João Alexandre Queiroz Juveniz

Universidade Federal de Mato Grosso do Sul

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Marcos F. Dall’Oglio

Hospital São Paulo

Henrique Rodrigues Scherer Coelho

Universidade Federal de Mato Grosso do Sul

Raquel Esther Hermosilla Nunez

Daher C. Chade

Instituto do Câncer do Estado de São Paulo

Miguel Srougi

Universidade de São Paulo

André Costa Matos

Hospital São Rafael

Adriano Nesrallah

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Soares Jp

Faculdade de Tecnologia e Ciências

Cláudio Bovolenta Murta

Dr. Euryclides Hospital de Jesus Zerbini

Andressa de Sousa Pimentel

Universidade Federal de Mato Grosso do Sul

Cooperative Institutions

Universidade de São Paulo

Instituto do Câncer do Estado de São Paulo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Hospital São Paulo

Microsoft (Brazil)

Universidade Federal de Mato Grosso do Sul

Anhanguera-Uniderp University

Hospital Sírio-Libanês

Cancer Institute (WIA)

Universidade Federal de São Paulo

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Predicting outcomes in partial nephrectomy: is the renal score useful?

International braz j urol (2017)

André Costa Matos Marcos F. Dall’Oglio José R. Colombo Alexandre Crippa João Alexandre Queiroz Juveniz

Introduction and Objective The R.E.N.A.L. nephrometry system (RNS) has been validated in multiple open, laparoscopic and robotic partial nephrectomy series. The aim of this study was to test the accuracy of R.E.N.A.L. nephrometry system in predicting perioperative outcomes in surgical treatment of kidney tumors <7.0cm in a prospective model. Materials and Methods Seventy-one patients were selected and included in this prospective study. We evaluate the accuracy of RNS in predicting perioperative outcomes (WIT, OT, EBL, LOS, conversion, complications and surgical margins) in partial nephrectomy using ROC curves, univariate and multivariate analyses. R.E.N.A.L. was divided in 3 groups: low complexity (LC), medium complexity (MC) and high complexity (HC). Results No patients in LC group had WIT >20 min, versus 41.4% and 64.3% MC and HC groups respectively (p=0.03); AUC=0.643 (p=0.07). RNS was associated with convertion rate (LC:28.6% ; MC:47.6%; HC:77.3%, p=0.02). Patients with RNS <8 were most often subjected to partial nephrectomy (93% x 72%, p=0.03) and laparoscopic partial nephrectomy (56.8% x 28%, p=0.02), AUC=0.715 (p=0.002). The RNS was also associated with operative time. Patients with a score >8 had 6.06 times greater chance of having a surgery duration >180 min. (p=0.017), AUC=0.63 (p=0.059). R.E.N.A.L. score did not correlate with EBL, complications (Clavien >3), LOS or positive surgical margin. Conclusion R.E.N.A.L. score was a good method in predicting surgical access route and type of nephrectomy. Also was associated with OT and WIT, but with weak accuracy. Although, RNS was not associated with Clavien >3, EBL, LOS or positive surgical margin.

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10.1590/s1677-5538.ibju.2016.0315

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1881 IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION ON RESIDUAL TUMOR AND UPSTAGING AT RETUR

The Journal of Urology (2013)

João Alexandre Queiroz Juveniz Adriano Nesrallah Alexandre C. Sant'Anna Carlos Hirokatsu Watanabe Silva Cláudio Bovolenta Murta

