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Jardim DL, Gonçalves E Silva A, Pompeo ASFL, Sarkis AS, Cardoso APG, Sasse AD, Fay AP, Soares A, Pompeo ACL, Carneiro A, Kann AG, Fogassa C, De Freitas CH, Chade DC, Herchenhorn D, De Almeida DVP, Da Rosa DAR, Wiermann EG, Schutz FAB, Kater FR, De Moura F, Korkes F, Meyer F, De Oliveira FNG, Sabino F, Almeida GL, Avanço G, Guimaraes GC, Lemos GC, Carvalhal GF, Kim H, Morbeck IP, Campagnari JC, Rinck JA, Da Ponte JRT, Da Trindade KM, Atem L, Borges L, Nogueira LM, Batista LTEA, Maia MC, Sadi MV, Rocha MAA, Luz MDA, Smaletz O, Lages PSM, Matuda RMK, Reis RBD, Indio RF, Fernandes RDC, Cavallero SR, Souza VC, Busato W, Alfer W, Maluf F. "Non-metastatic, Castration-resistant Prostate Cancer: Diagnostic and Treatment Recommendations by an Expert Panel from Brazil". Clin Genitourin Cancer 2023; 21:e58-e69. [PMID: 36266221 DOI: 10.1016/j.clgc.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Non-metastatic, castration-resistant prostate cancer (nmCRPC) is an important clinical stage of prostate cancer, prior to morbidity and mortality from clinical metastases. In particular, the introduction of novel androgen-receptor signaling inhibitors (ARSi) has changed the therapeutic landscape in nmCRPC. Given recent developments in this field, we update our recommendations for the management of nmCRPC. METHODS A panel of 51 invited medical oncologists and urologists convened in May of 2021 with the aim of discussing and providing recommendations regarding the most relevant issues concerning staging methods, antineoplastic therapy, osteoclast-targeted therapy, and patient follow-up in nmCRPC. Panel members considered the available evidence and their practical experience to address the 73 multiple-choice questions presented. RESULTS Key recommendations and findings include the reliance on prostate-specific antigen doubling time for treatment decisions, the absence of a clear preference between conventional and novel (i.e., positron-emission tomography-based) imaging techniques, the increasing role of ARSis in various settings, the general view that ARSis have similar efficacy. Panelists highlighted the slight preference for darolutamide, when safety is of greater concern, and a continued need to develop high-level evidence to guide the intensity of follow-up in this subset of prostate cancer. DISCUSSION Despite the limitations associated with a consensus panel, the topics addressed are relevant in current practice, and the recommendations can help practicing clinicians to provide state-of-the-art treatment to patients with nmCRPC in Brazil and other countries with similar healthcare settings.
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Affiliation(s)
- Denis L Jardim
- Hospital Sírio Libanês, Sociedade Beneficente de Senhoras, São Paulo, SP, Brasil
| | | | - Alexandre Saad Fere Lima Pompeo
- Hospital Beneficência Portuguesa, Departamento de Uro-Oncologia, São Paulo, SP, Brasil; Grupo de Uro-Oncologia do Hcor, São Paulo, SP, Brasil
| | - Alvaro Sadek Sarkis
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | | | | | | | - Andrey Soares
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil; Grupo Oncoclínicas, São Paulo, SP, Brasil; Latin American Cooperative Oncology Group (LACOG), Genitourinary Group
| | | | - Arie Carneiro
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | - Camilla Fogassa
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | - Daher Cezar Chade
- Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da USP, São Paulo, SP, Brasil
| | - Daniel Herchenhorn
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Rede D'Or, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | - Fabio Roberto Kater
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Fernando De Moura
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Fernando Korkes
- Grupo de uro-oncologia da Faculdade de Medicina do ABC, Santo André, SP, Brasil; Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Fernando Meyer
- Sociedade Brasileira de Urologia, Curitiba, PR, Brasil; Hospital Universitário Cajuru, Curitiba, PR, Brasil; Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
| | - Fernando Nunes Galvao De Oliveira
