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de Oliveira Ferreira C, Carneiro VCG, Araujo Mariz C. Germline mutations in BRCA1 and BRCA2 among Brazilian women with ovarian cancer treated in the Public Health System. BMC Cancer 2024; 24:499. [PMID: 38641594 PMCID: PMC11027424 DOI: 10.1186/s12885-024-12246-1] [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: 02/08/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Germline mutations in BRCA1 and BRCA2 genes are among the main causes of hereditary ovarian cancer. Identifying these mutations may reduce cancer risk, facilitate early detection, and enable personalized treatment. However, genetic testing is limited in the Brazilian Public Health System, and data regarding germline mutations in many regions are scarce. Therefore, the study aimed to investigate the prevalence of germline mutations in BRCA1 and BRCA2 in women with ovarian cancer treated in the Public Health System in Pernambuco, Brazil. METHODS A cross-sectional study was conducted in the Hereditary Cancer Program from two reference oncological centers in Pernambuco. Women (n = 45) with high-grade serous ovarian cancer underwent genetic counseling and DNA sequencing for BRCA1 and BRCA2 genes. RESULTS The prevalence of deleterious mutations in the BRCA1 and BRCA2 genes was 33%. Of the 15 germline mutations found, 13 were in BRCA1 and 2 in BRCA2; two mutations of unknown clinical significance were also found in BRCA2. Mutations c.5266dupC and c.2215 A > T were the most frequent; each was mutation observed in three patients. Additionally, the mutations c.7645dupT and c.921dupT were reported for the first time. CONCLUSION One in three women showed a pathogenic mutation, demonstrating a significant prevalence of germline mutations in this sample. Additionally, the small sample revealed an interesting number of mutations, indicating the need to explore more regions of the country.
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Affiliation(s)
| | - Vandré Cabral Gomes Carneiro
- Hospital de Câncer de Pernambuco, Recife, Pernambuco, Brazil
- Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil
| | - Carolline Araujo Mariz
- Instituto Aggeu Magalhães, FIOCRUZ, Recife, Pernambuco, Brazil.
- Faculdade de Medicina de Olinda, Olinda, Pernambuco, Brazil.
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Ramalho N, Carneiro VCG, Santos CL, de Oliveira Lima JT. Letter to the Editor. Menopause 2024:00042192-990000000-00308. [PMID: 38564705 DOI: 10.1097/gme.0000000000002352] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Nathalia Ramalho
- Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, BrazilOncologia D'Or, Recife, Pernambuco, Brazil
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Carneiro VCG, Batista TP, Andrade MR, Barros AV, Câmara LHLD, Ramalho NM, Lucena MA, Fontão DFS, Tancredi R, Silva Júnior TC, Bezerra ALR, Baiocchi G. Proof-of-concept randomized phase II non-inferiority trial of simple versus type B2 hysterectomy in early-stage cervical cancer ≤2 cm (LESSER). Int J Gynecol Cancer 2023; 33:498-503. [PMID: 36696980 DOI: 10.1136/ijgc-2022-004092] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To evaluate the non-inferiority and safety of simple hysterectomy in early stage (<2 cm) cervical cancer. METHODS This proof-of-concept randomized phase II non-inferiority trial was performed between May 2015 and April 2018 in three oncological centers in Northeast Brazil. Patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stages IA2-IB1 cervical cancer and tumors ≤2 cm were treated with either simple or modified radical hysterectomy (Querleu-Morrow type B2). Intention-to-treat analysis was carried out. The primary endpoint was 3-year disease-free survival and secondary endpoints were overall survival, operative outcomes, adjuvant therapy, and patient's health-related quality of life (QoL). RESULTS A total of 40 patients underwent either simple hysterectomy (n=20) or modified radical hysterectomy (n=20). All patients except three underwent open procedures (n=37/40, 92.5%). At a median follow-up of 52.1 months (IQR 43.9-60.1), 3-year disease-free survival was 95% (95% CI 68% to 99%) after simple hysterectomy and 100% (95% CI 100% to 100%) after modified radical hysterectomy (log-rank p=0.30). The corresponding 5-year overall survival rates were 90% (95% CI 64% to 97%) and 91% (95% CI 50% to 98%), respectively (log-rank p=0.46). The operative time was shorter after simple hysterectomy than after modified radical hysterectomy (150 min (IQR 137.5-180) vs 199.5 min (IQR 140-230); p=0.003), with a trend towards a longer time for vesical catheterization removal (1 day (IQR 1-1) vs 1 day (IQR 1-2); p=0.043). There was no post-operative mortality and the rates of post-operative complications were not statistically different between arms (15% and 25%; p=0.69). QoL questionnaires were received from only 17 patients (42.5%), with no major differences observed over time between the surgical arms. CONCLUSIONS Simple hysterectomy is safe and potentially non-inferior to the radical surgery in patients with early-stage cervical cancer ≤2 cm. TRIAL REGISTRATION NUMBER NCT02613286.
