EDUARDO HIROSHI AKAISHI
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Multivisceral resection for retroperitoneal liposarcoma-is it worth it? A 20-year single-center experience(2023) JR, Frederico Ribeiro Teixeira; ARAKAKI, Mariana Sousa; LIMA, Helber Vidal Gadelha; FERREIRA, Fabio de Oliveira; MENEGOZZO, Carlos Augusto Metidieri; SILVA, Eduardo Rissi; MONTERO, Edna Frasson de Souza; OYA, Toshiko; LIMA, Luiz Calima; AKAISHI, Eduardo Hiroshi; UTIYAMA, Edivaldo MassazoPurposeSoft tissue sarcomas are rare malignant tumors. Liposarcoma constitutes the most frequent histological subtype of retroperitoneal sarcoma. The prognosis of soft tissue sarcomas depends on clinical and histologic characteristics.ObjectiveEvaluate variables that may be related to the overall and local recurrence-free survival in patients with retroperitoneal liposarcoma and discuss the need for visceral resection en-bloc for tumors.MethodsA retrospective analysis was conducted of the medical records of 60 patients seen between 1997 and 2017 who underwent surgical resection of retroperitoneal liposarcoma.ResultsThe overall survival rate at 5 years of follow-up was 75.22% (95% confidence interval [CI] 0.58-0.86). The probability of a local recurrence-free survival at 5 years of follow-up was 26.04% (95% CI 0.11-0.44). The multivariate analysis showed that dedifferentiated or pleomorphic tumors and R2/fragmented resection were associated with a shorter time to recurrence. No other characteristics markedly influenced the overall survival (P > 0.05).ConclusionPatients with dedifferentiated or pleomorphic tumors and incomplete resection were associated with higher local recurrence rates than others. This study reinforces the need for complete and en-bloc resection with organs when there is clear involvement or technical surgical difficulty to maintain the tumor integrity.
- Current practice of Latin American centers in the treatment of peritoneal diseases with cytoreductive surgery with HIPEC(2018) QUADROS, C. A.; LAPORTE, G. A.; HUGUENIN, J. F. L.; BARRETO, E. J. S. S.; V, A. Barros; OLIVEIRA, A. F.; CARVALHO, A. L. L.; PETRUZZIELLO, A.; PAULA, A. C.; URBANO-RUIZ, A.; SANTOS, C. C.; GALHARDO, C. A. V. G.; JOHNSON, L. F. P.; VENDRAME, C. D.; SANTANA, D. P.; AKAISHI, E.; FERREIRA, F. O.; QUEIROZ, F. L.; MIRANDA, F. A. C. L.; LISSA, F. C. T.; SARMENTO, B. J. Q.; NASCIMENTO, G. J. S.; NOVASKI, G. L.; MEINHARDT, J. G. J.; MALI-JUNIOR, J.; V, J. Barreto-Junior; SALOMAO-JUNIOR, L. R.; V, C. Pinto; CAVALLA, C.; SANCHEZ-LORIA, F. A.; COELHO-JUNIOR, M. J. P.; PERROTTA, F. M.; FLORES-AYALA, E. G.; MARTINEZ-SAID, H.; DE-LA-FUENTE, H.; LOPEZ-BASAVE, H. N.; SANDOVAL-JAUREGUI, J.; BUTTE, J. M.; FLOREZ, J. P.; RUSO, M. L.; BELOTTO, M.; MATUS, R. R. G.; SOUZA-FILHO, O.; CAMARA, P. C.; SEITENFUS, R.; ANSELMI-JUNIOR, R. A.; CUTAIT, R.; V, R. M. L. Leal; BOFF, M. F.; SABBAG, R.; SILVA, R. G.; MORAN, A. R.; SALCEDO-HERNANDEZ, R. A.; AGUIAR-JUNIOR, S.; RAMIREZ, S. R.; REIS, T. J. C. C.; BATISTA, T. P.; FRANCISCHETTO, T.; GAVA, V. G.; ARIAS, F.; CASTRO, J. M. M.; PACHECO, M.; GARCIA, M. M.; VENANCIO, C.; LEONARDI, P. C.; ZANATTO, R. M.; WAINSTEIN, A. J. A.; CORDEIRO, E. Z.; PERINA, A. L. F.; FIGUEIREDO, P. H. M.; PEREIRA, L. F.; MOLINA, M. E.; VAZQUEZ, V. L.; TEIXEIRA-JUNIOR, F. J. R.Introduction: A combination therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed as a treatment option in patients with peritoneal metastasis of colorectal, ovarian, gastric cancers and sarcomas and as a current standard treatment for pseudomyxoma peritonei and peritoneal mesothelioma. There is a need to standardize its indication, drugs selection along with their concentrations and ways to deliver peritoneal chemotherapy solutions for best outcomes. Aim of the study: To investigate the current practice of Latin American (LA) Centers in which peritoneal diseases (PD) are treated. Patient and Methods: All centers from Latin American Registry of Peritoneal Diseases (LARPD) were invited to participate in a two rounds online survey, to describe their current practice in all indications of CRS with HIPEC for PD. Results: 76 out of 84 LARPD's centers answered the survey, with a response rate of 90,5%. The results represent the current practice of 248 surgeons that are members of LARPD's centers, in 8 LA countries, that at the time of the study had treated 2682 patients with CRS with HIPEC. All current practice aspects including indications, contra-indications, patient selection, methods of peritoneal chemotherapy delivery and treatment protocols are described in this manuscript. Conclusions: This survey is the first LA effort to publish current practice indications and treatment protocols of PD. Achieving consensus of best therapeutic options is essential to provide the best possible outcomes for patients with PD who could benefit from CRS with HIPEC therefore aiming at standardization of the procedure.
- Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): The First Reported Case in Brazil Using Standardized Technique with the Capnopen (R) Nebulizer Device(2021) AKAISHI, Eduardo Hiroshi; SILVA, Diego Greatti Vaz da; LIMA, Helber Vidal Gadelha; GRAPPERON-MATHIS, Roberta Lages M.; ARAKAKI, Mariana de Souza; GALINDO, Ivan Vinicius Andrade; DAIA, Lucas Afonso; ARARUNA, Gustavo Ferreira; OLIVEIRA, Andre Luiz Torres; MANCINI, Caio Nasser; HOFF, Paulo Marcelo GehmObjective: setting Background: Peritoneal metastasis is a common progression of abdominal-pelvic cancers, and it is associated with poorer oncological prognosis when compared to other metastasis sites. Its treatment has limited results, mainly because of poor bioavailability of chemotherapy within the abdominal cavity after systemic administration. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been proposed as a novel method to deliver chemotherapy directly into the peritoneal surface; it combines the effectiveness and response of an intraperitoneal therapy with benefits of a minimally invasive approach. The laparoscopic capnoperitoneum is used to instill chemotherapy particles in a more efficient way for distribution and penetration when compared to peritoneal lavage. In the present study, we describe the first PIPAC performed in Brazil, according to the standard technique previously described with the Capnopen (R) nebulizer device, as well as technique details based on our literature review. Case Report: A 67-year-old man with pancreatic adenocarcinoma metastatic to the liver at first diagnosis underwent systemic treatment with the FOLFIRINOX protocol. After a major clinical response due to systemic treatment, pancreaticoduodenectomy was performed with resection and radiofrequency ablation of hepatic nodules. After 7 months of follow-up, the patient's condition evolved with symptomatic relapse in the peritoneum. Aiming at better control of this site, multiple PIPAC procedures were performed, showing excellent control of the peritoneal cavity disease. The patient had a sustained response in the peritoneal cavity and showed systemic disease progression 6 months after the first PIPAC procedure, which deceased at 20 months after the first PIPAC procedure and 42 months after the primary diagnosis. Conclusions: This report shows that the PIPAC procedure is reproducible elsewhere, with safety and good functional results.
