LETICIA LEONE LAURICELLA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
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- Evolution of the surgical treatment of lung cancer at a tertiary referral center in Brazil, 2011-2018(2021) SOARES, Mariana Schettini; COLTRO, Laura Maria; LEITE, Pedro Henrique Cunha; COSTA, Priscila Berenice; LAURICELLA, Leticia Leone; PEGO-FERNANDES, Paulo Manuel; TERRA, Ricardo MingariniObjective: To evaluate the evolution of clinical and epidemiological data, as well as data related to diagnosis, staging, treatment, and survival, among patients undergoing curative surgery for lung cancer at a tertiary referral center in the city of Sao Paulo, Brazil. Methods: This was a retrospective study of cases in the International Association for the Study of Lung Cancer database. We selected only cases of patients undergoing curative surgery between January of 2011 and April of 2018. We determined overall and disease-free survival at 36 months and compared the data between two periods (2011-2014 and 2015-2018). Results: Comparing the two periods (N = 437 cases), we observed trends toward increases in the number of female patients, as well as in the proportions of former smokers (44.09% vs. 53.59%), of patients diagnosed with adenocarcinoma (52.21% vs. 59.72%), and of patients diagnosed at an earlier pathological stage, together with a decrease in 30-day mortality (4.05% vs. 2.39%). There were significant increases in the proportions of cases diagnosed at an earlier clinical stage (p = 0.002) or incidentally (p = 0.003). Although lobectomy was the main surgical technique employed, there was a proportional increase in segmentectomies (2.67% vs. 7.11%; p = 0.026). Overall and disease-free survival rates were 79.4% (95% CI: 74.0-83.9%) and 75.1% (95% CI: 69.1-80.1%), respectively. The difference in overall survival between the periods lost statistical significance when adjusted for pathological stage, the only factor that affected survival (log-rank: p = 0.038 to p = 0.079). Conclusions: The clinical and epidemiological evolution presented in this study corroborates global trends. The decrease in 30-day mortality was probably due to better patient selection and improved surgical techniques.
conferenceObject Lung Resection Analysis From Brazilian Society of Thoracic Surgery Database(2016) TERRA, Ricardo M.; TSUKAZAN, Maria Teresa Ruiz; FORTUNATO, Gustavo; CAMARGO, Spencer M.; LAURICELLA, Leticia; OLIVEIRA, Humberto A. De; PINTO, Darcy R.- Effectiveness and toxicity of adjuvant chemotherapy in patients with non-small cell lung cancer(2021) HARADA, Guilherme; NEFFA, Maria Fernanda Batistuzzo Vicentini; BONADIO, Renata Colombo; MENDOZA, Elizabeth Zambrano; CAPARICA, Rafael; LAURICELLA, Leticia Leone; TAKAGAKI, Teresa Yae; ROITBERG, Felipe Santa Rosa; TERRA, Ricardo Mingarini; JR, Gilberto De CastroObjective: Adjuvant chemotherapy (AC) improves survival of patients with resected non-small cell lung cancer (NSCLC). However, the cisplatin-vinorelbine regimen has been associated with a significant risk of clinically relevant toxicity. We sought to evaluate the effectiveness, safety, and feasibility of AC for NSCLC patients in a real-world setting. Methods: This was a single-center, retrospective cohort study of patients with stage I-III NSCLC undergoing surgery with curative intent between 2009 and 2018. AC was administered at the discretion of physicians. The patients were divided into two groups: AC group and no AC (control) group. Study outcomes included overall survival (OS) and recurrence-free survival (RFS), as well as the safety profile and feasibility of the cisplatin-vinorelbine regimen in a real-world setting. Results: The study involved 231 patients, 80 of whom received AC. Of those, 55 patients received the cisplatin- vinorelbine regimen. Survival analyses stratified by tumor stage showed that patients with stage II NSCLC in the AC group had better RFS (p = 0.036) and OS (p = 0.017) than did those in the no AC group. Among patients with stage III NSCLC in the AC group, RFS was better (p < 0.001) and there was a trend toward improved OS (p = 0.060) in comparison with controls. Of those who received the cisplatin- vinorelbine regimen, 29% had grade 3-4 febrile neutropenia, and 9% died of toxicity. Conclusions: These results support the benefit of AC for NSCLC patients in a real-world setting. However, because the cisplatin-vinorelbine regimen was associated with alarming rates of toxicity, more effective and less toxic alternatives should be investigated.
