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Papers by Valter Penna

Revista Brasileira De Ortopedia, 1998

ACM arq. catarin. med, 1997

Os autores têm como objetivo mostrar as taxas de cirurgias conservadoras, com o tratamento multid... more Os autores têm como objetivo mostrar as taxas de cirurgias conservadoras, com o tratamento multidisciplinar de tumores ósseos malignos. Setenta por cento dos 174 pacientes com osteossarcoma tratados com quimioterapia préoperatória no Hospital A.C. Camargo, no período de 1981 a 1994 tiveram os membros preservados, com taxa de recidiva local de 4% em seguimento médio de 5 anos. Fato semelhante ocorreu com o sarcoma de Ewing. Os autores concluem que além do impacto importante na sobrevida, a quimioterapia trouxe melhora significativa na qualidade de vida desses pacientes, pela preservação dos membros.

Annals of Vascular Surgery, Jul 1, 2003

Patients with tumors in limbs who undergo surgical treatment may present involvement of major ves... more Patients with tumors in limbs who undergo surgical treatment may present involvement of major vessels. The artery must be reconstructed for limb salvage and the vein may be reconstructed to avoid the onset of venous hypertension. The objective of this study was to analyze the results from surgical treatment of tumors associated with vascular reconstruction in limbs. A prospective follow-up was made of 17 patients with tumors involving major vessels in limbs who underwent vascular reconstruction. Arterial and venous reconstructions were performed in nine patients, arterial reconstruction was performed in six, and venous reconstruction in two patients. The vascular substitutes used were greater saphenous vein (19), expanded polytetrafluoroethylene prosthesis (5), and Dacron prosthesis (2). Vascular complications occurred in seven patients: one arterial graft rupture, three venous graft occlusions, and lymphedema in five patients. The following nonvascular complications occurred in 10 patients: pulmonary metastasis (7), local recurrence (2), neurological deficit (2), infection (2), partial necrosis of the flap (1), and enteric fistula (1). Six patients with pulmonary metastasis died. One patient underwent transfemoral amputation. Major vessel reconstruction in limbs associated with resection of neoplasms is a safe procedure. Venous revascularization should be performed using an autologous substitute.

Revista Brasileira De Ortopedia, 1996

* Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São P... more * Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São Paulo. 1. Diretor do Departamento de Cirurgia Pélvica. 2. Diretor do Departamento de Anatomia Patológica. 3. Médico Assistente do Departamento de Cirurgia Pélvica. 4. ...

Revista Brasileira De Ortopedia, Sep 1, 2011

Objectives: To evaluate the long-term clinical and radiological results from patients who underwe... more Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with

Orthopaedic Proceedings, Jul 1, 2010

The giant cell tumor of bone (GCT) is a locally aggressive intraosseous neoplasm, with an uncerta... more The giant cell tumor of bone (GCT) is a locally aggressive intraosseous neoplasm, with an uncertain biological behavior, constituted of giant multinuclear cells spread over tumoral tissue with a nucleus presenting the same features of the ovoid and fusiform cells forming its stroma. The local recurrence of GCT is often observed, mainly in the first three years after treatment, giving a rate of recurrence ranging in 20 to 50% of cases. Further aggravating the recurrence is the fact that after the relapse, the patient often also presents metastases in other organs. The aim of this study was to identify and to characterize differentially expressed genes that can be used in the prognostic, treatment and understanding of this physiopathology. To identify novel genes differentially expressed in GCT, we have applied rapid subtractive hybridization (RaSH). Samples of GCT and normal tissues were obtained at Tumor Bank of Barretos Cancer Hospital. After RNA extraction and cDNA synthesis the samples were submitted to Rapid hybridization Subtraction (RaSH) methodology for subtractive libraries elaboration. The RaSH subtractive libraries reveals the presence of 619 different clones including both normal and tumor tissues were identified. Of these, 450 in tumor sample and 169 in control tissue. Four biomarkers candidates were selected for validation: ZAK, KTN1, NEB, and ROCK1 genes, whose functions are, related to cell cycle checkpoint, transport of organelles, cytoskeletal matrix and cell adhesions. The validation of selected differentially expressed genes was performed using real time PCR. The putative molecular markers found in this work may help to find the basis for a molecular comprehension of GCT, thus improving diagnosis, treatment and outcome for patients with this tumor.

