JESUS PAULA CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- A novel model to estimate lymph node metastasis in endometrial cancer patients(2017) ANTON, Cristina; SILVA, Alexandre Silva e; BARACAT, Edmund Chada; DOGAN, Nasuh Utku; KOHLER, Christhardt; CARVALHO, Jesus Paula; FAVERO, Giovanni Mastrantonio diOBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration > 50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value > 21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy.
- Single-Site Robotic Radical Hysterectomy and Sentinel Lymphnode Biopsy in Cervical Cancer: A Case Report(2017) SILVA E SILVA, Alexandre; FERNANDES, Rodrigo Pinto; ARAUJO, Marcia Pereira de; CARVALHO, João Paulo Mancusi de; CARVALHO, Filomena Marino; FAVERO, Giovani Mastrantônio; CARVALHO, Jesus PaulaABSTRACT Robotic surgeries for cervical cancer have several advantages compared with lapa-rotomic or laparoscopic surgeries. Robotic single-site surgery has many advantages compared with the multiport approach, but its safety and feasibility are not established in radical oncologic surgeries. We report a case of a Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical carcinoma whose radical hysterectomy, sentinel lymph node mapping, and lymph node dissection were entirely performed by robotic single-site approach. The patient recovered very well, and was discharged from the hospital within 24 hours.
- Multiple HPV genotype infection impact on invasive cervical cancer presentation and survival(2017) GENTA, Maria Luiza Nogueira Dias; MARTINS, Toni Ricardo; LOPE, Rossana V. Mendoza; SADALLA, Jose Carlos; CARVALHO, Joao Paulo Mancusi de; BARACAT, Edmund Chada; LEVI, Jose Eduardo; CARVALHO, Jesus PaulaBackground Invasive cervical cancer (ICC) is the third most common malignant neoplasm affecting Brazilian women. Little is known about the impact of specific HPV genotypes in the prognosis of ICC. We hypothesized that HPV genotype would impact ICC clinical presentation and survival. Methods Women diagnosed with ICC at the Instituto do Ca A ncer do Estado de Sao Paulo (ICESP) between May 2008 and June 2012 were included in the study and were followed until December 2015. HPV genotype was detected from formalin-fixed paraffin-embedded (FFPE) tumor tissue samples using Onclarity (TM) system (BD Viper (TM) LT automated system). Results 292 patients aged 50 +/- 14 years were analyzed. HPVDNA was detected in 84% of patients. The HPV genotypes studied were: HPV16 (64%), HPV18 (10%), HPV33-58 (7%), HPV45 (5%), HPV31 (4%) and other high-risk HPV genotypes (11%). HPV genotypes showed different distributions regarding histological type and clinical stage. Patients were followed for 35-21 months. The overall survival at 5 years after diagnosis of cervical cancer was 54%. Age, clinical staging, histological type and multiple HPV genotypes infection detected in the same tumor specimen were associated with poorer overall survival on multivariate Cox proportional hazard analysis (p<0.05). No specific HPV genotype affected survival. Conclusion Multiple HPV genotype infection was associated with poorer ICC survival in our study, compared with single genotype infection. HPV genotyping from FFPE tumor tissue using an automated assay such as the Onclarity BD (TM) assay provides a simpler alternative for routine clinical use.
conferenceObject THE IMPORTANCE OF THE DRAINAGE SYSTEM AFTER INGUINOFEMORAL LYMPHANENECTOMY FOR THE TREATMENT OF VULVAR CANCER: A SERIE OF 25 CASES(2017) DIAS JR., A. Ribeiro; FARIA, M. B. Sartori; MIGLINO, G.; NOBREGA, F.; DIAS, M. L. Genta; ARAUJO, M. P.; SADALLA, J. C.; MANCUSI, J. P.; ANTON, C.; CARVALHO, J. Paula; BARACAT, E. Chada