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Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Surgery/Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Gynecology, Hospital de Cancer de Pernambuco, Recife, Brazil
| | - Thales Paulo Batista
- Surgery/Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil .,Surgery, UFPE, Recife, Brazil
| | - Manoel Rodrigues Andrade
- Gynecology, Hospital de Cancer de Pernambuco, Recife, Brazil.,Gynecology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | | | | | | | - Márcia Angélia Lucena
- Gynecology, Hospital de Cancer de Pernambuco, Recife, Brazil.,Surgery/Oncology, Universidade de Pernambuco, Recife, Brazil
| | - Diogenes Fernando Santos Fontão
- Gynecology, Hospital de Cancer de Pernambuco, Recife, Brazil.,Gynecology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | - Rodrigo Tancredi
- Clinical Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Clinical Oncology, Hospital de Cancer de Pernambuco, Recife, Brazil
| | | | - Artur Lício Rocha Bezerra
- Gynecology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Surgery/Oncology, Universidade de Pernambuco, Recife, Brazil
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Carneiro VCG, Gifoni ACLVC, Mauro Rossi B, Andrade CEMDC, Lima FTD, Galvão HDCR, Casali da Rocha JC, Silva Barreto LSD, Ashton‐Prolla P, Guindalini RSC, Farias TPD, Andrade WP, Fernandes PHDS, Ribeiro R, Lopes A, Tsunoda AT, Azevedo BRB, Marins CAM, Oliveira Uchôa DNDA, Dos Santos EAS, Fernández Coimbra FJ, Dias Filho FA, Lopes FCDO, Fernandes FG, Ritt GF, Laporte GA, Guimaraes GC, Feitosa e Castro Neto H, dos Santos JC, de Carvalho Vilela JB, Meinhardt Junior JG, Cunha JRD, Medeiros Milhomem L, da Silva LM, Maciel LDF, Ramalho NM, Leite Nunes R, Guido de Araújo R, de Assunção Ehrhardt R, Delgado Bocanegra RE, Silva Junior TC, Oliveira VRD, Silva Surimã W, de Melo Melquiades M, Ribeiro HSDC, Oliveira AF. Cancer risk‐reducing surgery: Brazilian society of surgical oncology guideline part 1 (gynecology and breast). J Surg Oncol 2022; 126:10-19. [DOI: 10.1002/jso.26812] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Department of Surgey, Gynecology, Oncology Instituto de Medicina Integral Professor Fernando Figueira Recife Brazil
- Department of Pelvic Surgery, Hereditary Cancer Program Hospital de Câncer de Pernambuco Recife Brazil
- Department of Oncogenetic, Oncology Oncologia D'or Rio de Janeiro Brazil
| | | | - Benedito Mauro Rossi
- Department of Oncogenetic, Surgical Oncology Hospital Sírio Libanês São Paulo Brazil
| | | | - Fernanda Teresa de Lima
- Department of Oncogenetic Hospital Israelita Albert Einstein São Paulo Brazil
- Department of Oncogenetic UNIFESP‐EPM São Paulo Brazil
| | | | | | | | | | | | | | - Wesley Pereira Andrade
- Department of Surgery Hospital Beneficência Portuguesa São Paulo Brazil
- Department of Surgery Hospital Oswaldo Cruz São Paulo Brazil
- Department of Surgery Hospital Santa Catarina São Paulo Brazil
| | | | - Reitan Ribeiro
- Department of Surgical Oncology Hospital Erasto Gaertner Curitiba Brazil
| | - Andre Lopes
- Department of Surgical Oncology São Camilo Oncologia São Paulo Brazil
| | - Audrey Tieko Tsunoda
- Department of Surgical Oncology Hospital Erasto Gaertner Curitiba Brazil
- Department of Surgery Pontifícia Universidade Católica do Paraná Curitiba Brazil
| | - Bruno Roberto Braga Azevedo
- Department of Surgical Oncology Oncoclínicas Curitiba Brazil
- Department of Surgery Pilar Hospital Curitiba Brazil
| | - Carlos Augusto Martinez Marins
