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Ribeiro HSC, Menezes JN, da Costa WL, F. de Jesus VH, Diniz AL, Godoy AL, de Farias IC, Torres SM, Neotti T, Mello CAL, Begnami MDFS, Dias‐Neto E, Riechelmann RP, Fernandez Coimbra FJ. PD‐L1 expression in gastric and gastroesophageal junction cancer patients treated with perioperative chemotherapy. J Surg Oncol 2022; 126:150-160. [DOI: 10.1002/jso.26929] [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: 01/01/2022] [Revised: 04/27/2022] [Accepted: 05/08/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Héber S. C. Ribeiro
- Department of Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
| | | | - Wilson L. da Costa
- Department of Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
- Department of Medicine/Epidemiology and Population Sciences Baylor College of Medicine Houston Texas USA
| | | | - Alessandro L. Diniz
- Department of Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
| | - André L. Godoy
- Department of Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
| | | | - Silvio M. Torres
- Department of Abdominal Surgery A. C. Camargo Cancer Center São Paulo Brazil
| | - Tatiane Neotti
- Department of Pathology A. C. Camargo Cancer Center São Paulo Brazil
| | - Celso A. L. Mello
- Department of Clinical Oncology A. C. Camargo Cancer Center São Paulo Brazil
| | | | - Emmanuel Dias‐Neto
- Laboratory of Medical Genomics A. C. Camargo Cancer Center São Paulo Brazil
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Arra DASM, Ribeiro HSC, Henklain G, Barbosa A, Torres SM, Diniz AL, Godoy AL, Farias IC, Costa WL, Coimbra FJF. Surgery or active surveillance for pNETs < 2 cm: Preliminary results from a single center Brazilian cohort. J Surg Oncol 2022; 126:168-174. [DOI: 10.1002/jso.26931] [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: 12/31/2021] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 01/27/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Wilson L. Costa
- A.C. Camargo Cancer Center Sao Paulo Brazil
- Department of Medicine/Epidemiology and Population Sciencies, Baylor College of Medicine Houston Texas USA
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Vaz da Silva DG, Ribeiro HSC, Arra DASM, Torres SM, Diniz AL, Godoy AL, Farias IC, Costa WL, Coimbra FJF. Predictors of long-term survival in patients with hepatic resection of colorectal metastases: Analysis of a Brazilian Cancer Center Cohort. J Surg Oncol 2020; 121:893-900. [PMID: 32153041 DOI: 10.1002/jso.25893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/07/2019] [Accepted: 02/22/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hepatic metastases are a major cause of death in patients with colorectal cancer. A comprehensive assessment of the prognostic factors associated with long-term survival could improve patient selection for surgical approaches and decrease morbidity and futile locoregional treatments. METHODS We performed a retrospective analysis of patients who underwent hepatectomy for colorectal liver metastases at a single center from 2000 to 2012. RESULTS To identify factors associated with 5- and 10-year overall (OS) and disease-free survival (DFS), we analyzed 280 patients and 150 patients in the 5- and 10-year cohorts, respectively. Only seven relapses occurred after 5 years of follow-up, and no relapses occurred after 10 years. Multivariable analysis indicated that bilobar disease and extra-hepatic disease before hepatectomy were independent 5- and 10-year predictors of OS, and major postoperative complications predicted OS in the 5-year survival cohort only. Our analysis indicated that prognostic factors associated with DFS included some confounders and was therefore inconclusive. CONCLUSIONS Taken together, our results suggest that the predictors of 5- and 10-year OS rates of colorectal cancer patients with hepatic metastases are similar, differing only by postoperative complications that influenced exclusively 5-year survival. Since no relapse occurred 10 years after hepatic resection, oncological remission is likely.