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Clínica de Oncologia do Grupo CAM (CLION), Salvador, BA, Brasil
| | - Fernando Sabino
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Hospital Santa Lúcia, Brasília, DF, Brasil; Hospital Universitário de Brasília, Brasília, DF, Brasil
| | | | | | | | | | - Gustavo Franco Carvalhal
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil; Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Hanna Kim
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Igor Protzner Morbeck
- Hospital Sírio Libanês, Sociedade Beneficente de Senhoras, São Paulo, SP, Brasil; Universidade Católica de Brasília, Brasília, DF, Brasil
| | - Joao Carlos Campagnari
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Clínica de Urologia e Nefrologia, São Paulo, SP, Brasil
| | | | | | - Karine Martins Da Trindade
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Rede D'Or, Fortaleza, CE, Brasil
| | | | - Leonardo Borges
- Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Lucas Mendes Nogueira
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | | | - Manuel Caitano Maia
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Hospital Porto Dias, Department of Medical Oncology, Belém, Pará, Brasil
| | | | | | - Murilo De Almeida Luz
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Hospital Erasto Gaertner, Curitiba, PR, Brasil
| | - Oren Smaletz
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | | | | | | | - Roni De Carvalho Fernandes
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil; Irmandade da Santa Casa de Misericórdia de São Paulo - Hospital Central, São Paulo, SP, Brasil
| | - Sandro Roberto Cavallero
- Centro de Tratamento Oncológico (CTO), Belém, PA, Brasil; Hospital Adventista de Belém (HAB), Belém, PA, Brasil
| | - Vinicius Carrera Souza
- Instituto D'Or de Ensino e Pesquisa, Salvador, BA, Brasil; Rede D'Or, Salvador, BA, Brasil
| | - Wilson Busato
- Universidade do Vale do Itajai (UNIVALI), Itajai, SC, Brasil
| | - Wladimir Alfer
- Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Fernando Maluf
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil.
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Maluf FC, Pereira FMT, Serrano Uson PL, Bastos DA, Rodrigues da Rosa DA, Wiermann EG, Schutz FA, Kater FR, de Oliveira FNG, Marques Monteiro FS, de Pádua FV, Orlandi FJ, de Almeida Saito HP, Ayadi M, Boghikian PS, Kopp RM, de Carvalho RS, de Fogace RN, de Araújo Cavallero SR, Aguiar S, Souza VC, Sommer SG. Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC). JCO Glob Oncol 2021; 7:550-558. [PMID: 33856896 PMCID: PMC8162577 DOI: 10.1200/go.20.00505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios. METHODS A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Responses were compiled and presented in percentage of clinicians supporting each response. Questions had 4-8 options for response. RESULTS Recommendations for staging in mCSPC were split but there was consensus that chest x-ray, abdominal and pelvic computed tomography, and bone scan should be used where resources are limited. In both de novo and relapsed low-volume mCSPC, orchiectomy alone in limited resources was favored and in relapsed high-volume disease, androgen deprivation therapy plus docetaxel in limited resources and androgen deprivation therapy plus abiraterone in high-resource settings were consensus. A 3-weekly regimen of docetaxel was consensus among voters. When using abiraterone, a regimen of 1,000 mg plus prednisone 5 mg/d is optimal, but in limited-resource settings, half the panel agreed that abiraterone 250 mg with fatty foods plus prednisone 5 mg/d is acceptable. The panel recommended against the use of osteoclast-targeted therapy to prevent osseous complications. There was consensus that monitoring of patients undergoing systemic treatment should only be conducted in case of prostate-specific antigen elevation or progression-suggestive symptoms. CONCLUSION The treatment recommendations for most topics addressed differed between the best-practice setting and resource-limited setting, accentuating the need for high-quality evidence that contemplates the effect of limited resources on the management of mCSPC.