Revista Brasileira De Ortopedia, 1993

... DE REZENDE, GILBERTO LUIZ CAMANHO, ARNALDO JOS?? HERNANDEZ Ap??s a ... tratamento multidiscip... more ... DE REZENDE, GILBERTO LUIZ CAMANHO, ARNALDO JOS?? HERNANDEZ Ap??s a ... tratamento multidisciplinar * AUTORES:VALTER PENNA, ADEMAR LOPES, MARCOS HAJIME TANAKA, WU ... CLAUDIO BONAMIN, LUIZ CARLOS SOBANIA, NELSON OTSUKA, ROBERTO L ...

Revista Brasileira de Ortopedia, Feb 1, 2009

Objetivo: As endopróteses parciais de joelho para as ressecções em sarcomas ósseos demonstram ser... more Objetivo: As endopróteses parciais de joelho para as ressecções em sarcomas ósseos demonstram serem boa solução para o tratamento de pacientes com imaturidade esquelética. O objetivo deste estudo é avaliar o escore funcional, as vantagens, as desvantagens e indicações para esta técnica cirúrgica em quatorze pacientes em um protocolo brasileiro de osteossarcoma e sarcoma de Ewing. Métodos: Análise retrospectiva realizada para identificar a evolução funcional e as possíveis complicações do procedimento. 14 pacientes com idade entre 10 e 22 anos avaliados funcionalmente pelos critérios de Enneking/ISOLS (International Society of Limb Salvage), sendo todos operados na mesma Instituição e pelo mesmo cirurgião. Foram utilizadas endopróteses parciais das extremidades distal do fêmur e proximal da tíbia com reconstrução ligamentar. Resultados: A análise do escore funcional de Enneking/ISOLS demonstrou 78,6 % de excelentes resultados e 21,4% de bons. Dos 14 pacientes, todos portadores de tumores primitivos ósseos em protocolo de quimioterapia, nove não apresentaram nenhum tipo de complicação e cinco indivíduos evoluíram com complicações relacionadas ao procedimento, sendo que houve relação estatística positiva entre os maus resultados e a presença de complicações (p=0,027). Conclusão: As endopróteses parciais de joelhos são menos prejudiciais ao estoque ósseo de pacientes com esqueleto imaturo. As críticas sobre os maus resultados funcionais estão sendo suplantadas pelas novas técnicas de reconstrução, corretos protocolos de reabilitação, qualidade e tecnologia dos implantes, e o aumento da curva de aprendizado. Essa opção de tratamento permite a preservação do estoque ósseo e a possibilidade de revisão da artroplastia não convencional de modo menos agressivo.

Clinical Orthopaedics and Related Research, Sep 1, 1991

IIB osteosarcoma. Current management, local control, and survival statistics-São Paulo, Brazil.

Revista Brasileira De Ortopedia, 1993

Jornal of the Foot & Ankle, Aug 31, 2021

We report an unusual case of extra-articular gouty tophus in the left medial malleolus. A 33-year... more We report an unusual case of extra-articular gouty tophus in the left medial malleolus. A 33-year-old man with a previous diagnosis of chronic gout presented with mild, non-disabling ankle pain associated with gout attacks. Imaging and histopathologic findings were inconclusive. The tumor was surgically resected, and the cavity was filled with methyl methacrylate. Histopathology confirmed the diagnosis in a sample collected intraoperatively. Giant cell tumor and bone cyst were ruled out. The patient had a good postoperative outcome.

* Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São P... more * Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São Paulo. 1. Diretor do Departamento de Cirurgia Pélvica. 2. Diretor do Departamento de Anatomia Patológica. 3. Médico Assistente do Departamento de Cirurgia Pélvica. 4. ...

Arquivos Brasileiros de Endocrinologia & Metabologia, 2014

Objective: To conduct a literature review on the diagnosis and management of Paget’s disease of b... more Objective: To conduct a literature review on the diagnosis and management of Paget’s disease of bone. Materials and methods: This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society of Endocrinology and Metabolism (SBEM) as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the Endocrine Society, Brazilian Society for Endocrinology Annual Meetings and the American Society for Bone and Mineral Research Annual Meeting during the last 5 years. Grading quality of evidence and strength of recommendation were adapted from the first report of the Oxford Centre for Evidence-based Medicine. All grades of recommendation, including “D”, are based on scientific evidence. The differences between A, B, C and D, are due exclusively to the methods employed in generating evidence. Conclusion: We present a scientific statement on Pag...

Acta Ortopedica Brasileira, 2011

Of these, seven were treated with external hemipelvectomy (classic) and 14 with internal hemipelv... more Of these, seven were treated with external hemipelvectomy (classic) and 14 with internal hemipelvectomy. Evaluation was done based on Enneking's surgical classification for internal hemipelvectomy. Results: Overal survival in two years was 63,9%. Median survival of 43 months. Functional outcomes demonstrated that procedures with inominate bone ressection reached 12,5%, 62,5% and 25% of bad, good and excellent results, respectively. When inominate bone was preserved the results were 16,7% and 83,3% good and excellent, respectively. No endoprosthesis or bone graft reconstructions were done. Conclusions: Hemipelvectomy is an unusual procedure that is rarely performed because it is infrequently indicated and because of its high morbidity rate. In some reports, the morbidity rate has reached 77% of the cases. We did not perform any type of reconstruction or arthrodesis based on complications and the experience of good results with this method. Our results are similar to the main reports and are still subject of discussion by the oncologic surgeons. Level of evidence IV, Case-control study.

Revista de Medicina, 2009

Objetivos: Fornecer informações sobre a doença de Camurati-Engelmann, também conhecida como Displ... more Objetivos: Fornecer informações sobre a doença de Camurati-Engelmann, também conhecida como Displasia Diafisária Progressiva, possibilitando o seu diagnóstico pelo profissional de saúde. Método: Relato de caso associado a revisão da literatura científica sobre o tema. Discussão: Doença rara, de herança autossômica dominante, caracterizada por hiperostose progressiva com envolvimento das diáfises dos ossos. Os sintomas mais comuns são dores em extremidades, alteração da deambulação, fatigalibidade e fraqueza muscular. Seu diagnóstico é clínico-radiológico. O tratamento consiste basicamente na administração de glicocorticóides e anti-inflamatórios não esteroidais para melhorar os sintomas clínicos como dor e fadiga.

Journal of Adolescent and Young Adult Oncology, 2013

Little information is available regarding the tumor features, prognostic factors, and treatment r... more Little information is available regarding the tumor features, prognostic factors, and treatment results in children and adolescents and young adults (AYAs) with osteosarcoma diagnosed in developing countries. We reviewed the results of three observational cohorts of osteosarcoma patients treated in an emerging country. Methods: A total of 604 patients below the age of 30 years with high-grade osteosarcoma were prospectively enrolled in the Brazilian Osteosarcoma Treatment Group (BOTG) studies III, IV, and V. Gender, age, time from onset of symptoms to diagnosis, primary tumor site, presence or absence of metastases at diagnosis, tumor size, type of surgery (limb-sparing or amputation), treatment protocol, and histological response were correlated with survival. Results: The estimated 5-year overall survival and event-free survival (EFS) rates for the 553 eligible patients were 49% and 39% respectively; of the 390 non-metastatic patients included in the total, overall-and event-free survival were 59% and 48% respectively. Metastases at diagnosis, primary tumor site, type of surgery, and histological response were significant predictors of overall survival and EFS in univariate and multivariate analysis, whereas tumor size and treatment protocol lost prognostic significance in multivariate analysis. Conclusion: We report on the outcome of three consecutive studies for the treatment of osteosarcoma carried out in Brazil over 15 years. Although the survival rates presented are below those reported in current literature, it represents the result of a favorable experience gathered from the national collaborative work.