- Department of Head and Neck, Oncological Surgery INCA Rio de Janeiro Brazil
- Department of Surgery Hospital Federal dos Servidores do Estado Rio de Janeiro Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jorge Guardiola Meinhardt Junior
- Department of Surgery Santa Casa de Misericórdia de Porto Alegre Porto Alegre Brazil
- Department of Surgery Hospital Santa Rita Porto Alegre Brazil
| | | | | | - Luciana Mata da Silva
- Department of Pelvic Surgery, Hereditary Cancer Program Hospital de Câncer de Pernambuco Recife Brazil
| | | | - Nathalia Moreira Ramalho
- Department of Surgey, Gynecology, Oncology Instituto de Medicina Integral Professor Fernando Figueira Recife Brazil
- Department of Oncogenetic, Oncology Oncologia D'or Rio de Janeiro Brazil
| | - Rafael Leite Nunes
- Department of Surgery GNDI Notredame Intermédica—Hospital Salvalus São Paulo Brazil
| | - Rodrigo Guido de Araújo
- Department of Pelvic Surgery, Hereditary Cancer Program Hospital de Câncer de Pernambuco Recife Brazil
| | | | | | | | | | | | | | - Heber Salvador de Castro Ribeiro
- Department of Oncogenetic, Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
- SBCO 2021‐2023 BBSO presidente Rio de Janeiro Brazil
| | - Alexandre Ferreira Oliveira
- Department of Surgery Universidade Federal de Juiz de Fora Juiz de Fora Brazil
- SBCO 2019‐2021 BBSO presidente Rio de Janeiro Brazil
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Batista TP, Carneiro VCG, Tancredi R, Badiglian Filho L, Rangel RLC, Lopes A, Sarmento BJQ, Leão CS. A phase 2 trial of short-course Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) at interval cytoreductive surgery (iCRS) for advanced ovarian cancer. Rev Col Bras Cir 2022; 49:e20223135. [PMID: 35239855 PMCID: PMC10578806 DOI: 10.1590/0100-6991e-20223135] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 07/25/2021] [Accepted: 10/06/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to report the final analysis of a phase 2 trial assessing the efficacy and safety of short-course hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with advanced epithelial ovarian cancer (EOC). METHODS this was an open-label, multicenter, single-arm trial of HIPEC in patients with advanced EOC who underwent interval cytoreductive surgery (iCRS) after neoadjuvant chemotherapy (NACT). HIPEC was performed as a concentration-based regimen of platinum-based chemotherapy for 30 minutes. Primary endpoint was the rate of disease progression occurring at nine months following iCRS plus HIPEC (PD9). Secondary endpoints were postoperative complications, time to start adjuvant chemotherapy, length of hospital and ICU stay, quality of life (QoL) over treatment, and ultimately 2-year progression-free survival (PFS) and overall survival (OS). Analysis was by intention-to-treat with final database lock for survival outcomes on February 23, 2021. RESULTS fifteen patients with stage III EOC were enrolled between February 2015 and July 2019, in four centers. The intention to treat PD9 was 6.7%. With a median follow-up of 33 months (IQR, 24.3-46.5), the median PFS was 18.1 months and corresponding 2-year rates of PFS and OS was 33.3% and 93.3%, respectively. Three patients (20%) experienced graded III complications. Median length of hospital and ICU stay was 5 (IQR, 4-6.5) and 1 (IQR, 1-1) days, respectively. Time to restart systemic chemotherapy was 39 (IQR, 35-49.3) days and no significant difference over time in QoL was observed. CONCLUSIONS we demonstrate preliminary efficacy and safety of short-course HIPEC in patient with advanced EOC.