You have accessJournal of UrologyBladder Cancer: Metastatic Disease + Staging1 Apr 20131881 IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION ON RESIDUAL TUMOR AND UPSTAGING AT RETUR JOÃO ALEXANDRE QUEIROZ JUVENIZ, ADRIANO JOÃO NESRALLAH, ALEXANDRE CRIPPA SANT'ANNA, CARLOS HIROKATSU WATANABE SILVA, CLAUDIO BOVOLENTA MURTA, DAHER CEZAR CHADE, FLAVIO GUILERME MOREIRA ARÊAS, JULIANA NAVES RAVANINI, MAURICIO DENER CORDEIRO, MARCOS FRANCISCO DALL'OGLIO, and MIGUEL SROUGI JOÃO ALEXANDRE QUEIROZ JUVENIZJOÃO ALEXANDRE QUEIROZ JUVENIZ SÃO PAULO, Brazil More articles by this author , ADRIANO JOÃO NESRALLAHADRIANO JOÃO NESRALLAH SÃO PAULO, Brazil More articles by this author , ALEXANDRE CRIPPA SANT'ANNAALEXANDRE CRIPPA SANT'ANNA SÃO PAULO, Brazil More articles by this author , CARLOS HIROKATSU WATANABE SILVACARLOS HIROKATSU WATANABE SILVA SÃO PAULO, Brazil More articles by this author , CLAUDIO BOVOLENTA MURTACLAUDIO BOVOLENTA MURTA SÃO PAULO, Brazil More articles by this author , DAHER CEZAR CHADEDAHER CEZAR CHADE SÃO PAULO, Brazil More articles by this author , FLAVIO GUILERME MOREIRA ARÊASFLAVIO GUILERME MOREIRA ARÊAS SÃO PAULO, Brazil More articles by this author , JULIANA NAVES RAVANINIJULIANA NAVES RAVANINI SÃO PAULO, Brazil More articles by this author , MAURICIO DENER CORDEIROMAURICIO DENER CORDEIRO SÃO PAULO, Brazil More articles by this author , MARCOS FRANCISCO DALL'OGLIOMARCOS FRANCISCO DALL'OGLIO SÃO PAULO, Brazil More articles by this author , and MIGUEL SROUGIMIGUEL SROUGI SÃO PAULO, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2300AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transurethral resection of bladder tumor (TURBT) is the standard procedure for diagnosis and treatment of bladder cancer (BC). However, recurrence and progression rates are still high, possibly related to residual tumors neglected in the initial resection. Our objective was to analyze whether the frozen section for pathologic evaluation during the TURBT is useful in improving the effectiveness of the procedure by increasing muscular layer sample in the material and avoiding incomplete resections. METHODS We prospectively selected 70 consecutive patients assigned to TURBT which were randomized to undergo either frozen section biopsy of the tumor bed during the procedure or standard resection procedure (control group: no frozen section). Both groups were evaluated with a reTURBT. Pathology reports were reviewed by uropathologist. Inclusion criteria: first TURBT without any previous treatment for bladder tumor. Exclusion criteria: incomplete resection, recurrent bladder cancer. Sixty-four patients met the criteria for randomization. (Group 1, n = 28; Group 2, n=36). RESULTS Both groups were comparable regarding age, gender, stage, grade and number of lesions. All patients in group 1 (frozen section) had muscle layer represented, while only 58,3% of patients in the control group (p <0.01). At reTURBT, there was no statistical difference between the groups regarding residual tumor rate (81% without tumor in group 1 versus 73.5% in Group 2, p = 0.054) and pathologic stage (p = 0.075) (Table 1). While all 5 patients in the frozen section group with T2 disease were diagnosed at 1st TURBT, 33.3% (1) of patients with T2 stage in the control group was diagnosed at reTURBT only (Table 2), although not statistically significant probably due to small sample size. CONCLUSIONS Our results supports the prove of principal that frozen section biopsy of bladder tumor bed may increase the diagnosis of T2 disease at first TURBT, which may lead to reduced number of patients who undergo reTURBT and delay until appropriate radical treatment for muscle-invasive BC. Table 1. - Stage in ReTURBT × Group Cis ou Tx (n,%) T0 (n,%) Groups Frozen Biopsy 4 (19) 17 (81) Control 9 (26.5) 25 (73.5) Total 13 (23.6) 42 (76.4) p 0.529 Chi-square test Table 2. - T2 at first TURBT × Group T2 1st TURBT (n,%) ReTURBT (n,%) Groups Frozen Biopsy 5 (100) 0 (0) Control 2 (66.7) 1(33.3) Total 7 (87.5) 1 (12.5) p 0.375 Chi-square test © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e771 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information JOÃO ALEXANDRE QUEIROZ JUVENIZ SÃO PAULO, Brazil More articles by this author ADRIANO JOÃO NESRALLAH SÃO PAULO, Brazil More articles by this author ALEXANDRE CRIPPA SANT'ANNA SÃO PAULO, Brazil More articles by this author CARLOS HIROKATSU WATANABE SILVA SÃO PAULO, Brazil More articles by this author CLAUDIO BOVOLENTA MURTA SÃO PAULO, Brazil More articles by this author DAHER CEZAR CHADE SÃO PAULO, Brazil More articles by this author FLAVIO GUILERME MOREIRA ARÊAS SÃO PAULO, Brazil More articles by this author JULIANA NAVES RAVANINI SÃO PAULO, Brazil More articles by this author MAURICIO DENER CORDEIRO SÃO PAULO, Brazil More articles by this author MARCOS FRANCISCO DALL'OGLIO SÃO PAULO, Brazil More articles by this author MIGUEL SROUGI SÃO PAULO, Brazil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