The authors show the value of multidisciplinary treatment on limb sparing of patients with malign... more The authors show the value of multidisciplinary treatment on limb sparing of patients with malignant bone tumors. From 1981 to 1994, 70% of 174 patients with osteosarcoma treated with pre-operative chemotherapy, had limb sparing surgery with recurrence rate of 4% in mean follow-up of 5 years. Similar results were achieved in patients with Ewing’s sarcoma. The authors print out the improvement in survival and quality of life with multidisciplinar approach. *Trabalho realizado no Departamento de Cirurgia Pélvica do Hospital A. C. Camargo da Fundação Antonio Prudente São Paulo SP. 1Titulares do Serviço de Ortopedia Diretor do Departamento de Cirurgia Pélvica Endereço para correspondência: Ademar Lopes Hospital A.C. Campos Rua Prof. Antonio Prudente, 211 São Paulo SP Descritores: Osteossarcoma Sarcoma de Ewing cirurgia

Objetivo: Demonstrar a experiência de uma única instituição em hemipelvectomias internas sem reco... more Objetivo: Demonstrar a experiência de uma única instituição em hemipelvectomias internas sem reconstrução. Avaliar as cirurgias pélvicas preservadoras e as amputações interílio-abdominais e seu prognóstico. Métodos: 21 pacientes com tumores primitivos pélvicos submetidos à hemipelvectomia com ou sem preservação de membro. Sete foram tratados com hemipelvectomias externas (amputação) e 14 com internas, entre junho de 2004 e julho de 2009. A classificação cirúrgica utilizada foi a de Enneking para tumores pélvicos. O método de avaliação funcional foi o escore de ISOLS/MSTS. Resultados: A sobrevida dos pacientes em dois anos foi de 63,9%. A média de sobrevida do grupo todo foi de 43 meses. A avaliação funcional demonstrou que as hemipelvectomias preservadoras com ressecção do osso inominado obtiveram 12,5%, 62,5% e 25% de resultados ruins, bons e excelentes, respectivamente. Nos casos em que o osso inominado foi preservado, os resultados foram 16,7% e 83,3% bons e excelentes, respectiv...

Acta Ortopedica Brasileira, 2012

Objetivo: Demonstrar a experiencia de uma unica instituicao em hemipelvectomias internas sem reco... more Objetivo: Demonstrar a experiencia de uma unica instituicao em hemipelvectomias internas sem reconstrucao. Avaliar as cirurgias pelvicas preservadoras e as amputacoes interilio-abdominais e seu prognostico. Materiais e Metodos: 21 pacientes com tumores primitivos pelvicos submetidos a hemipelvectomia com ou sem preservacao de membro. Sete foram tratados com hemipelvectomias externas (amputacao) e 14 com internas, entre junho de 2004 e julho de 2009. A classificacao cirurgica utilizada foi a de Enneking para tumores pelvicos. O metodo de avaliacao funcional foi o escore de ISOLS/MSTS. Resultados: A sobrevida dos pacientes em dois anos foi de 63,9%. A media de sobrevida do grupo todo foi de 43 meses. A avaliacao funcional demonstrou que as hemipelvectomias preservadoras com resseccao do osso inominado obtiveram 12,5%, 62,5% e 25% de resultados ruins, bons e excelentes, respectivamente. Nos casos em que o osso inominado foi preservado, os resultados foram 16,7% e 83,3% bons e excelente...