bookPart Quilotórax(2021) LAURICELLA, Letícia Leone; PêGO-FERNANDES, Paulo Manuel- Segmentectomia pulmonar anatômica robótica: aspectos técnicos e desfechos(2019) TERRA, Ricardo Mingarini; LAURICELLA, Leticia Leone; HADDAD, Rui; DE-CAMPOS, José Ribas Milanes; NABUCO-DE-ARAUJO, Pedro Henrique Xavier; LIMA, Carlos Eduardo Teixeira; SANTOS, Felipe Carvalho Braga dos; PEGO-FERNANDES, Paulo ManuelABSTRACT Objective: to report our initial experience with pulmonary robotic segmentectomy, describing the surgical technique, the preferred positioning of portals, initial results and outcomes. Methods: we collected data, from a prospective robotic surgery database, on patients undergoing robotic segmentectomy between January 2017 and December 2018. All patients had lung cancer, primary or secondary, or benign diseases, and were operated on with the Da Vinci system, by the three portals technique plus one utilitarian incision of 3cm. We dissected the hilar structures individually and performed the ligatures of the arterial and venous branches, of the segmental bronchi, as well as a parenchymal transection, with endoscopic staplers. We carried out systematic dissection of mediastinal lymph nodes for non-small cell lung cancer (NSCLC) cases. Results: forty-nine patients, of whom 33 were women, underwent robotic segmentectomy. The average age was of 68 years. Most patients had NSCLC (n=34), followed by metastatic disease (n=11) and benign disease (n=4). There was no conversion to laparoscopic or open surgery, or to lobectomy. The median total operative time was 160 minutes, and the median console time, 117 minutes. Postoperative complications occurred in nine patients (18.3%), of whom seven (14.2%) had prolonged hospitalization (>7 days) due to persistent air fistula (n=4; 8.1%) or abdominal complications (n=2.4%). Conclusion: robotic segmentectomy is a safe and viable procedure, offering a short period of hospitalization and low morbidity.
- Robotic thoracic surgery for resection of thymoma and tumors of the thymus: technical development and initial experience(2020) TERRA, Ricardo Mingarini; MILANEZ-DE-CAMPOS, Jose Ribas; HADDAD, Rui; TRINDADE, Juliana Rocha Mol; LAURICELLA, Leticia Leone; BIBAS, Benoit Jacques; PEGO-FERNANDES, Paulo ManuelObjective: To evaluate the results of resection of tumors of the thymus by robotic thoracic surgery, analyzing the extent of resection, postoperative complications, time of surgery, and length of stay. Methods: Retrospective study from a database involving patients diagnosed with a tumor of the thymus and undergoing robotic thoracic surgery at one of seven hospitals in Brazil between October of 2015 and June of 2018. Results: During the study period, there were 18 cases of resection of tumors of the thymus: thymoma, in 12; carcinoma, in 2; and carcinoid tumor, in 1; high-grade sarcoma, in 1; teratoma, in 1; and thymolipoma, in 1. The mean lesion size was 60.1 +/- 32.0 mm. Tumors of the thymus were resected with tumor-free margins in 17 cases. The median (interquartile range) for pleural drain time and hospital stay, in days, was 1 (1-3) and 2 (2-4), respectively. There was no need for surgical conversion, and there were no major complications. Conclusions: Robotic thoracic surgery for resection of tumors of the thymus has been shown to be feasible and safe, with a low risk of complications and with postoperative outcomes comparable to those of other techniques.
conferenceObject Predictors of Hospital Discharge in Cancer Patients with Pericardial Effusion Who Undergo Surgical Pericardial Drainage(2015) KAZANTZIS, Thamara; TERRA, Ricardo M.; BIBAS, Benoit J.; LAURICELLA, Leticia L.; ARAUJO, Pedro N.; DELA-VEGA, Alberto J. M.; PEGO-FERNANDES, Paulo M.bookPart Segmentectomia anterior do lobo superior direito (S3)(2023) LAURICELLA, Leticia Leone; TERRA, Ricardo Mingarini; KAZANTZIS, ThamarabookPart Fixação dos arcos costais e do esterno no trauma torácico(2023) CAMPOS, José Ribas Milanez; MARIANI, Alessandro Wasum; TEDDE, Miguel Lia; LAURICELLA, Leticia LeoneconferenceObject Efficacy and safety of adjuvant chemotherapy in lung cancer: Real-world evidence(2019) ROITBERG, F. S. R.; NEFFA, M. F. B. V.; BONADIO, R. R. C. C.; HARADA, G.; MENDOZA, E. Z.; MAK, M. P.; TAKAHASHI, T. K.; MARTINS, R. E.; MESQUITA, C.; SANTINI, F. C.; ARAUJO, P. H. X. N. de; LAURICELLA, L. L.; PRADO, G. F.; TAKAGAKI, T. Y.; MELLO, E. S. de; GABRIELLI, F.; CARVALHO, H. D. A. de Andrade; TERRA, R. M.; CASTRO JR., G. de