10.1016/j.juro.2013.02.2300

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INFECÇÕES CAUSADAS POR N. GONORRHOEAE: PERFIL EPIDEMIOLÓGICO EM CAPITAL DA REGIÃO CENTRO-OESTE

The Brazilian Journal of Infectious Diseases (2022)

Andressa de Sousa Pimentel Alan Das Neves Mellânia Rodriges Goveia Gleyson Murillo Aguilera Moraes Tauanne Fernanda Dos Santos

A gonorreia é a segunda infecção sexualmente transmissível (IST) mais prevalente no mundo. No Brasil, o diagnóstico e tratamento dessa infecção apresenta abordagem sindrômica, característica que dificulta a identificação da população usualmente acometida. O respectivo trabalho objetiva conhecer o perfil epidemiológico de paciente com Gonorreia no Centro de Triagem e Aconselhamento, referência em Campo Grande - MS. Foram incluídos no estudo pacientes com infecções causadas por N. gonorrhoeae atendidos no período de 03/05/2021 a 30/07/2021 no Centro de Testagem e Aconselhamento "Dr. Gessírio Domingos Mendes" - CTA/DST em Campo Grande - MS. A análise microbiológica foi realizada no Laboratório do Hospital Universitário de Mato Grosso do Sul. A coleta de dados clínicos foi realizada em entrevista realizada pelo médico do serviço. Dos 21 pacientes incluídos no estudo, todos eram homens e solteiros, sendo a maioria situada na faixa etária entre 21 e 40 anos (85,7%). Quanto a escolaridade, 28,6% concluíram o ensino médio e 28,0% apresentaram ensino superior completo. Somente 19,0% dos entrevistados faziam regular uso da camisinha. Do total de pacientes, 19% mantinham relação com homens, 66,7% com mulheres e 14,3% com ambos. Cerca de 19,0% possuía parceiro fixo, enquanto 42% não trocaram de parceiro nos últimos 6 meses. Quanto aos sintomas, 91,0% referiram corrimento uretral e 42,8% relataram disúria. A bacterioscopia foi positiva em 12 amostras, sendo que somente 6 meios foi observado o crescimento em cultura e 3 obtiveram resultados negativos mesmo com secreção presente sugerindo a doença. O estudo demonstra que jovens heterossexuais, com média/alta escolaridade e parceiro/a fixo estão sendo acometidos por IST´s, visto que maioria destes pacientes não utilizam preservativo durante o ato sexual. O perfil epidemiológico observado difere daquele apresentado comumente na literatura nacional e internacional, as quais descrevem pacientes homossexuais, com baixa escolaridade e/ou com elevada troca de parceiro como população padrão dessa infecção. A mudança epidemiológica indica alterações das ações de prevenção, de modo que campanhas de conscientização façam-se mais presentes neste meio. O aumento da incidência em pacientes heterossexuais acende um alerta secundário para suas respectivas parceiras, uma vez que estas tendem a apresentar uma manifestação subclínica e complicações severas da doença.

10.1016/j.bjid.2021.102190

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High R.E.N.A.L. nephrometry score is associated with partial to total nephrectomy conversion, in treatment of renal cancer

Surgery and Rehabilitation (2018)

Soares Jp André Costa‐Matos Toledo LGM João Alexandre Queiroz Juveniz Dall Oglio M

Aim: To test the hypothesis that R.E.N.A.L. nephrometry score is able to predict surgical conversion, from laparoscopic to open nephrectomy, or totalization, from partial to total nephrectomy. Methods:Between January 2010 and June 2012, 320 patients underwent radical or partial nephrectomy at a Tertiary Institution, of which 173 (54.1%) had a tumor <7cm.Of these, 71 (41%) patients were selected for the prospective study according to inclusion and exclusion criteria.Score's accuracy in predicting surgical conversion rate was analyzed by using ROC curve and it's best cutoff point was identified. Results:The accuracy of R.E.N.A.L. nephrometry score in predicting conversion rate demonstrated an AUC of 0.715 (95% CI: 0.595-0.836;p=0.002).By evaluating a cutoff point, it was found 46% sensitivity and 78% specificity for R.E.N.A.L. >9.From patients who underwent totalization, 4/46 (8.9%) had a R.E.N.A.L. score <9 and 7/25 (28%) had a R.E.N.A.L. score ≥9, OR 4.08, p=0.03. Conclusion:R.E.N.A.L. nephrometry score can help predicting the need of total nephrectomy or conversion to open surgery.Renal unit loss was associated with high complexity tumors (score ≥9), with this cutoff point representing a fourfold higher chance of conversion from partial nephrectomy to radical in treatment of renal cancer.