Revista Brasileira De Ortopedia, 1998

ACM arq. catarin. med, 1997

Os autores têm como objetivo mostrar as taxas de cirurgias conservadoras, com o tratamento multid... more Os autores têm como objetivo mostrar as taxas de cirurgias conservadoras, com o tratamento multidisciplinar de tumores ósseos malignos. Setenta por cento dos 174 pacientes com osteossarcoma tratados com quimioterapia préoperatória no Hospital A.C. Camargo, no período de 1981 a 1994 tiveram os membros preservados, com taxa de recidiva local de 4% em seguimento médio de 5 anos. Fato semelhante ocorreu com o sarcoma de Ewing. Os autores concluem que além do impacto importante na sobrevida, a quimioterapia trouxe melhora significativa na qualidade de vida desses pacientes, pela preservação dos membros.

Annals of Vascular Surgery, Jul 1, 2003

Patients with tumors in limbs who undergo surgical treatment may present involvement of major ves... more Patients with tumors in limbs who undergo surgical treatment may present involvement of major vessels. The artery must be reconstructed for limb salvage and the vein may be reconstructed to avoid the onset of venous hypertension. The objective of this study was to analyze the results from surgical treatment of tumors associated with vascular reconstruction in limbs. A prospective follow-up was made of 17 patients with tumors involving major vessels in limbs who underwent vascular reconstruction. Arterial and venous reconstructions were performed in nine patients, arterial reconstruction was performed in six, and venous reconstruction in two patients. The vascular substitutes used were greater saphenous vein (19), expanded polytetrafluoroethylene prosthesis (5), and Dacron prosthesis (2). Vascular complications occurred in seven patients: one arterial graft rupture, three venous graft occlusions, and lymphedema in five patients. The following nonvascular complications occurred in 10 patients: pulmonary metastasis (7), local recurrence (2), neurological deficit (2), infection (2), partial necrosis of the flap (1), and enteric fistula (1). Six patients with pulmonary metastasis died. One patient underwent transfemoral amputation. Major vessel reconstruction in limbs associated with resection of neoplasms is a safe procedure. Venous revascularization should be performed using an autologous substitute.

Revista Brasileira De Ortopedia, 1996

* Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São P... more * Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São Paulo. 1. Diretor do Departamento de Cirurgia Pélvica. 2. Diretor do Departamento de Anatomia Patológica. 3. Médico Assistente do Departamento de Cirurgia Pélvica. 4. ...

Revista Brasileira De Ortopedia, Sep 1, 2011

Objectives: To evaluate the long-term clinical and radiological results from patients who underwe... more Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with

Orthopaedic Proceedings, Jul 1, 2010

The giant cell tumor of bone (GCT) is a locally aggressive intraosseous neoplasm, with an uncerta... more The giant cell tumor of bone (GCT) is a locally aggressive intraosseous neoplasm, with an uncertain biological behavior, constituted of giant multinuclear cells spread over tumoral tissue with a nucleus presenting the same features of the ovoid and fusiform cells forming its stroma. The local recurrence of GCT is often observed, mainly in the first three years after treatment, giving a rate of recurrence ranging in 20 to 50% of cases. Further aggravating the recurrence is the fact that after the relapse, the patient often also presents metastases in other organs. The aim of this study was to identify and to characterize differentially expressed genes that can be used in the prognostic, treatment and understanding of this physiopathology. To identify novel genes differentially expressed in GCT, we have applied rapid subtractive hybridization (RaSH). Samples of GCT and normal tissues were obtained at Tumor Bank of Barretos Cancer Hospital. After RNA extraction and cDNA synthesis the samples were submitted to Rapid hybridization Subtraction (RaSH) methodology for subtractive libraries elaboration. The RaSH subtractive libraries reveals the presence of 619 different clones including both normal and tumor tissues were identified. Of these, 450 in tumor sample and 169 in control tissue. Four biomarkers candidates were selected for validation: ZAK, KTN1, NEB, and ROCK1 genes, whose functions are, related to cell cycle checkpoint, transport of organelles, cytoskeletal matrix and cell adhesions. The validation of selected differentially expressed genes was performed using real time PCR. The putative molecular markers found in this work may help to find the basis for a molecular comprehension of GCT, thus improving diagnosis, treatment and outcome for patients with this tumor.