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Affiliation(s)
- Thales Paulo Batista
- - IMIP - Instituto de Medicina Integral Professor Fernando Figueira, Department of Surgery/Oncology - Recife - PE - Brasil
- - UFPE - Universidade Federal de Pernambuco, Center of Medical Science - Recife - PE - Brasil
| | - Vandré Cabral Gomes Carneiro
- - IMIP - Instituto de Medicina Integral Professor Fernando Figueira, Department of Surgery/Oncology - Recife - PE - Brasil
- - HCP - Hospital de Câncer de Pernambuco, Department of Gynecology - Recife - PE - Brasil
| | - Rodrigo Tancredi
- - IMIP - Instituto de Medicina Integral Professor Fernando Figueira, Department of Clinical Oncology - Recife - PE - Brasil
- - HCP - Hospital de Câncer de Pernambuco, Department of Clinical Oncology - Recife - PE - Brasil
| | | | | | - André Lopes
- - IBCC - Instituto Brasileiro de Controle do Câncer, Department of Gynecology - São Paulo - SP - Brasil
| | - Bruno José Queiroz Sarmento
- - IHBDF - Instituto Hospital de Base do Distrito Federal, Serviço de Oncologia Cirúrgica - Brasília - DF - Brasil
| | - Cristiano Souza Leão
- - IMIP - Instituto de Medicina Integral Professor Fernando Figueira, Departamento de Cirurgia - Recife - PE - Brasil
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Carneiro VCG, Ramalho NM. Letter to the Editor: Comment on ''Cytoreductive Surgery with or without HIPEC After Neoadjuvant Chemotherapy in Ovarian Cancer: A Phase 3 Clinical Trial''. Ann Surg Oncol 2022; 29:3351-3352. [PMID: 35166953 DOI: 10.1245/s10434-022-11432-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/12/2021] [Indexed: 01/21/2023]
Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, CEP: 50070-550, Brazil. .,Neoh Oncologia D'or, Recife, CEP: 50070-170, Brazil. .,Hospital de Cancer de Pernambuco, Recife, CEP: 50040-000, Brazil.
| | - Nathalia Moreira Ramalho
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, CEP: 50070-550, Brazil.,Neoh Oncologia D'or, Recife, CEP: 50070-170, Brazil
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Carneiro VCG, Ramalho NM. Secondary cytoreduction for relapsed ovarian cancer. Lancet Oncol 2021; 22:e231. [PMID: 34087140 DOI: 10.1016/s1470-2045(21)00187-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Instituto de Medicina Integral Professor Fernando Figueira, Recife 50070-550, Brazil; Neoh Oncologia D'or, Recife, Brazil; Hospital de Câncer de Pernambuco, Recife, Brazil.