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Affiliation(s)
- Fernando Cotait Maluf
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | | | - Diogo Assed Bastos
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Sirio-Libanês, São Paulo, Brazil.,Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | - Evanius Garcia Wiermann
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Instituto de Oncologia do Paraná, Curitiba, Brazil
| | - Fábio A Schutz
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | - Fábio Roberto Kater
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | - Fernando Sabino Marques Monteiro
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Santa Lucia, Brasília, Brazil.,Hospital Universitário de Brasília, Brasília, Brazil
| | - Fernando Vidigal de Pádua
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Sírio Libanês, Brasília, Brazil
| | | | | | - Mouna Ayadi
- Institut Salah-Azaïz de Cancerologie, Tunis.,Faculté de Médecine, Tunis, Tunisia
| | | | - Ray Manneh Kopp
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Clínica Porto Azul, Barranquilla, Colombia.,Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ricardo Saraiva de Carvalho
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | - Rodrigo Nogueira de Fogace
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | | | - Vinicius Carreira Souza
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Grupo de oncologia D'Or, Rio de Janeiro, Brazil
| | - Silke Gillessen Sommer
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona and Università della Svizzera Italiana, Lugano, Switzerland.,Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
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Hajjar LA, Costa IBSDSD, Lopes MACQ, Hoff PMG, Diz MDPE, Fonseca SMR, Bittar CS, Rehder MHHDS, Rizk SI, Almeida DR, Fernandes GDS, Beck-da-Silva L, Campos CAHDM, Montera MW, Alves SMM, Fukushima JT, Santos MVCD, Negrão CE, Silva TLFD, Ferreira SMA, Malachias MVB, Moreira MDCV, Valente Neto MMR, Fonseca VCQ, Soeiro MCFDA, Alves JBS, Silva CMPDC, Sbano J, Pavanello R, Pinto IMF, Simão AF, Dracoulakis MDA, Hoff AO, Assunção BMBL, Novis Y, Testa L, Alencar Filho ACD, Cruz CBBV, Pereira J, Garcia DR, Nomura CH, Rochitte CE, Macedo AVS, Marcatti PTF, Mathias Junior W, Wiermann EG, Val RD, Freitas H, Coutinho A, Mathias CMDC, Vieira FMDAC, Sasse AD, Rocha V, Ramires JAF, Kalil Filho R. Brazilian Cardio-oncology Guideline - 2020. Arq Bras Cardiol 2020; 115:1006-1043. [PMID: 33295473 PMCID: PMC8452206 DOI: 10.36660/abc.20201006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ludhmila Abrahão Hajjar
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | | | - Paulo Marcelo Gehm Hoff
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Instituto D'or Pesquisa e Ensino, Rio de Janeiro, RJ - Brasil
| | - Maria Del Pilar Estevez Diz
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Silvia Moulin Ribeiro Fonseca
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital Sírio Libanês, São Paulo, SP - Brasil
| | - Cristina Salvadori Bittar
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital Sírio Libanês, São Paulo, SP - Brasil
| | - Marília Harumi Higuchi Dos Santos Rehder
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital Sírio Libanês, São Paulo, SP - Brasil
| | - Stephanie Itala Rizk
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | | | - Luís Beck-da-Silva
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil.,Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil
| | | | | | | | - Júlia Tizue Fukushima
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Maria Verônica Câmara Dos Santos
- Sociedade Brasileira de Oncologia Pediátrica (SOBOPE), São Paulo, SP - Brasil.,Departamento de Cardiopatias Congênitas e Cardiologia Pediátrica (DCC/CP) da Sociedade Brasileira de Cardiologia (SBC), Rio de Janeiro, RJ - Brasil
| | - Carlos Eduardo Negrão
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Silvia Moreira Ayub Ferreira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | - Juliana Barbosa Sobral Alves
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - João Sbano
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Ricardo Pavanello
- Hospital do Coração da Associação do Sanatório Sírio - HCor, São Paulo, SP - Brasil
| | | | | | | | - Ana Oliveira Hoff
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Yana Novis
- Hospital Sírio Libanês, São Paulo, SP - Brasil
| | - Laura Testa
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Cecília Beatriz Bittencourt Viana Cruz
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Juliana Pereira
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Diego Ribeiro Garcia
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Cesar Higa Nomura
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | | | - Wilson Mathias Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Renata do Val
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | - André Deeke Sasse
- Grupo SOnhe, Campinas, SP - Brasil.,Universidade Estadual de Campinas (Unicamp), Campinas, SP - Brasil
| | - Vanderson Rocha
- Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - José Antônio Franchini Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Roberto Kalil Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.,Instituto do Câncer Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
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Sasse AD, Dos Reis RB, Nogueira LM, Maluf FC, Herchenhorn D, Smaletz O, Lima VS, Schutz F, Bastos D, Wiermann EG, Morbeck IAP, Jardim LF, Souza VC, Carvalho IT, Leite ETT, Nardozza A, Pompeo ACL, Bretas F, Leal MLDO, Sadi MV, da Ponte JRT, Carvalhal GF. Second brazilian consensus on the treatment of advanced prostate cancer - a SBOC-SBU-SBRT panel review. Int Braz J Urol 2019; 45:449-458. [PMID: 31038861 PMCID: PMC6786127 DOI: 10.1590/s1677-5538.ibju.2018.0798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/09/2019] [Indexed: 01/04/2023] Open
Abstract
Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers. The aim of this consensus is to align different opinions and interpretations of the medical literature in a practical and patient-oriented approach. The first Brazilian Consensus on the Treatment of Advanced Prostate Cancer was published in 2017, with the goal of reducing the heterogeneity of therapeutic conduct in Brazilian patients with metastatic prostate cancer. We acknowledge that in Brazil the incorporation of different technologies is a big challenge, especially in the Sistema Único de Saúde (SUS), which allows for the disparity in the options available to patients treated in different institutions. In order to update the recommendations and to make them objective and easily accessible, once more a panel of specialists was formed in order to discuss and elaborate a new Brazilian Consensus on Advanced Prostate Cancer. This Consensus was written through a joint initiative of the Brazilian Society of Clinical Oncology (SBOC) and the Brazilian Society of Urology (SBU) to support the clinical decisions of physicians and other health professionals involved in the care of patients with prostate cancer.
