MARIA LUIZA NOGUEIRA DIAS GENTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- BORDERLINE OVARIAN TUMORS-10 YEARS SINGLE CENTER EXPERIENCE(2019) FERNANDES, R.; ANTON, C.; SILVA, A. Silva e; CARVALHO, J. P. Mancusi; ARAUJO, M.; GENTA, M. L. Dias; SAMPAIO, D.; MIGLINO, G.; DIAS JR., A.; SADALLA, J. C.; CARVALHO, J. Paula
- Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study(2019) DIAS-JR, Altamiro Ribeiro; SOARES-JR, Jose Maria; FARIA, Maria Beatriz Sartor de; GENTA, Maria Luiza Noqueira Dias; CARVALHO, Jesus Paula; BARACAT, Edmund C.OBJECTIVES: Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps. The aim of this study was to evaluate the feasibility of leaving the surgical vulvar open wound for secondary healing in situations where primary closure of the vulvar wound is not possible. METHODS: This case-control pilot study analyzed 16 women with a diagnosis of squamous cell carcinoma of the vulva who first underwent inguinofemoral lymphadenectomy, 6-week sessions of chemotherapy and 25 daily sessions of radiotherapy. Afterward, excision of the vulvar lesion with free margins was performed between January 2011 and July 2017. Twelve patients underwent primary closure of the wound (control), and in 4 patients, the surgical wound was left open for secondary healing by means of a hydrofiber (case). The inclusion criteria were a) FIGO-2009 stage II up to IIIC; b) squamous cell carcinoma; and c) no evidence of pelvic or extrapelvic disease or pelvic nodal involvement. The exclusion criteria were extrapelvic disease or pelvic nodal involvement, another primary cancer, or a poor clinical condition. ClinicalTrials.gov: NCT02067052. RESULTS: The mean age of the patients at the time of the intervention was 62.1. The distribution of the stages was as follows: II, n=6 (37 %); IIIA, n=1 (6%), IIIB, n=1 (6%) and IIIC, n=8 (51%). The mean operative time was 45 minutes. The hospital stay duration was 2 days. Full vulvar healing occurred after an average of 30 days in the control group and after an average of 50 days in the case group. CONCLUSION: A secondary healing strategy may be an option for the treatment of vulvar cancer in situations of non-extensive surgical wounds when primary closure of the wound is not possible.
- Neoadjuvant Chemotherapy With Cisplatin and Gemcitabine Followed by Chemoradiation Versus Chemoradiation for Locally Advanced Cervical Cancer: A Randomized Phase II Trial(2019) COSTA, Samantha Cabral S. da; BONADIO, Renata Colombo; GABRIELLI, Flavia Carolina G.; ARANHA, Andrea S.; GENTA, Maria Luiza N. Dias; MIRANDA, Vanessa C.; FREITAS, Daniela de; ABDO FILHO, Elias; FERREIRA, Patricia A. O.; MACHADO, Karime K.; SCARANTI, Mariana; CARVALHO, Heloisa de A.; ESTEVEZ-DIZ, Maria Del PilarPURPOSE Although chemoradiation therapy (CRT) with cisplatin remains the standard treatment of patients with locally advanced cervical cancer (LACC), 40% of patients present with disease recurrence. Additional treatment strategies are required to improve outcomes. We conducted a trial to evaluate the efficacy and safety of neoadjuvant chemotherapy (NAC) with cisplatin and gemcitabine followed by CRT. METHODS In this phase II trial, patients with LACC (International Federation of Gynecology and Obstetrics stage IIB to IVA or with positive lymph nodes) were randomly assigned to three cycles of NAC with cisplatin and gemcitabine followed by standard CRT with weekly cisplatin plus pelvic radiotherapy or to standard CRT alone. The primary end point was 3-year progression-free survival (PFS). Secondary end points were response rate, 3-year locoregional control, 3-year overall survival (OS), safety, and quality of life. RESULTS From 107 patients enrolled in the trial, 55 were randomly assigned to the NAC arm and 52 to the CRT-alone arm. The majority of patients had squamous cell carcinoma (87.8%). After a median follow-up of 31.7 months, NAC was associated with an inferior PFS, with 3-year PFS rates of 40.9% v 60.4% in the CRT arm (hazard ratio, 1.84; 95% CI, 1.04 to 3.26; P = .033). NAC also was associated with a lower OS (3-year OS rate, 60.7% v 86.8%; hazard ratio, 2.79; 95% CI, 1.29 to 6.01; P = .006). After treatment completion, complete response rates were 56.3% in the NAC arm and 80.3% in the CRT arm (P = .008). Toxicities were similar in both arms, with the exception of hypomagnesemia and neuropathy being more common with NAC. CONCLUSION This study shows that the addition of NAC consisting of cisplatin and gemcitabine to standard CRT is not superior and is possibly inferior to CRT alone for the treatment of LACC. (C) 2019 by American Society of Clinical Oncology