| | - Nathalia Moreira Ramalho
- Instituto de Medicina Integral Professor Fernando Figueira, Recife 50070-550, Brazil; Neoh Oncologia D'or, Recife, Brazil
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Carneiro VCG, Ramalho NM. Should we or should we not? Risk reduction bilateral salpingectomy for BRCA mutation carriers. Int J Gynecol Cancer 2021; 31:1096. [PMID: 33990355 DOI: 10.1136/ijgc-2021-002682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Instituto de Medicina Integral Prof Fernando Figueira, Recife, Brazil .,Hospital de Cancer de Pernambuco, Recife, Brazil
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Ribeiro R, Fontes Cintra G, Barrozo A, Tieko Tsunoda A, Pupo Nogueira A, Andreazza Laporte G, de Araújo RLC, Jara Reis R, Patury P, Reis RD, Affonso RJ, Moretti Marques R, Leal RMLV, Oliveira AF, Henrique Zanvettor P, de Oliveira Lopes FC, Arenhart Pessini S, Lopes A, de Azevedo RN, de Assis Gobetti G, Silva KFPE, Andrade CEMDC, Carneiro VCG, Fin FR, de Castilho TJC, Kwiatkowski FV, Simões JC, Foiato T, de Oliveira VR, Augusto Casteleins W, Filippi LT, Zanini LAG, de Maria Maués Sacramento R, de Souza RS, Castro Lanaze G, Barreto E, Fonteles Ritt G, Ziggiatti Güth G, de Sousa TA, Cruz RP, Schwengber A, Bocanegra RED, da Silva JPA, Tayeh MRA, Filho JDN, Gatelli CN, Adriano MG, Toniazzi Lissa F, de Oliveira Cucolicchio G, Loureiro CMB, Cunha JRD, Lourenço Lira D, de Araújo EO, de Resende FAM, Venâncio Pinto C, Mendes Medeiros G, Baiocchi G. Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources. J Surg Oncol 2019; 121:730-742. [PMID: 31845348 DOI: 10.1002/jso.25797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 11/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Approximately 70% of cancer-related deaths occur in low- and middle-income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines. OBJECTIVES The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers. METHODS The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations. RESULTS For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives. CONCLUSIONS It is possible to provide adequate treatment for most EC patients in resource-limited areas, but the first option should be referral to specialized centers with more resources.
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Affiliation(s)
- Reitan Ribeiro
- Department of Surgical Oncology, Erasto Gaertner Hospital, Curitiba, Brazil
| | | | - Abner Barrozo
- Department of Surgical Oncology, Instituto Brasileiro de Controle de Câncer, São Paulo, Brazil
| | | | | | - Gustavo Andreazza Laporte
- Departament of Surgical Oncology, Santa casa de Porto Alegre/Santa Rita Hospital/Universidade Federal de ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Rosilene Jara Reis
- Departament of Surgical Oncology, Santa casa de Porto Alegre/Santa Rita Hospital/Universidade Federal de ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Patricia Patury
- Gynecologic Oncology Department, National Cancer Institute, Rio de Janeiro, Brazil
| | - Ricardo Dos Reis
- Gynecologic Oncology Department, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Renato Moretti Marques
- Gynecologic Oncology Division, Oncologic Center, Albert Einstein Hospital, São Paulo, Brazil
| | | | | | | | | | - Suzana Arenhart Pessini
- Department of Gynecologic Oncology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Gynecologic Oncology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Lopes
- Department of Gynecology, Instituto Brasileiro de Controle do Câncer, São Paulo, Brazil
| | | | | | | | | | | | - Fabio Roberto Fin
- Gynecologic Oncology Department, São Vicente Hospital, Curitiba, Brazil
| | | | | | - João Carlos Simões
- Department of Surgical Oncology, Mackenzie University Hospital, Curitiba, Brazil
| | - Tariane Foiato
- Department of Surgical Oncology, Cascavel Cancer Hospital, Castavel, Brazil
| | | | | | - Lucas Torelly Filippi
- Department of Surgical Oncology, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil
| | | | | | | | | | - Elio Barreto
- Department of Oncology, Onofre Lopes University Hospital, Natal, Brazil
| | | | | | | | - Ricardo Pedrini Cruz
- Department of Surgical Oncology, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil
| | - Alex Schwengber
- Department of Surgical Oncology, Ana Nery Hospital, Jacarezinho, Brazil
| | | | | | - Muhamed Read Ali Tayeh
- Department of Surgical Oncology, Materninade Marieta Konder Bornhausen Hospital, Itajaí, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Cláudio Venâncio Pinto
- Department of Surgical Oncology, Centro de Câncer de Brasília (CETTRO), Brasilia, Brazil
| | | | - Glauco Baiocchi
- Department of Gynecologic Oncology, AC Camargo Cancer Center, São Paulo, Brazil
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Carneiro VCG. Comment on: Prognostic factors and adjuvant therapy on survival in early-stage cervical adenocarcinoma/adenosquamous carcinoma after primary radical surgery: A Taiwanese Gynecologic Oncology Group (TGOG) study. Surg Oncol 2016; 25:467. [PMID: 27793441 DOI: 10.1016/j.suronc.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/11/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Vandré Cabral Gomes Carneiro
- Hospital de Cancer de Pernambuco, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife-Pe, Brazil.