Renal tumor

10.15761/srj.1000131

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A importância da biópsia de congelação como método complementar à ressecção endoscópica em câncer de bexiga: um estudo prospectivo randomizado

João Alexandre Queiroz Juveniz

Background and Purpose: Despite recent improvements of bladder cancer treatment, recurrence and progression rates are still high, possibly related to residual or overlooked tumors at the first transurethral resection (TUR), which strongly emphasizes the importance of the quality of this method.In order to improve the effectiveness of the procedure, we sought to evaluate the impact of frozen section during TUR, aiming on increasing muscular layer sample in the specimen, which may minimize incomplete resections and understaging.Patients and Methods: We prospectively included 150 consecutive patients assigned to TUR which were randomized to undergo either frozen section biopsy of the tumor bed during the TUR procedure until muscle was obtained or standard resection procedure (no frozen section).Nineteen patients were excluded after randomization, leaving 131 for analysis.All patients underwent a second TUR performed 4-6 weeks later.Frozen sections and final pathology reports were centralized and all performed by pathologists, the doubtful cases were reviewed by one uropathologist.Exclusion criteria: incomplete resection at first TUR, no criteria for second TUR according to EUA Guideline Update 2011 and previous bladder cancer treatment.(Group w/ biopsy, n = 64; Group control, n=67).Results: Both groups were comparable regarding age, gender, size and number of lesions.The majority of patients had high grade tumor in both groups.In the group where frozen section was obtained, muscle-invasive disease was higher (23% x 3%, p<0,001).All patients in this group had muscle layer represented in the final pathology at the first TUR, while only 60% of patients in the control group (p <0.001), including 40,5% of patients with pTa, 81,5% with pT1 e 100% with pT2 and Cis.Ninety percent of patients in the biopsy group had no residual tumor compared to 65% of the control group at second TUR (p=0,002).While all 15 patients in the frozen section group with T2 disease were diagnosed at first Abstract TUR, only 2 of 6 patients (33%) in the control group were diagnosed initially.The surgery duration was longer in the study group with mean of 50 min x 42 min (p=0,037) and there were no significant differences regarding complications (perforation and transfusion rates).Conclusion: Our results support the prove of principal that standard TUR with frozen section biopsy of bladder tumor bed increase the disease control and improve the diagnosis of T2 tumors, which may lead to reduced the number of patients in need a second TUR and avoid pT2 disease diagnosis delay, with no more complications.

Guideline

10.11606/t.5.2017.tde-18012017-153659

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Carcinoma de células renais claras e de origem genética: relato de caso

Brazilian Journal of Health Review (2023)

Daniel Galvão Vidal Henrique Rodrigues Scherer Coelho João Alexandre Queiroz Juveniz Laís Namy Nakasse Mori Antônio Augusto Palombo Mendes

O propósito desta investigação foi caracterizar a condução e o tratamento de uma patologia, especificamente um caso raro de Neoplasia Renal bilateral, tendo como referência as informações obtidas no prontuário do paciente e no seguimento ambulatorial. O método de pesquisa utilizado foi o de relato de caso, no qual a metodologia adotada pautou-se na coleta cronológico de dados do prontuário médico, desde a admissão no hospital até os retornos ambulatoriais. O paciente em questão era do sexo masculino, 33 anos, sendo acompanhado desde o seu diagnóstico até a fase de tratamento em que se encontrava. Compareceu à unidade de Pronto Atendimento do Hospital Universitário Maria Aparecida Pedrossian com quadro de hematúria macroscópica associada a dor em flanco bilateral. Realizou-se tomografia com contraste, tendo evidência de doença policística renal e pancreática, além de lesões neoplásicas bilateral. Realizou-se também Nefrectomia Parcial à direita e pesquisa genética com diagnóstico de doença de von Hippel-Lindau, a qual deve ser lembrada em pacientes com neoplasia renal, principalmente associada a outros comemorativos, sendo que o seu diagnóstico permite ao paciente uma condução clínica mais assertiva e individualizada.