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Affiliation(s)
| | - Heber S C Ribeiro
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Dante A S M Arra
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Silvio M Torres
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Alessandro L Diniz
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - André L Godoy
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Igor C Farias
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Wilson L Costa
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.,Department of Medicine, Epidemiology, and Population Sciences, Dan L Duncan Comprehensive, Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Felipe J F Coimbra
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
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Marques MC, C Ribeiro HS, Costa WL, de Jesus VHF, de Macedo MP, Diniz AL, Godoy AL, Farias IC, Aguiar S, Riechelmann RSP, S Begnami MDF, Coimbra FJF. Is primary sidedness a prognostic factor in patients with resected colon cancer liver metastases (CLM)? J Surg Oncol 2018; 117:858-863. [PMID: 29611198 DOI: 10.1002/jso.25048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 10/25/2017] [Accepted: 02/21/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Recent studies have suggested that sidedness of origin from colorectal adenocarcinomas is a predictor of survival, however the impact of this factor in patients with resected colon cancer liver metastases (CLM) is not clear. So, in this study, we compared clinic and pathologic characteristics and long-term survival of patients with resected CLM according to the primary tumor location. METHODS This is a retrospective analyzes of a prospective database. Patients with resected CLM from 1998 to 2012 were included. Right colon included tumors from cecum to middle transverse colon, and left colon included tumors from splenic flexure to sigmoid. RESULTS One hundred fifty-one patients were included, 27 right colon and 124 left colon. In the latter group, there were more patients with synchronous disease (67.7 × 6.2%, P = 0.026) and a higher CEA (22.0 × 11.7 ng/mL, P = 0.001). However, K-Ras mutation was more frequent in right sided tumors (75.0 × 24.1%, P = 0.001). There was no difference in long term survival in both groups in this series even when adjusted for the confounding variables. CONCLUSION Sidedness do not seem to be a predictor of long term survival in patients with resected colon cancer liver metastases.
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Affiliation(s)
- Márcio C Marques
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Héber S C Ribeiro
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wílson L Costa
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | - Mariana P de Macedo
- Anatomic Pathology Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Alessandro L Diniz
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - André L Godoy
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Igor C Farias
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Samuel Aguiar
- Pelvic Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Felipe J F Coimbra
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
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Fava BEC, da Costa WL, Medeiros MLL, Sonagli M, de Castro Ribeiro HS, Diniz AL, Godoy AL, de Farias IC, de Jesus VHF, Begnami MDFS, Coimbra FJF. Neoadjuvant intraperitoneal chemotherapy followed by radical surgery and HIPEC in patients with very advanced gastric cancer and peritoneal metastases: report of an initial experience in a western single center. World J Surg Oncol 2018; 16:62. [PMID: 29566715 PMCID: PMC5863812 DOI: 10.1186/s12957-018-1363-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Received: 10/04/2017] [Accepted: 03/09/2018] [Indexed: 12/29/2022] Open
Abstract
Background The association of preoperative systemic and intraperitoneal chemotherapy has been described in Eastern patients with very good outcomes in treatment responders. The aim of this paper is to describe the initial results of this multidisciplinary regimen in gastric cancer patients with very advanced peritoneal metastases. Case presentation We present here the first four cases who received the treatment protocol. They had a baseline PCI between 19 and 33. Two patients had received systemic chemotherapy prior to this regimen. Three of them had significant response and were taken to cytoreductive surgery, while one patient who had 12 cycles of chemotherapy previously showed signs of disease progression and subsequently died. There was no significant postoperative morbidity, and three patients remain alive, two of them with no signs of recurrence. Conclusion Systemic and intraperitoneal chemotherapy led to a marked response in peritoneal disease extent in our initial experience and allowed three of four patients with very advanced disease to be treated with cytoreductive surgery.