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Bezerra ALR, Batista TP, Martins MR, Carneiro VCG. Surgical treatment of clinically early-stage endometrial carcinoma without systematic lymphadenectomy. Rev Assoc Med Bras (1992) 2014; 60:571-6. [DOI: 10.1590/1806-9282.60.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/19/2014] [Indexed: 01/14/2023] Open
Abstract
Objective: the main aim of this study was to describe the authors’ experience with the surgical treatment of endometrial cancer without systematic lymphadenectomy. Methods: a retrospective cohort study was carried out on a subset of patients suffering of clinically early-stage endometrial carcinoma who underwent hysterectomy and salpingo-oophorectomy without systematic (radical) lymph nodes dissection at our centers from June, 2002, to November, 2011. Descriptive statistics were explored as medians (interquartile range) or frequencies (percentages), as appropriated, and the Kaplan–Meier method was applied for survival estimation. Results: eighty-three patients who underwent surgical treatment with no lymph node dissection (n = 20; 24.1%) or with only a sampling procedure (n=63; 75.98%) were selected for analysis. Among these patients, 27 (32.53%) underwent surgery alone and 56 (67.46%) received some adjuvant treatment. Postoperative complications occurred in five patients (6.02%). Over a median follow-up of 27.4 months (Q25 = 13.7 – Q75 = 46.5), 15 (18.07%) patients suffered from relapses and 11 deaths occurred as result of disease recurrence. Cumulative 1, 2 and 3-year disease- free survivals were 97.32, 91.18 and 78.02%, respectively. Conclusion: on a case-by-case basis, the surgical treatment of clinically early-stage endometrial carcinoma without systematic lymphadenectomy did not seem to decrease survival outcomes and presented low rates of surgical morbidity in our experience, but was also related to a high rate use of adjuvant therapy.
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Affiliation(s)
| | - Thales Paulo Batista
- Instituto de Medicina Integral Professor Fernando Figueira, Brazil; Hospital do Câncer de Pernambuco, Brazil
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Batista TP, Bezerra ALR, Martins MR, Carneiro VCG. How important is the number of pelvic lymph node retrieved to locorregional staging of cervix cancer? Einstein (Sao Paulo) 2014; 11:451-5. [PMID: 24488383 PMCID: PMC4880381 DOI: 10.1590/s1679-45082013000400008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 11/06/2013] [Indexed: 11/26/2022] Open
Abstract
Objective: To explore how important is the number of pelvic lymph nodes dissected for the nodal staging in FIGO IA2-IB2 cervical cancer, submitted to radical surgical treatment. Methods: A cross-sectional study was carried out on patients who underwent Piver class II radical hysterectomy and pelvic lymphadenectomy, in two centers in the state of Pernambuco, from January, 2001 to December, 2008. The analysis of the area under the ROC curve was adopted as a summary-measure of discriminatory power of the number of nodes dissected in predicting the pelvic nodal status. Additionally, we also confirm our findings using logistic regression and the Fisher's exact test. Results: The postoperative pathological study included 662 pelvic lymph nodes dissected (median per-patient=9, q25=6 − q75=13) from 69 patients. The ROC curve analysis revealed AUC=0.642, for the discriminatory value of the number of nodes dissected in predicting the pelvic nodal status. Similar findings were found after categorization using 10 and 15 lymph nodes as cut-offs (AUC=0.605 and 0.526, respectively). Logistic regression revealed odds ratio of 0.912 (95% CI=0.805-1.032; p=0.125) for the predictive value of the number of nodes dissected, and a number of nodes ≥10 or ≥15 lymph nodes was not significantly associated with the nodal status by the Fischer's exact test (p=0.224 and p=0.699, respectively). Conclusion: The number of pelvic lymph nodes dissected did not correlate with pelvic lymph node metastatic involvement. This study suggests that dissection of a greater number of lymph nodes does not increase locoregional nodal staging in cervical cancer.
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