Publications by authors named "Guilherme C Cotti"
Prognostic factors for local recurrence in patients with rectal cancer submitted to neoadjuvant chemoradiotherapy and total mesorectal excision.
Clinics (Sao Paulo)
August 2024
Unlabelled: Prognostic factors for local recurrence in patients with rectal cancer submitted to neoadjuvant chemoradiotherapy and total mesorectal excision.
Background: The standard curative treatment for locally advanced rectal cancer of the middle and lower thirds is long-course chemoradiotherapy followed by total mesorectal excision.
Purpose: To evaluate the prognostic factors associated with local recurrence in patients with rectal cancer submitted to neoadjuvant chemoradiotherapy and total mesorectal excision.
The Role of Probe-Based Confocal Laser Endomicroscopy (pCLE) in the Diagnosis of Sustained Clinical Complete Response Under Watch-and-Wait Strategy After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Adenocarcinoma: a Score Validation.
J Gastrointest Surg
September 2023
Background: Watch-and-wait strategy has been increasingly accepted for patients with clinical complete response (cCR) after multimodal treatment for locally advanced rectal adenocarcinoma. Close follow-up is essential to the early detection of local regrowth. It was previously demonstrated that probe-based confocal laser endomicroscopy (pCLE) scoring using the combination of epithelial and vascular features might improve the diagnostic accuracy of cCR.
View Article and Find Full Text PDFBackground: Clinical complete responders after chemoradiation for rectal cancer are increasingly being managed by a watch-and-wait strategy. Nonetheless, a significant proportion will experience a local regrowth, and the long-term oncological outcomes of these patients is not totally known.
Objective: The purpose of this study was to analyze the outcomes of patients who submitted to a watch-and-wait strategy and developed a local regrowth, and to compare these results with sustained complete clinical responders.
The risk of radiotherapy-induced malignancies (RIMs) is a concern when treating Li-Fraumeni syndrome (LFS) or Li-Fraumeni Like (LFL) patients. However, the type of TP53 pathogenic germline variant may possibly influence this risk. TP53 p.
View Article and Find Full Text PDFBackground: Total mesorectal excision is the standard radical operation after neoadjuvant chemoradiotherapy for patients with middle/low locally advanced rectal cancer. However, it carries significant rates of morbidity, sexual/urinary dysfunction, fecal impairment and permanent stoma. The ability to identify patients with a complete or nearly-complete response could help steer patients to less-invasive surgery or a watch-and-wait strategy.
View Article and Find Full Text PDFPathologic complete response implies a fewer number of lymph nodes in specimen of rectal cancer patients treated by neoadjuvant therapy and total mesorectal excision.
Int J Surg
August 2018
Article Synopsis
- - Studies suggest that neoadjuvant chemoradiation may lead to a lower yield of lymph nodes in rectal cancer patients, particularly affecting those undergoing total mesorectal excision.
- - In a study of 95 patients who received preoperative treatment, results showed that 81 patients (85%) had 12 or more lymph nodes removed, but only the pathological complete response was linked to having less than 12 lymph nodes harvested.
- - The findings indicate that the number of lymph nodes retrieved shouldn't be used as a measure of successful cancer resection for patients achieving a complete pathological response, despite the limitations of the study's retrospective data collection.
Article Synopsis
- The study aimed to identify clinical and pathological factors affecting complications, survival, and cancer recurrence in patients undergoing multivisceral en bloc resection for colorectal cancer.
- Between January 2009 and February 2014, 105 patients were analyzed, revealing significant statistics like a 37.1% morbidity rate, a 1.9% 30-day mortality rate, and varying rates of recurrence after surgery.
- Key findings indicated that factors such as positive surgical margins and lymph node involvement contributed to poorer oncological outcomes and lower overall survival rates, with lymph node involvement being the most influential factor.
Pathologic Complete Response in Rectal Cancer: Can We Detect It? Lessons Learned From a Proposed Randomized Trial of Watch-and-Wait Treatment of Rectal Cancer.
Dis Colon Rectum
April 2016
Background: Chemoradiotherapy has the potential to downsize and downstage tumors before surgery, decrease locoregional recurrence, and induce a complete sterilization of tumor cells for middle and low locally advanced rectal cancer. A watch-and-wait tactic has been proposed for patients with clinical complete response.
Objective: The purpose of this study was to verify our ability to identify complete clinical response in patients with rectal cancer based on clinical and radiologic criteria.
Background: Introduction of stapled hemorrhoidopexy by Longo in 1998 represented a radical change in the treatment of hemorrhoids. By avoiding multiple excisions and suture lines in the perianal region, stapled hemorrhoidopexy is intended to offer less postoperative pain than with conventional techniques.
Objective: To report and analyze the intra and postoperative results gained during initial experience with stapled hemorrhoidopexy.