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Affiliation(s)
- Bianca Escorel Costa Fava
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - Wilson Luiz da Costa
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil.
| | - Maria Luiza L Medeiros
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - Marina Sonagli
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - Héber Salvador de Castro Ribeiro
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - Alessandro L Diniz
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - André L Godoy
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | - Igor C de Farias
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
| | | | | | - Felipe J F Coimbra
- Department of Abdominal Surgery, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211, Liberdade, Sao Paulo, CEP 01501-900, Brazil
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Ribeiro HSC, Costa WL, Diniz AL, Godoy AL, Herman P, Coudry RA, Begnami MDFS, Mello CAL, Silva MJB, Zurstrassen CE, Coimbra FJF. Extended preoperative chemotherapy, extent of liver resection and blood transfusion are predictive factors of liver failure following resection of colorectal liver metastasis. Eur J Surg Oncol 2013; 39:380-5. [PMID: 23351680 DOI: 10.1016/j.ejso.2012.12.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 11/22/2012] [Accepted: 12/07/2012] [Indexed: 12/19/2022] Open
Abstract
AIM The aim of this study was to determine the incidence and prognostic factors of postoperative liver failure in patients submitted to liver resection for colorectal metastases. METHOD Patients with CLM who underwent hepatectomy from 1998 to 2009 were included in retrospective analysis. Postoperative liver failure was defined using either the 50-50 criteria or the peak of serum bilirubin level above 7 mg/dL independently. RESULTS Two hundred and nine (209) procedures were performed in 170 patients. 120 surgeries were preceded by chemotherapy within six months. The overall morbidity rate was 53.1% and 90-day mortality was 2.3%. Postoperative liver failure occurred in 10% of all procedures, accounting for a mortality rate of 9.5% among this group of patients. In multivariate analysis, extent of liver resection, need of blood transfusion and more than eight preoperative chemotherapy cycles were independent prognostic factors of postoperative liver insufficiency. This complication was not related with the chemotherapy regimen used. CONCLUSION We conclude that postoperative liver failure has a relatively low incidence (10%) after CLM resection, but a remarkable impact on postoperative mortality rate. The amount of liver resected, the need of blood transfusion and extended preoperative chemotherapy are independent predictors of its occurrence and this knowledge can be used to prevent postoperative liver failure in a multidisciplinary approach.
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Affiliation(s)
- H S C Ribeiro
- Department of Abdominal Surgery, A.C. Camargo Cancer Hospital, Rua Antonio Prudente, 211 Liberdade, CEP 01501-900, Sao Paulo, Brazil.
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Kirchheiner J, Seeringer A, Godoy AL, Ohmle B, Maier C, Beschoner P, Sim EJ, Viviani R. CYP2D6 in the brain: genotype effects on resting brain perfusion. Mol Psychiatry 2011; 16:237, 333-41. [PMID: 20368706 DOI: 10.1038/mp.2010.42] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The cytochrome P450 2D6 (CYP2D6) is a genetically polymorphic enzyme involved in the metabolism of several psychoactive drugs. Beside its expression in the liver, CYP2D6 is highly expressed in several regions of the brain, such as the hippocampus, thalamus, hypothalamus and the cortex, but its function in the brain is not well understood. The CYP2D6 enzyme may also have a physiological role due to its involvement in neurotransmitter biotransformation. In this study, CYP2D6 genotyping was performed in N=188 healthy individuals and compared with brain perfusion levels at rest, which may reflect an ongoing biological process regulating the reactivity of the individual to emotional stimuli and the detection of signals evoking fear. Relative to N=42 matched extensive metabolizers, N=14 poor metabolizers were associated with 15% higher perfusion levels in the thalamus (P=0.03 and 0.003). Effects were also present in the whole (N=188) sample divided into metabolizer groups, or finely graded into seven CYP2D6 activity levels. A weaker effect was observed in the right hippocampus (P=0.05). An exploratory analysis, extended to the whole brain, suggested the involvement of CYP2D6 in regions associated with alertness or serotonergic function. These findings support the hypothesis of a functional role of CYP2D6 in the brain.
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Affiliation(s)
- J Kirchheiner
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, Ulm, Germany.
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Viviani R, Sim EJ, Lo H, Beschoner P, Osterfeld N, Seeringer A, Godoy AL, Kirchheiner J, Meier C. Resting brain perfusion in healthy carriers of the serotonin transporter promoter polymorphism. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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