http://repositorio.ufc.br/handle/riufc/422 2026-05-31T05:20:58Z http://repositorio.ufc.br/handle/riufc/86542 Título: Nódulos tireoidianos e carcinoma papilífero na infância e adolescência: preditores clínico patológicos de malignidade e metástase cervical Autor(es): Macedo, Mário Sérgio Rocha Abstract: The incidence of thyroid nodules and differentiated thyroid carcinomas in children and adolescents has increased in recent decades, with a biological behavior distinct from that observed in adults and a higher frequency of lymph node metastasis. This study had three objectives: (1) to describe the clinical, laboratory, ultrasonographic, cytological, and histopathological profile of children and adolescents undergoing thyroidectomy; (2) to identify predictors of benignity and malignancy in thyroid nodules; and (3) to investigate clinicopathological predictors of cervical metastasis in patients with papillary thyroid carcinoma. A retrospective study was conducted including patients younger than 18 years who underwent thyroid surgery between January 2013 and May 2023. Surgical indications, ultrasonography findings, and fine-needle aspiration biopsy results were analyzed, along with histopathological findings standardized according to the 5th edition of the World Health Organization (WHO) classification and the College of American Pathologists (CAP) protocol, staging based on the 8th edition of the American Joint Committee on Cancer (AJCC), risk stratification according to the American Thyroid Association pediatric guidelines (ATA, 2015), use of radioiodine therapy, and oncological outcomes. Factors associated with outcomes were evaluated using bivariate analyses, multivariate logistic regression, and Firth’s penalized regression. Among 91 patients, 40.6% had malignant neoplasms, predominantly papillary thyroid carcinoma, with cervical lymph node involvement in 78.1% of cases (25/32). Ultrasonographic microcalcifications (OR 28.64; 95%CI 3.29–249.31; p = 0.002) and age ≤ 10 years (OR 5.69; 95%CI 1.21–26.75; p = 0.028) were independent predictors of malignancy. In the subcohort of 32 papillary thyroid carcinomas, only extrathyroidal extension remained an independent predictor of cervical metastasis after multivariate adjustment (OR 14.29; 95%CI 1.28–2028.82; p = 0.028). These findings reinforce the high rate of locoregional dissemination of papillary thyroid carcinoma and highlight the role of structured ultrasonographic assessment and detailed histopathological analysis in risk stratification and surgical planning. Tipo: Dissertação 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86138 Título: Estudo prospectivo da resposta a quimioterapia neoadjuvante na determinação do tratamento cirúrgico conservador em pacientes com câncer de mama Autor(es): Machado, Francisco Heine Ferreira Abstract: This present prospective study mtended to evaluate the contribution of neoadjuvant chemotherapy upon the reduction of breast malignant tumors with views to perform conservative operation as oposed to a more aggressive radical surgical procedure. Thirty two patients with mfiiltrating carcinoma of the breast stages I, IIa, lib, DIa and DIb eligible to underço radical inastectomy were included in this work. All patients studied were submited to fisical examination with measure of tumor size using tumorimeter, mammography, mammary ltrasonography, citology and core biopsy of the tuinor using tru-cut needle. With confirmed carcinoma of the breast upon results either from citology or core biopsy, aU patients received combmed neoadjuvant chemotherapy with 5- fluorouracü SOOmg/m , epirrubicine 50mg/m and cyclophophamide 500mg/m (FEC), every 21 days for three consecutive cycles as their initial therapy. After tree cycles of chemotherapy, patients were subjected again to the previous applied set of investigations including fisical examination with new measure of the tumor, mammography, mammary ultrasonography, citology and core biopsy of remaining tumor. Surçical local treatment m the form of either radical mastectomy (Madden operation) or quadrantectomy plus axilary clearence was performed. The mean tumor volumes before and after adjuvant chemotherapy were according to dsical exammatíon 24.23cm and 7.53cm , measured by mammography 10.81cm and 5.93cm3 and evaluated through mammary ultrasonography 5.70cm3 and 2.67 Objective response (OR) based on results from the above performed investigations was considered when patients presented either complete tumor size reduction (100%) or tumor size reduction equal or superior to 50%. Objective response (OR) based on fisical examination was observed m 84.5% of patients. When mammography was applied as the anaUzing method 81.2% of patients also presented objective response (OR). Accordmg mammary ultrasonography 80.0% of patients presented objective response (OR). These results were therefore very simuar irrespective of the method of evaluation applied. The rate of breast sakage was 81.2% which means that