco Aurelio Vamondes; BRANDAO, Lenine Garcia; CERNEA, Claudio RobertoObjective. The aim of the study was to compare the thickness of primary tumors with the frequency of nodal metastases and survival in patients surgically treated for T1/T2N0 oral tongue squamous cell carcinoma. Study Design. This is a retrospective longitudinal study with 74 patients. Results. None of the patients with a tumor thickness (TT) <= 7 mm presented with nodal metastasis, whereas 25 of the patients with a TT > 7 mm (51.0%) developed metastases (P < .0001). Multivariate analysis showed that TT > 7 mm was a risk factor for occult nodal metastasis (odds ratio = 8.7; P = .002) with 81.9% accuracy. TT > 10 mm was also a predictive factor of worse disease-free survival in these patients (hazard ratio = 12.2; P = .003). Conclusions. Tumor thickness of greater than 7 mm is predictive of a higher incidence of lymph node metastasis, and a TT > 10 mm is predictive of worse disease-free survival in squamous cell carcinoma of the oral tongue.
- Epithelial-mesenchymal transition related to bone invasion in oral squamous cell carcinoma(2022) VANINI, Jaqueline Vaz; KOYAMA, Leonardo Kenji Sakaue; MATOS, Leandro Luongo de; FIGUEREDO JUNIOR, Jose Martins; CERNEA, Claudio Roberto; NAGANO, Cibele Pidorodeski; COUTINHO-CAMILLO, Claudia Malheiros; HSIEH, Ricardo; LOURENCO, Silvia VanessaIntroduction: Bone invasion is an important prognostic factor in oral squamous cell carcinoma, leading to a lower survival rate and the use of aggressive treatment approaches. Epithelial-mesenchymal transition (EMT) is possibly involved in this process, because it is often related to mechanisms of cell motility and invasiveness. This study examined whether a panel of epithelial-mesenchymal markers are present in cases of oral squamous cell carcinoma with bone invasion and whether these proteins have any relationship with patients' clinical-pathological parameters and prognostic factors. Methods: Immunohistochemical analysis of E-cadherin, twist, vimentin, TGF beta 1, and periostin was performed in paraffin-embedded samples of 62 oral squamous cell carcinoma cases. Results: The analysis revealed that most cases (66%) presented with a dominant tumor infiltrative pattern in bone tissue, associated with lower survival rates, when compared with cases with a dominant erosive invasion pattern (P = 0.048). Twenty-seven cases (43%) expressed markers that were compatible with total or partial EMT at the tumor-bone interface. There was no association between evidence of total or partial EMT and other demographic or prognostic features. E-cadherin-positive cases were associated with tobacco smoking (P = 0.022); vimentin-positive cases correlated with tumors under 4 cm (P = 0.043). Twistexpression was observed in tumors with a dominant infiltrative pattern (P = 0.041) and was associated with the absence of periostin (P = 0.031). Conclusion: We observed evidence of total or partial EMT in oral squamous cell carcinoma bone invasion. The transcription factor twist appears to be involved in bone invasion and disease progression. (C) 2022 The Authors.
- 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.
- 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.