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Affiliation(s)
| | - Rodolfo Borges Dos Reis
- Departamento de Urologia, Universidade de São Paulo- USP, Campus de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | - Lucas Mendes Nogueira
- Divisão de Urologia e Departamento de Cirurgia Hospital das Clínicas, Universidade Federal de MG - UFMG, Belo Horizonte, MG, Brasil
| | | | | | - Oren Smaletz
- Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, Brasil
| | | | - Fábio Schutz
- Hospital Beneficência Portuguesa de São Paulo, SP, Brasil
| | - Diogo Bastos
- Departamento de Oncologia, Instituto do Câncer do Estado de São Paulo - ICESP, SP, Brasil
| | | | | | - Leonardo Fontes Jardim
- Departamento de Oncologia, Instituto do Câncer do Estado de São Paulo - ICESP, SP, Brasil
| | | | | | | | - Archimedes Nardozza
- Departamento de Urologia e Cirurgia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | | | | | | | - Marcus Vinicius Sadi
- Departamento de Urologia e Cirurgia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | | | - Gustavo F Carvalhal
- Divisão de Urologia e Departamento de Cirurgia, Pontifícia Universidade Católica do Rio Grande do Sul - PUC RS, Porto Alegre, RS, Brasil
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5
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Sasse AD, Wiermann EG, Herchenhorn D, Bastos DA, Schutz FA, Maluf FC, Coura G, Morbeck IAP, Cerci JJ, Smaletz O, Lima VS, Adamy A, Campos FSD, Carvalhal GF, Cezar LC, Dall'Oglio MF, Sadi MV, Reis RBD, Nogueira L. First Brazilian Consensus of Advanced Prostate Cancer: Recommendations for Clinical Practice. Int Braz J Urol 2017; 43:407-415. [PMID: 28199075 PMCID: PMC5462130 DOI: 10.1590/s1677-5538.ibju.2016.0490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/21/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer. Objectives This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology. Materials and Methods Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants. Results and Conclusions The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions.
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Affiliation(s)
| | | | | | - Diogo Assed Bastos
- Departamento de Oncologia, Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brasil.,Departamento de Oncologia, Hospital Sirio-Libanes, São Paulo, SP, Brasil
| | - Fabio A Schutz
- Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil
| | - Fernando Cotait Maluf
- Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil.,Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | - George Coura
- Instituto do Câncer, Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | - Oren Smaletz
- Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | | | - Ari Adamy
- Departamento de Urologia, Hospital Santa Casa, Curitiba, PR, Brasil
| | | | - Gustavo Franco Carvalhal
- Departamento de Cirurgia e Departamento de Urologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | | | | - Rodolfo Borges Dos Reis
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Lucas Nogueira
- Departamento de Urologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte. MG, Brasil
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6
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Coimbra FJF, Ribeiro HSDC, Marques MC, Herman P, Chojniak R, Kalil AN, Wiermann EG, Cavallero SRDA, Coelho FF, Fernandes PHDS, Silvestrini AA, Almeida MFA, de Araújo ALE, Pitombo M, Teixeira HM, Waechter FL, Ferreira FG, Diniz AL, D'Ippolito G, D'Ippolito G, Begnami MDFDS, Prolla G, Balzan SMP, de Oliveira TB, Szultan LA, Lendoire J, Torres OJM. FIRST BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 1: PRE-TREATMENT EVALUATION. Arq Bras Cir Dig 2016; 28:222-30. [PMID: 26734788 PMCID: PMC4755170 DOI: 10.1590/s0102-6720201500040002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/11/2015] [Indexed: 02/07/2023]
Abstract
Background : Liver metastases of colorectal cancer are frequent and potentially fatal event
in the evolution of patients with these tumors. Aim : In this module, was contextualized the clinical situations and parameterized
epidemiological data and results of the various treatment modalities established.