twenty six out of thirty two patients previously etígible to radical mastectomy underwent conservative surçery. The esthetic results obtained from conseryative surçery were considered good and excellent. The neoadjuvant Qt was efective to promove significance response, without stimulate important agressive m the pacients. The toxicity induced by neoadjuvant chemotherapy caused a high percentage of alopecia and a moderate incidence of nausea and vomits. These resuhs indicate that neoadjuvant chemotherapy can modify the use of radical mastectomy to a nnore conservative surçical treatment in the majority of patients studied. Futhermore, neoadjuvant chemotherapy response may be used to select patients with aggresive non-responsive breast tumors to receive other combmations of chemotherapy drugs which may be more efifective during post operative chemotherapy. Tipo: Dissertação 1996-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85968 Título: Mastectomia radical modificada com drenagem por sucção contínua versus sem drenagem Autor(es): Juaçaba, Ricardo Carvalho Abstract: This research was conducted in order to analyze the results of seroma formation after modified radical mastectomy using suction drain versus no suction drain with a wound closure tecnique. This prospective study included seventy-two (72) patients who had operable breast cancer. All patients underwent modified radical mastectomy (Madden surgery) followed by wound closure using inabsorvent stitch between the skin and the chest wall musculature. The axila was also closed and the suction drains were placed beneath the skin and in the axila. The drains were removed 24 hours after surgery. Of the seventy-two (72) patients in the study, thirty-seven underwent the surgery and had drains placed. Thirty-five patients had no drains place following surgery. Evaluations factors included: age, weigth, clinical stage, number of axillary lymph nodes removed and positive lymph nodes. Complications (thus are of study) in both groups of patients included: seroma, infected seroma, skin necroses, hematoma and wound infection. The results of these seventy-two patients showed no significant statistical difference between the two groups in relation to: age (p=0.59), weight (p=0.25), height (p=0.83), clinical stage (p=0.44), lymph nodes removed (p=0.63) and positive lymph nodes (p=0.94). Surgical complications occurred in 10 patients (27%) in the first group (with drains) and in 12 patients (34,3%) in group two (without drains). Seroma formation was present in 8 patients in group 1 (21,6%) and in 10 patients in group 2 (28,6%). No significant statistical difference was noted between the two groups in relationship to the total number of complications (p=0.50) and seroma (p=0.49). The author concluded that modified radical mastectomy (associated with wound closure) and without drains can be safely performed without increasing surgical complications Tipo: Dissertação 2001-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85404 Título: Avaliação da radicalidade oncológica em ressecções colo-retais comparando os acessos laparoscópico e laparotómico Autor(es): Leão, Pedro Henrique Saraiva Abstract: A excísão video-laparoscópica de lesões benignas cofo-retaís como alternativa operatória ao método laparotomico, vem sendo aceita mundialmente desde 1992. Contudo, tal operação, quando com pretensões curativas do câncer colo-retal, não foi ainda totalmente abonada pêlos especialistas. Nesta dissertação foram comparados prospectivamente dois grupos de l O (dez) pacientes portadores de lesões malignas cofo-retais. O Grupo l foi abordado pelo acesso convencional da laparotomia, i.e., intervenção aberta; os pacientes do Grupo II foram operados mediante um acesso vídeo-laparoscópíco. As operações, foram realizadas no Departamento de Cirurgia, da Faculdade de Medicina da Universidade Federal do Ceará e no Hospital Geral Dr. César Cais. Os resultados foram cotejados principalmente quanto aos seguintes fatores; (a) percentual de linfonodos removidos; (b) tempos de execução de ambas as técnicas; (c) tamanho das peças ressecadas; (d) margens próxima! e distal das ressecções; (e) complicações trans-operatórias; (f) reinicio da peristalse intestinal pós-operatóría; e (g) alta hospitalar. Foram praticadas as seguintes técnicas cirúrgicas: retosígmoidectomia abdominal, hemicolectomías esquerda e direita, colectomia parcial, e amputação abdomino-perineal (operação de Milesj. Não ocorreu nenhuma instância de necessidade de conversão nos pacientes operados lapa roscopícamente. Houve semelhança estatística no tocante aos itens a, c. e d, acima mencionados, o que demonstra a exeqüibílidade e a radicalídade do acesso laparoscópico, e aponta para sua plena e talvez maiore aceitação futura, como alternativa nas ressecções das neoplasias malignas colo-retais. Tais achados, contudo, sugerem a necessidade de revisões continuadas em causuisticas prospectivas mais extensas. Tipo: Dissertação 2000-01-01T00:00:00Z