bookPart Tumores de Retroperitônio no Adulto(2013) AKAISHI, Eduardo; TEIXEIRA, FredericoconferenceObject 0.75mm Breslow Index as Standard Cut-off in Sentinel Lymph Node Biopsy for Melanoma(2012) MOUTINHO, V.; AKAISHI, E.; UTIYAMA, E.; MENDES, G.; TEIXEIRA, F.; FERREIRA, F.; PERINA, A.; RASSLAN, S.Introduction: Breslow index is the most important risk factor for melanoma progression. Breslow index cutoff to perform sentinel node biopsy is not consensual among institutions worldwide. Our study aims to discuss if 0.75mm is an adequate cut-off for sentinel node biopsy for melanoma. Methods: Retro- spective charts from initial 115 patient files from May/2008 to June/2011 were analyzed. Sentinel lymph node biopsy was routinely carried out in patients with Breslow >0.75mm and in high risk patients with Breslow < or =0.75mm (pres-ence of ulceration, regression, mitoses and Clark levels IV/V). Two groups were defined based on Breslow: (A) < or =1.00mm - major group with 17 patients; (B) 0.76-1.00mm - subgroup of 5 patients at threshold for sentinel biopsy. Both groups were compared with Breslow > 1.00 patients as Control Group, using Fischer’s test. High risk of recurrence characteristics were reviewed in patients with Breslow <0.76mm and expressed as percentages. Results: Sen- tinel lymph node biopsies were positive in 40,5% (15/37) of melanomas with Breslow >1.00mm. In patients with Breslow < or =1.00mm (A) there was 5.8% (1/17) sentinel node positivity. In the subgroup of patients with Breslow 0.76- 1.00mm (B) sentinel nodes were positive in 20% (1/5). When testing statisti- cally, Group A (< or =1.00mm) was different from Control group patients (> 1.00mm) regarding sentinel node positivity (p=0.008), while Group B (0.75- 1.00 mm) was similar to Control group patients (p=0.35). In patients with Bres- low <0.76 mm with high risk characteristics on pathologic report, ulceration was not present in any patient, 16,7% were Clark levels IV/V, mitoses were present in 70% of patients, lesions were in vertical phase of growth in 40% and regression was present in 36%. Conclusions: 1. Sentinel node biopsy in melanomas with Breslow 0.76-1.00mm should be routinely indicated due to a high positivity rate (20% in our sample) in this range. 2. Node positivity in patients with Breslow <0.76mm (5.8%) was statistically different from node positivity in Breslow >1.00mm group (40%; p=0.008) rising the question that indication of sentinel node biopsy in Breslow <0.76mm is controversial.conferenceObject Impact of histopathological revision and molecular pathology in the diagnosis of sarcomas in a reference center in Brazil.(2022) LOPES, Carlos Diego Holanda; QUEIROZ, Marcello Moro; SAMPAIO, Luana Alencar Fernandes; PERINA, Andre; AKAISHI, Eduardo Hiroshi; TEIXEIRA, Frederico Ribeiro; FERREIRA, Fabio Oliveira; HANNA, Samir Abdallah; SILVA, Joao Luis da; LIMA, Luiz Guilherme C. A. De; OLIVEIRA, Claudia Regina G. C. M. De; MUNHOZ, Rodrigo Ramella- Effect of cytoreductive surgery and HIPEC on survival in comparison to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups.(2018) MERCIER, Frederic; AMBLARD, Iris; BARTLETT, David L.; LEVINE, Edward Allen; BARATTI, Dario; PISO, Pompiliu; MORRIS, David L.; RAU, Beate; TENTES, Antonios Apostolos K.; TUECH, Jean-Jacques; QUENET, Francois; AKAISHI, Eduardo Hiroshi; POCARD, Marc; YONEMURA, Yutaka; LORIMIER, Gerard; DELROEUX, Delphine; VILLENEUVE, Laurent; GLEHEN, Olivier; PASSOT, Guillaume
- Leiomyosarcoma of the inferior vena cava: Survival rate following radical resection(2017) TEIXEIRA JR., Frederico Jose Ribeiro; COUTO NETTO, Sergio Dias do; PERINA, Andre Luis De Freitas; TORRICELLI, Fabio C. M.; TEIXEIRA, Luciana Ragazzo; ZERATI, Antonio Eduardo; FERREIRA, Fabio de Oliveira; AKAISHI, Eduardo Hiroshi; NAHAS, William Carlos; UTIYAMA, Edivaldo MassazoLeiomyosarcoma (LMS) of inferior vena cava (IVC) is a rare neoplasm affecting approximately 1/100,000 people. The prognosis is poor and potential curative intent occurs through challenging operations, such as vena cava resection, occasionally multivisceral when required, and vascular reconstruction. There are few retrospective series regarding this retroperitoneal neoplasm, and the aim of the present study was to discuss the experience at the Sao Paulo Cancer Institute and Clinics Hospital of University of Sao Paulo Medical School, Sao Paulo, Brazil. The current study is a retrospective review of 7 patients treated in the two tertiary hospitals between 2005 and 2013. Oncological and operative aspects were discussed, primarily regarding surgical aspects highlighting en bloc resection, vascular reconstruction, and the overall survival and recurrence rates. All the patients were treated with radical intent, 4 of whom underwent multivisceral resection, with the kidney being the most resected organ. The location of the IVC tumor was described using Kulaylat's description and the median tumor size was 10 cm. Vascular reconstruction was necessary in 4 patients. The overall survival rate at 3 and 5 years was 100, and 25%, respectively. The disease-free survival rate at 3 and 5 years was 57 and 20%, respectively. In conclusion, IVC LMS is a rare and severe retroperitoneal neoplasm, with multivisceral resections remaining a surgical challenge. The treatment requires numerous experienced surgeons and the impact of microscopic free margins remains unclear. Vascular reconstruction depends on several aspects regarding primarily the topography of the tumor.