Method: Was realized deep discussion on detecting and staging metastatic colorectal
cancer, as well as employment of imaging methods in the evaluation of response to
instituted systemic therapy. Results : The next step was based on the definition of which patients would have their
metastases considered resectable and how to expand the amount of patients elegible
for modalities with curative intent. Conclusion : Were presented clinical, pathological and molecular prognostic factors,
validated to be taken into account in clinical practice.
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Affiliation(s)
| | | | | | - Paulo Herman
- American Hepato-Pancreato-Biliary Association, São Paulo, Brazil
| | - Rubens Chojniak
- American Hepato-Pancreato-Biliary Association, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | - Marcos Pitombo
- American Hepato-Pancreato-Biliary Association, São Paulo, Brazil
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7
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Arruda É, dos Anjos Jacome AA, Toscano ALDCC, Silvestrini AA, Rêgo ASB, Wiermann EG, da Cunha GF, de Melo HRL, Morejón KML, Goldani LZ, Pereira LC, Silva MH, Treistman MS, Pereira MCT, Romero PMBX, Schmerling RA, Guedes RAV, de Camargo VP. Erratum on “Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma” [Braz. J. Infect. Dis. 18 (3) (2014) 315–326]. Braz J Infect Dis 2014. [PMCID: PMC9427499 DOI: 10.1016/j.bjid.2014.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Érico Arruda
- Sociedade Brasileira de Infectologia, Vila Mariana, SP, Brazil
| | | | - Ana Luiza de Castro Conde Toscano
- Instituto de Infectologia Emílio Ribas e Centro de Referência e Treinamento em DST/AIDS, São Paulo, SP, Brazil
- Corresponding author at: Av. Doutor Arnaldo, 165, São Paulo, SP 01246-900, Brazil.
| | | | | | | | | | | | | | | | | | | | - Mauro Sergio Treistman
- Serviço de Infectologia de Rede Hospitalar Privada e Câmara Técnica de Doenças Infecciosas do CREMERJ, Brazil
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8
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Arruda É, Jacome AADA, Toscano ALDCC, Silvestrini AA, Rêgo ASB, Wiermann EG, Cunha GFD, Melo HRLD, Morejón KML, Goldani LZ, Pereira LC, Silva MH, Treistman MS, Pereira MCT, Romero PMBX, Schmerling RA, Guedes RAV, Camargo VPD. Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma. Braz J Infect Dis 2014; 18:315-26. [PMID: 24525061 PMCID: PMC9427498 DOI: 10.1016/j.bjid.2014.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/23/2014] [Indexed: 12/26/2022] Open
Abstract
Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome. In 1994, it was finally demonstrated that the presence of a herpes virus associated with Kaposi's sarcoma called HHV-8 or Kaposi's sarcoma herpes virus and its genetic sequence was rapidly deciphered. The prevalence of this virus is very high (about 50%) in some African populations, but stands between 2% and 8% for the entire world population. Kaposi's sarcoma only develops when the immune system is depressed, as in acquired immunodeficiency syndrome, which appears to be associated with a specific variant of the Kaposi's sarcoma herpes virus. There are no treatment guidelines for Kaposi's sarcoma established in Brazil, and thus the Brazilian Society of Clinical Oncology and the Brazilian Society of Infectious Diseases developed the treatment consensus presented here.
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Affiliation(s)
- Érico Arruda
- Sociedade Brasileira de Infectologia Infectologia, Vila Mariana, SP, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | - Mauro Sergio Treistman
- Serviço de Infectologia de Rede Hospitalar Privada e Câmara Técnica de Doenças Infecciosas do CREMERJ
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