Revista Brasileira De Ortopedia, 1993

... DE REZENDE, GILBERTO LUIZ CAMANHO, ARNALDO JOS?? HERNANDEZ Ap??s a ... tratamento multidiscip... more ... DE REZENDE, GILBERTO LUIZ CAMANHO, ARNALDO JOS?? HERNANDEZ Ap??s a ... tratamento multidisciplinar * AUTORES:VALTER PENNA, ADEMAR LOPES, MARCOS HAJIME TANAKA, WU ... CLAUDIO BONAMIN, LUIZ CARLOS SOBANIA, NELSON OTSUKA, ROBERTO L ...

Revista Brasileira de Ortopedia, Feb 1, 2009

Objetivo: As endopróteses parciais de joelho para as ressecções em sarcomas ósseos demonstram ser... more Objetivo: As endopróteses parciais de joelho para as ressecções em sarcomas ósseos demonstram serem boa solução para o tratamento de pacientes com imaturidade esquelética. O objetivo deste estudo é avaliar o escore funcional, as vantagens, as desvantagens e indicações para esta técnica cirúrgica em quatorze pacientes em um protocolo brasileiro de osteossarcoma e sarcoma de Ewing. Métodos: Análise retrospectiva realizada para identificar a evolução funcional e as possíveis complicações do procedimento. 14 pacientes com idade entre 10 e 22 anos avaliados funcionalmente pelos critérios de Enneking/ISOLS (International Society of Limb Salvage), sendo todos operados na mesma Instituição e pelo mesmo cirurgião. Foram utilizadas endopróteses parciais das extremidades distal do fêmur e proximal da tíbia com reconstrução ligamentar. Resultados: A análise do escore funcional de Enneking/ISOLS demonstrou 78,6 % de excelentes resultados e 21,4% de bons. Dos 14 pacientes, todos portadores de tumores primitivos ósseos em protocolo de quimioterapia, nove não apresentaram nenhum tipo de complicação e cinco indivíduos evoluíram com complicações relacionadas ao procedimento, sendo que houve relação estatística positiva entre os maus resultados e a presença de complicações (p=0,027). Conclusão: As endopróteses parciais de joelhos são menos prejudiciais ao estoque ósseo de pacientes com esqueleto imaturo. As críticas sobre os maus resultados funcionais estão sendo suplantadas pelas novas técnicas de reconstrução, corretos protocolos de reabilitação, qualidade e tecnologia dos implantes, e o aumento da curva de aprendizado. Essa opção de tratamento permite a preservação do estoque ósseo e a possibilidade de revisão da artroplastia não convencional de modo menos agressivo.

Clinical Orthopaedics and Related Research, Sep 1, 1991

IIB osteosarcoma. Current management, local control, and survival statistics-São Paulo, Brazil.

Revista Brasileira De Ortopedia, 1993

Jornal of the Foot & Ankle, Aug 31, 2021

We report an unusual case of extra-articular gouty tophus in the left medial malleolus. A 33-year... more We report an unusual case of extra-articular gouty tophus in the left medial malleolus. A 33-year-old man with a previous diagnosis of chronic gout presented with mild, non-disabling ankle pain associated with gout attacks. Imaging and histopathologic findings were inconclusive. The tumor was surgically resected, and the cavity was filled with methyl methacrylate. Histopathology confirmed the diagnosis in a sample collected intraoperatively. Giant cell tumor and bone cyst were ruled out. The patient had a good postoperative outcome.

* Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São P... more * Trab. realiz. no Dep. de Cirurgia Pélvica do Hosp. AC Camargo da Fund. Antonio Prudente – São Paulo. 1. Diretor do Departamento de Cirurgia Pélvica. 2. Diretor do Departamento de Anatomia Patológica. 3. Médico Assistente do Departamento de Cirurgia Pélvica. 4. ...

Arquivos Brasileiros de Endocrinologia & Metabologia, 2014

Objective: To conduct a literature review on the diagnosis and management of Paget’s disease of b... more Objective: To conduct a literature review on the diagnosis and management of Paget’s disease of bone. Materials and methods: This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society of Endocrinology and Metabolism (SBEM) as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the Endocrine Society, Brazilian Society for Endocrinology Annual Meetings and the American Society for Bone and Mineral Research Annual Meeting during the last 5 years. Grading quality of evidence and strength of recommendation were adapted from the first report of the Oxford Centre for Evidence-based Medicine. All grades of recommendation, including “D”, are based on scientific evidence. The differences between A, B, C and D, are due exclusively to the methods employed in generating evidence. Conclusion: We present a scientific statement on Pag...

Acta Ortopedica Brasileira, 2011

Of these, seven were treated with external hemipelvectomy (classic) and 14 with internal hemipelv... more Of these, seven were treated with external hemipelvectomy (classic) and 14 with internal hemipelvectomy. Evaluation was done based on Enneking's surgical classification for internal hemipelvectomy. Results: Overal survival in two years was 63,9%. Median survival of 43 months. Functional outcomes demonstrated that procedures with inominate bone ressection reached 12,5%, 62,5% and 25% of bad, good and excellent results, respectively. When inominate bone was preserved the results were 16,7% and 83,3% good and excellent, respectively. No endoprosthesis or bone graft reconstructions were done. Conclusions: Hemipelvectomy is an unusual procedure that is rarely performed because it is infrequently indicated and because of its high morbidity rate. In some reports, the morbidity rate has reached 77% of the cases. We did not perform any type of reconstruction or arthrodesis based on complications and the experience of good results with this method. Our results are similar to the main reports and are still subject of discussion by the oncologic surgeons. Level of evidence IV, Case-control study.

Revista de Medicina, 2009

Objetivos: Fornecer informações sobre a doença de Camurati-Engelmann, também conhecida como Displ... more Objetivos: Fornecer informações sobre a doença de Camurati-Engelmann, também conhecida como Displasia Diafisária Progressiva, possibilitando o seu diagnóstico pelo profissional de saúde. Método: Relato de caso associado a revisão da literatura científica sobre o tema. Discussão: Doença rara, de herança autossômica dominante, caracterizada por hiperostose progressiva com envolvimento das diáfises dos ossos. Os sintomas mais comuns são dores em extremidades, alteração da deambulação, fatigalibidade e fraqueza muscular. Seu diagnóstico é clínico-radiológico. O tratamento consiste basicamente na administração de glicocorticóides e anti-inflamatórios não esteroidais para melhorar os sintomas clínicos como dor e fadiga.

Journal of Adolescent and Young Adult Oncology, 2013

Little information is available regarding the tumor features, prognostic factors, and treatment r... more Little information is available regarding the tumor features, prognostic factors, and treatment results in children and adolescents and young adults (AYAs) with osteosarcoma diagnosed in developing countries. We reviewed the results of three observational cohorts of osteosarcoma patients treated in an emerging country. Methods: A total of 604 patients below the age of 30 years with high-grade osteosarcoma were prospectively enrolled in the Brazilian Osteosarcoma Treatment Group (BOTG) studies III, IV, and V. Gender, age, time from onset of symptoms to diagnosis, primary tumor site, presence or absence of metastases at diagnosis, tumor size, type of surgery (limb-sparing or amputation), treatment protocol, and histological response were correlated with survival. Results: The estimated 5-year overall survival and event-free survival (EFS) rates for the 553 eligible patients were 49% and 39% respectively; of the 390 non-metastatic patients included in the total, overall-and event-free survival were 59% and 48% respectively. Metastases at diagnosis, primary tumor site, type of surgery, and histological response were significant predictors of overall survival and EFS in univariate and multivariate analysis, whereas tumor size and treatment protocol lost prognostic significance in multivariate analysis. Conclusion: We report on the outcome of three consecutive studies for the treatment of osteosarcoma carried out in Brazil over 15 years. Although the survival rates presented are below those reported in current literature, it represents the result of a favorable experience gathered from the national collaborative work.