- Cardiophrenic lymph node resection in cytoreduction for primary advanced or recurrent epithelial ovarian carcinoma: a cohort study(2019) LOPES, Andre; COSTA, Ronaldo Lucio Rangel; PAULA, Raphael di; ANTON, Cristina; CALHEIROS, Ytauan; SARTORELLI, Vivian; KANASHIRO, Yara Mitie; LIMA, Joao Alves de; YAMADA, Alayne; PINTO, Gabriel Lowndes de S.; VIANNA, Maria Regina; GENTA, Maria Luiza Nogueira Dias; RIBEIRO, Ulysses; SANTOS, Marcelo Oliveira dosObjectives To evaluate the clinical outcomes of epithelial ovarian carcinoma patients who underwent cardiophrenic lymph node resection. Methods We retrospectively reviewed the records of all surgically treated patients with advanced epithelial ovarian carcinoma (stages IIIC-IV) who underwent cardiophrenic lymph node resection between 2002 and 2018. Only those in whom cardiophrenic lymph node involvement was the only detectable extra-abdominal disease were included. Patients with suspected cardiophrenic lymph node metastasis on staging images underwent a transdiaphragmatic incision to access the para-cardiac space after complete abdominal cytoreduction achievement. Data on disease-free survival, overall survival, and surgical procedures performed concurrently with cardiophrenic lymph node resection were collected. Results Of the total 456 patients, 29 underwent cardiophrenic lymph node resection; of these, 24 patients met the inclusion criteria. Twenty-two, one, and one patients had high grade serous epithelial ovarian carcinoma, low grade epithelial ovarian carcinoma, and ovarian carcinosarcoma, respectively. Ten patients had recurrent disease (recurrence group). Fourteen patients underwent cytoreduction during primary treatment (primary debulking group); four underwent cytoreduction after neoadjuvant chemotherapy. Cardiophrenic lymph node resection was performed on the right side in 19 patients, left side in three, and bilaterally in two. The average procedural duration was 28 minutes, with minimal blood loss and no severe complications. Twenty-one patients had cardiophrenic lymph node positivity. The median disease-free intervals were 17 and 12 months in the recurrent and primary debulking surgery groups, respectively. The mediastinum was the first recurrence site in 10 patients. Five patients developed brain metastases. Five patients had an overall survival beyond 50 months. Conclusions Although rare, the cardiophrenic lymph nodes may be a site of metastasis of ovarian cancer. Although their presence might indicate future recurrence, some patients may achieve long-term survival. Resection should be considered in cases of suspicious involvement to confirm extra-abdominal disease and achieve complete cytoreduction.
- TOXICITY PROFILE IN PATIENTS SUBMITTED TO NEW STRATEGY FOR THE TREATMENT OF VULVAR CANCER EMPLOYING SENTINEL LYMPH NODE SCINTIGRAPHY, SURGERY, CHEMOTHERAPY, AND RADIOTHERAPY(2019) DIAS- JR., A.; NAJAS, G.; GABRIELLI, F.; CARVALHO, H.; MIGLINO, G.; FARIA, M. B. Sartor; ARAUJO, M.; GENTA, M. L. Nogueira Dias; CARVALHO, J. Paula; BARACAT, E. Chada
- LAPAROSCOPIC PARAORTIC LYMPHDENECTOMY BY ANATOMICAL HIGHLIGHTED LANDMARKS(2019) FERNANDES, R.; ALEXANDRE, S. E. S.; ANTON, C.; CARVALHO, J. P. Mancusi; ARAUJO, M.; GENTA, M. L. Dias; SAMPAIO, D.; MIGLINO, G.; DIAS JR., A.; SADALLA, J. C.; CARVALHO, J. P.
- OVARIAN TUMOR IN PATIENTS WITH PREVIOUS GASTROINTESTINAL CARCINOMA(2019) NOBREGA, F.; ANTON, C.; SILVA, A. Lopes de Farias e; GENTA, M. L. Nogueira Dias; CARVALHO, J. P. Mancusi de; CARVALHO, J. Paula
- ROLE OF COMPLETION HYSTERECTOMY AFTER CONCOMITANT CHEMORADIATION IN CERVICAL CANCER OUTCOME(2019) KLEINE, R. Truffa; SADALLA, J. C.; GENTA, M. L. N. D.; SUAREZ, G. M.; CARVALHO, J. P. M. de; MAURO, G. P.; ANTON, C.; CARVALHO, J. P.
- HISTOPATHOLOGICAL RESPONSE ON CLINICORADIOLOGICAL PRESENTATION AND PROGNOSIS OF PATIENTS WITH ADVANCED HIGH GRADE SEROUS OVARIAN CARCINOMA TREATED WITH NEOADJUVANT CHEMOTHERAPY(2019) LOPES, A.; GENTA, M. L. Nogueira D.; MIRANDA, V. da Costa; LOPEZ, R. V. Mendonza; CARVALHO, F. Marino; CARVALHO, J. Paula
- HIGH COMMON ILIAC SENTINEL LYMPH NODE IN UTERINE CERVICAL CANCER(2019) CARVALHO, J. P. Mancusi De; NOBREGA, F. de Souza; FERNANDES, R. Pinto; DIAS JUNIOR, A. Ribeiro; GENTA, M. L. Nogueira Dias; CARVALHO, J. Paula