10.34119/bjhrv6n2-062

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MP65-10 THE IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION: A RANDOMIZED PROSPECTIVE TRIAL

The Journal of Urology (2014)

João Alexandre Queiroz Juveniz Alexandre Crippa Sant Anna Marcos Francisco Dall Oglio Adriano Nesrallah

You have accessJournal of UrologyBladder Cancer: Staging1 Apr 2014MP65-10 THE IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION: A RANDOMIZED PROSPECTIVE TRIAL João Alexandre Queiroz Juveniz, Alexandre Crippa Sant Anna, Marcos Francisco, Dall Oglio, Adriano João Nesrallah, Daher Cezar Chade, Sanarelly Pires Adonias, Andre Costa Matos, and Miguel Srougi João Alexandre Queiroz JuvenizJoão Alexandre Queiroz Juveniz More articles by this author , Alexandre Crippa Sant AnnaAlexandre Crippa Sant Anna More articles by this author , Marcos FranciscoMarcos Francisco More articles by this author , Dall OglioDall Oglio More articles by this author , Adriano João NesrallahAdriano João Nesrallah More articles by this author , Daher Cezar ChadeDaher Cezar Chade More articles by this author , Sanarelly Pires AdoniasSanarelly Pires Adonias More articles by this author , Andre Costa MatosAndre Costa Matos More articles by this author , and Miguel SrougiMiguel Srougi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1907AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite recent improvements of bladder cancer treatment, recurrence and progression rates are still high, possibly related to residual or overlooked tumors at the first transurethral resection (TURBT), which strongly emphasizes the importance of this method. In order to improve the effectiveness, we sought to evaluate the impact of frozen section during TURBT, aiming on increasing muscular layer sample in the specimen, which may minimize incomplete resections and understaging. METHODS We prospectively included 150 consecutive patients assigned to TURBT which were randomized to undergo either frozen biopsy of the tumor bed until muscle was obtained or standard resection procedure. Nineteen patients were excluded after randomization, leaving 131 for analysis. All patients repeated TURBT 4-6 weeks later. Frozen sections and final pathology reports were performed by an uropathologist. Exclusion criteria: incomplete resection at first TURBT, no criteria for repeat TURBT according to AUA Guideline and previous bladder cancer treatment (Biopsy Group, n = 64; Control Group, n=67). RESULTS Both groups were comparable regarding age, gender, size and number of lesions. All patients in the biopsy group had muscle layer represented in the final pathology at TURBT, while only 59% of patients in the control group (p <0.001) and muscle-invasive disease was higher in this first group (23% x 3%, p=0,001). Ninety percent of patients in the biopsy group had no residual tumor compared to 65% of the control group at repeat TURBT (p=0,003). While all 15 patients in the biopsy group with T2 disease were diagnosed at first TURBT, only 2 of 6 patients (33%) in the control group were diagnosed initially. There were no significant differences between groups regarding complications and surgery duration. CONCLUSIONS Our results support the prove of principal that standard TURBT with frozen biopsy of bladder tumor bed increase the disease control and T2 tumors diagnosis, which may lead to reduced number of patients in need a second TUR and avoid pT2 disease diagnosis delay. Stage in Repeat TURBT x Group Stage Cis or Tx (%) T0 (%) Group Biopsy 5 (10) 45 (90) Control 20 (35) 36 (65) p 0.003 Chi-square test Cis: Carcinoma in situ; Tx: pTa,pT1 and pT2 pT2 diagnose at first x Group pT2 First TURBT ( %) Repeat TURBT (%) Group Biopsy 15 (100) 0 (0) Control 2 (33) 4(67) p 0,003 Fisher test © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e695 Advertisement Copyright & Permissions© 2014MetricsAuthor Information João Alexandre Queiroz Juveniz More articles by this author Alexandre Crippa Sant Anna More articles by this author Marcos Francisco More articles by this author Dall Oglio More articles by this author Adriano João Nesrallah More articles by this author Daher Cezar Chade More articles by this author Sanarelly Pires Adonias More articles by this author Andre Costa Matos More articles by this author Miguel Srougi More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

10.1016/j.juro.2014.02.1907

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INFLAMMATORY MYOFIBROBLASTIC TUMOR OF THE BLADDER: A CASE REPORT

International Journal of Health Science (2025)

Raquel Esther Hermosilla Nunez João Gilberto Kazuo Aguena Henrique Rodrigues Scherer Coelho Marilza Campos de Magalhães João Alexandre Queiroz Juveniz

Bladder tumor

10.22533/at.ed.1595102511028

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