Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva

Rio de Janeiro, Brazil

Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva

Rio de Janeiro, Brazil
SEARCH FILTERS
Time filter
Source Type

Palumbo A.,Federal University of Rio de Janeiro | Palumbo A.,Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva | de Oliveira Meireles Da Costa N.,Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva | Bonamino M.H.,Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva | And 2 more authors.
Molecular Cancer | Year: 2015

The recent exponential increase in our knowledge of cellular and molecular mechanisms involved in carcinogenesis has largely failed to translate into new therapies and clinical practices. This lack of success may result in part from the fact that most studies focus on tumor cells as potential therapeutic targets and neglect the complex microenvironment that undergoes profound changes during tumor development. Furthermore, an unfortunate association of factors such as tumor genetic complexity, overestimation of biomarker and drug potentials, as well as a poor understanding of tumor microenvironment in diagnosis and prognosis leads to the current levels of treatment failure regarding a vast majority of cancer types. A growing body of evidence points to the importance of the functional diversity of immune and structural cells during tumor development. In this sense, the lack of technologies that would allow for molecular screening of individual stromal cell types poses a major challenge for the development of therapies targeting the tumor microenvironment. Progress in microenvironment genetic studies represents a formidable opportunity for the development of new selective drugs because stromal cells have lower mutation rates than malignant cells, and should prove to be good targets for therapy. © 2015 Palumbo et al.


PubMed | Federal University of Rio de Janeiro and Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva
Type: | Journal: Molecular cancer | Year: 2015

The recent exponential increase in our knowledge of cellular and molecular mechanisms involved in carcinogenesis has largely failed to translate into new therapies and clinical practices. This lack of success may result in part from the fact that most studies focus on tumor cells as potential therapeutic targets and neglect the complex microenvironment that undergoes profound changes during tumor development. Furthermore, an unfortunate association of factors such as tumor genetic complexity, overestimation of biomarker and drug potentials, as well as a poor understanding of tumor microenvironment in diagnosis and prognosis leads to the current levels of treatment failure regarding a vast majority of cancer types. A growing body of evidence points to the importance of the functional diversity of immune and structural cells during tumor development. In this sense, the lack of technologies that would allow for molecular screening of individual stromal cell types poses a major challenge for the development of therapies targeting the tumor microenvironment. Progress in microenvironment genetic studies represents a formidable opportunity for the development of new selective drugs because stromal cells have lower mutation rates than malignant cells, and should prove to be good targets for therapy.


Couto A.G.H.,Federal University of Fluminense | Araujo B.,Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva | Torres de Vasconcelos R.A.,Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva | Renni M.J.,Hospital do Cancer II | And 3 more authors.
World Journal of Surgical Oncology | Year: 2016

Background: Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil. Methods: This retrospective case series collected data from 35 adult patients who underwent hemipelvectomy between 2000 and 2013. Survival rates after surgery were determined, and group comparisons were performed using the Kaplan-Meier method and the log-rank test. Mantel-Cox test and multiple linear regression analysis with stepwise forward selection were performed for univariate and multivariate analyses, respectively. Results: Mean survival time was 32.8 ± 4.6 months and 5-year survival rate was 27 %. Of the 35 patients, 23 patients (65.7 %) underwent external hemipelvectomy and 12 patients (34.3 %) underwent internal hemipelvectomy. The survival rate was significantly higher in patients with bone tumors than in those with soft tissue sarcomas (P = 0.024). The 5-year cumulative probability of survival was significantly lower in patients who underwent external hemipelvectomy than in those who underwent internal hemipelvectomy (P = 0.043). In the univariate and multivariate analyses, only advanced disease stage (3 and 4) was identified as a significant independent predictor of reduced survival (P = 0.0003). Balanced general anesthesia combined with epidural block was the most frequent anesthesia technique. Median intraoperative crystalloid volume and red blood cell transfusions were 3500 mL and 2 units, respectively. Conclusions: Overall mean survival time after hemipelvectomy was 32.8 months. Advanced disease stage might be independently associated with reduced survival. Smaller amounts of fluids and transfusions were administered and time to discharge was shorter. Acute and chronic pain as well as wound complications are still important challenges in hemipelvectomy. © 2016 The Author(s).


PubMed | Federal University of Fluminense, Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva and Hospital do Cancer II
Type: Journal Article | Journal: World journal of surgical oncology | Year: 2016

Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil.This retrospective case series collected data from 35 adult patients who underwent hemipelvectomy between 2000 and 2013. Survival rates after surgery were determined, and group comparisons were performed using the Kaplan-Meier method and the log-rank test. Mantel-Cox test and multiple linear regression analysis with stepwise forward selection were performed for univariate and multivariate analyses, respectively.Mean survival time was 32.84.6months and 5-year survival rate was 27%. Of the 35 patients, 23 patients (65.7%) underwent external hemipelvectomy and 12 patients (34.3%) underwent internal hemipelvectomy. The survival rate was significantly higher in patients with bone tumors than in those with soft tissue sarcomas (P=0.024). The 5-year cumulative probability of survival was significantly lower in patients who underwent external hemipelvectomy than in those who underwent internal hemipelvectomy (P=0.043). In the univariate and multivariate analyses, only advanced disease stage (3 and 4) was identified as a significant independent predictor of reduced survival (P=0.0003). Balanced general anesthesia combined with epidural block was the most frequent anesthesia technique. Median intraoperative crystalloid volume and red blood cell transfusions were 3500mL and 2units, respectively.Overall mean survival time after hemipelvectomy was 32.8months. Advanced disease stage might be independently associated with reduced survival. Smaller amounts of fluids and transfusions were administered and time to discharge was shorter. Acute and chronic pain as well as wound complications are still important challenges in hemipelvectomy.

Loading Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva collaborators
Loading Instituto Nacional Of Cancer Jose Of Alencar Gomes Da Silva collaborators