The authors show the value of multidisciplinary treatment on limb sparing of patients with malign... more The authors show the value of multidisciplinary treatment on limb sparing of patients with malignant bone tumors. From 1981 to 1994, 70% of 174 patients with osteosarcoma treated with pre-operative chemotherapy, had limb sparing surgery with recurrence rate of 4% in mean follow-up of 5 years. Similar results were achieved in patients with Ewing’s sarcoma. The authors print out the improvement in survival and quality of life with multidisciplinar approach. *Trabalho realizado no Departamento de Cirurgia Pélvica do Hospital A. C. Camargo da Fundação Antonio Prudente São Paulo SP. 1Titulares do Serviço de Ortopedia Diretor do Departamento de Cirurgia Pélvica Endereço para correspondência: Ademar Lopes Hospital A.C. Campos Rua Prof. Antonio Prudente, 211 São Paulo SP Descritores: Osteossarcoma Sarcoma de Ewing cirurgia

Objetivo: Demonstrar a experiência de uma única instituição em hemipelvectomias internas sem reco... more Objetivo: Demonstrar a experiência de uma única instituição em hemipelvectomias internas sem reconstrução. Avaliar as cirurgias pélvicas preservadoras e as amputações interílio-abdominais e seu prognóstico. Métodos: 21 pacientes com tumores primitivos pélvicos submetidos à hemipelvectomia com ou sem preservação de membro. Sete foram tratados com hemipelvectomias externas (amputação) e 14 com internas, entre junho de 2004 e julho de 2009. A classificação cirúrgica utilizada foi a de Enneking para tumores pélvicos. O método de avaliação funcional foi o escore de ISOLS/MSTS. Resultados: A sobrevida dos pacientes em dois anos foi de 63,9%. A média de sobrevida do grupo todo foi de 43 meses. A avaliação funcional demonstrou que as hemipelvectomias preservadoras com ressecção do osso inominado obtiveram 12,5%, 62,5% e 25% de resultados ruins, bons e excelentes, respectivamente. Nos casos em que o osso inominado foi preservado, os resultados foram 16,7% e 83,3% bons e excelentes, respectiv...

Acta Ortopedica Brasileira, 2012

Objetivo: Demonstrar a experiencia de uma unica instituicao em hemipelvectomias internas sem reco... more Objetivo: Demonstrar a experiencia de uma unica instituicao em hemipelvectomias internas sem reconstrucao. Avaliar as cirurgias pelvicas preservadoras e as amputacoes interilio-abdominais e seu prognostico. Materiais e Metodos: 21 pacientes com tumores primitivos pelvicos submetidos a hemipelvectomia com ou sem preservacao de membro. Sete foram tratados com hemipelvectomias externas (amputacao) e 14 com internas, entre junho de 2004 e julho de 2009. A classificacao cirurgica utilizada foi a de Enneking para tumores pelvicos. O metodo de avaliacao funcional foi o escore de ISOLS/MSTS. Resultados: A sobrevida dos pacientes em dois anos foi de 63,9%. A media de sobrevida do grupo todo foi de 43 meses. A avaliacao funcional demonstrou que as hemipelvectomias preservadoras com resseccao do osso inominado obtiveram 12,5%, 62,5% e 25% de resultados ruins, bons e excelentes, respectivamente. Nos casos em que o osso inominado foi preservado, os resultados foram 16,7% e 83,3% bons e excelente...