RAPHAEL LEONARDO CUNHA DE ARAUJO

(Fonte: Lattes)
Índice h a partir de 2011
5
Lattes
ResearcherID
ORCID
Projetos de Pesquisa
Unidades Organizacionais

Filtros

Limpar filtros

Configurações

search.filters.applied.f.dateIssued: 2015 ×

Resultados de Busca

Agora exibindo 1 - 2 de 2
  • article 48 Citação(ões) na Scopus
    Chemotherapy for Patients with Colorectal Liver Metastases Who Underwent Curative Resection Improves Long-Term Outcomes: Systematic Review and Meta-analysis
    (2015) ARAUJO, Raphael L. C.; GOENEN, Mithat; HERMAN, Paulo
    Hepatic resection is considered the standard of care for patients with resectable colorectal liver metastases (CRLM), but the benefits of using systemic chemotherapy for these patients have not been completely proven. Although systemic chemotherapy is likely to improve recurrence-free survival (RFS), no differences in overall survival (OS) have been demonstrated to date. This study aimed to compare surgery plus systemic chemotherapy, regardless timing of administration, with surgery alone, analyzing long-term outcomes for patients with CRLM who underwent liver resection with curative intent. Systematic review and meta-analysis of studies published from January 1991 to December 2013 were used to compare surgery alone and surgery plus chemotherapy for patients with CRLM who underwent liver resection with curative intent. All randomized clinical trials (RCTs) were included in the study. Selection of high-quality observational comparative studies (OCSs) was based on a validated tool, the Methodological Index for Nonrandomized Studies. Comparison of RFS and OS was performed using a fixed-effects model and the hazard ratio (HR). Concerning OS, 5 studies (3 RCTs and 2 OCSs) comprising 2,475 patients were analyzed, and chemotherapy (1,024 patients) relatively improved OS rates for 23 % of the patients versus surgery alone (HR, 0.77; 95 % confidence interval [CI] 0.67-0.88; p < 0.001). Four studies, totaling 1,592 patients, reported RFS (3 using RCTs and 1 using OCSs), showing that chemotherapy (702 patients) relatively improved RFS for 29 % of the patients (HR, 0.71; 95 % CI 0.61-0.83; p < 0.001). This meta-analysis demonstrated that the use of chemotherapy for patients with CRLM who underwent resection with curative intent is a worthwhile strategy for improving both RFS and OS.
  • article 5 Citação(ões) na Scopus
    Role of Cytoreduction Surgery With HIPEC in the Management of Peritoneal Carcinomatosis From Colorectal Cancer and Pseudomyxoma Peritonei
    (2015) ARAUJO, Raphael L. C.; LOPES, Gilberto; AISEN, Marcelo
    For most cancers, peritoneal carcinomatosis (PC) usually is considered a systemic disease and portends a very poor prognosis. However, in colorectal cancer, especially the mucinous colorectal adenocarcinoma (MCA) subtype and epithelial appendiceal neoplasms-particularly pseudomyxoma peritonei (PMP)-the pattern of PC represents local celomic extension of disease rather than systemic metastasis. Among the treatment options for isolated PC, cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has become the de facto standard of care in many institutions, based on prospective single-center and multicenter studies and randomized clinical data. However, the use of HIPEC seems to benefit only patients who have undergone complete CRS and present with favorable histology (MCA and PMP). Determining the feasibility of complete CRS is the key to adequate patient selection, because peritoneal tumor burden, both before and after CRS, is the main prognostic factor. If complete CRS is achieved, HIPEC may be offered in the effort to improve long-term outcomes.