Investigator

Francisco Jose Candido dos Reis

Full Professor · Ribeirao Preto Medical School - University of Sao Paulo, Gynecology and Obstetrics

FJCFrancisco Jose Ca…
Papers(11)
A propensity score-ma…Analysis of the relat…Incidence of urologic…Unveiling delays: und…Clinical and patholog…BRCA1 Expression by I…Immunohistochemistry …Impact of ICU bed ava…Treatment delay and t…Author’s Reply to Jia…Experiences of women …
Collaborators(10)
Vinicius Cesar Motera…Lorena Alves TeixeiraJames D. BrentonJulio Cesar Rosa e Si…Jurandyr Moreira de A…Licerio MiguelNino Jose Wilson Mote…Omero Benedito Poli N…Aerica de Figueiredo …Bruna Helena Mellado
Institutions(2)
Universidade De So Pa…University of Cambrid…

Papers

A propensity score-matched case-control study of laparoscopy and laparotomy for endometrial cancer

A surgery is essential for the management of early endometrial carcinoma. Due to the comorbidities associated with the disease, the complications of surgery are common. Laparoscopic surgery may reduce surgical complications but also have oncological risks. We aimed to compare recurrence and overall survival (OS) associated with laparoscopy and laparotomy for early endometrial cancer. We included women treated for presumed early endometrial carcinoma at the Clinics Hospital of Ribeirão Preto Medical School from January 1998 to December 2017. We designed a 1:2 propensity score-matched case-control and compared the patients' characteristics, short-term outcomes, recurrence, and OS. A total of 252 women were included in this study, 168 underwent laparotomy, and 84 underwent laparoscopy. The two groups were well balanced according to most of the variables, and obesity was a characteristic of patients in both groups. Laparoscopy was associated with increased surgical time (194.7 min vesus 165.6 min; p<0.001) and reduced rate of surgical complications (6.5% versus 0; p=0.038). Laparoscopic surgery was not associated with the risk of tumor recurrence (HR: 0.41, 95%CI 0.14-1.19, p=0.100) or all-cause mortality (HR: 0.49, 95%CI 0.18-1.35, p=0.170). Laparoscopy was safe in terms of oncological outcomes and was associated with a lower rate of surgical complications. Our data support the use of minimally invasive surgery as the preferential approach in the management of early endometrial carcinoma.

Incidence of urologic co-morbidities after abdominal radical hysterectomy: a systematic review of clinical trials

This study aimed to estimate the incidence of intra-operative, structural, and functional post-operative urologic complications associated with abdominal radical hysterectomy for cervical cancer. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted in PubMed, EMBASE, CINAHL, and Web of Science up to July 2025. Inclusion criteria were randomized trials including women with cervical cancer undergoing abdominal radical hysterectomy and reporting urologic complications. Data extraction and risk of bias assessment were independently performed by 2 reviewers. Urologic morbidities were classified as intra-operative, structural, and functional. Meta-analyses were conducted using random- or common-effects models, depending on heterogeneity. A total of 10 studies comprising 1247 patients were included. For intra-operative complications, the incidence of bladder injury was 0.2% (95% CI 0% to 1.2%) and of ureteral injury 0.3% (95% CI 0% to 1.1%), with low heterogeneity. In contrast, the rates of structural post-operative complications, such as genitourinary fistulas (0.3% to 5.7%) and ureteral obstruction or hydronephrosis (8.2% to 11%), and functional complications, including urinary retention or bladder atony (6.7% to 12.3%), and urinary incontinence (1.7% to 11%), were drawn from heterogeneous studies with variable definitions and assessments. Because of this substantial heterogeneity, these values should be interpreted only as descriptive ranges rather than precise pooled estimates. Accordingly, a meta-analysis was not performed for structural and functional complications. Abdominal radical hysterectomy is associated with a low incidence of intra-operative urologic injuries but a notable risk of structural and functional complications, particularly, in patients receiving adjuvant radiotherapy. These findings highlight the need for patient counseling, standardized outcome reporting, and strategies to minimize long-term genitourinary morbidity. CRD420250484975.

Clinical and pathological associations of PTEN expression in ovarian cancer: a multicentre study from the Ovarian Tumour Tissue Analysis Consortium

Abstract Background PTEN loss is a putative driver in histotypes of ovarian cancer (high-grade serous (HGSOC), endometrioid (ENOC), clear cell (CCOC), mucinous (MOC), low-grade serous (LGSOC)). We aimed to characterise PTEN expression as a biomarker in epithelial ovarian cancer in a large population-based study. Methods Tumours from 5400 patients from a multicentre observational, prospective cohort study of the Ovarian Tumour Tissue Analysis Consortium were used to evaluate associations between immunohistochemical PTEN patterns and overall survival time, age, stage, grade, residual tumour, CD8+ tumour-infiltrating lymphocytes (TIL) counts, expression of oestrogen receptor (ER), progesterone receptor (PR) and androgen receptor (AR) by means of Cox proportional hazard models and generalised Cochran–Mantel–Haenszel tests. Results Downregulation of cytoplasmic PTEN expression was most frequent in ENOC (most frequently in younger patients; p value = 0.0001) and CCOC and was associated with longer overall survival in HGSOC (hazard ratio: 0.78, 95% CI: 0.65–0.94, p value = 0.022). PTEN expression was associated with ER, PR and AR expression (p values: 0.0008, 0.062 and 0.0002, respectively) in HGSOC and with lower CD8 counts in CCOC (p value &lt; 0.0001). Heterogeneous expression of PTEN was more prevalent in advanced HGSOC (p value = 0.019) and associated with higher CD8 counts (p value = 0.0016). Conclusions PTEN loss is a frequent driver in ovarian carcinoma associating distinctly with expression of hormonal receptors and CD8+ TIL counts in HGSOC and CCOC histotypes.

BRCA1 Expression by Immunohistochemistry and Prognosis in Ovarian Cancer: A Systematic Review and Meta-Analysis

Homologous recombination deficiencies are associated with increased platinum sensitivity and potential response to poly (ADP-ribose) polymerase inhibitors in epithelial ovarian cancer. As an alternative to germline testing or somatic tumor sequencing, BRCA1 deficiency can be detected by immunohistochemistry and might predict homologous recombination deficiencies. This study aimed to assess the association between BRCA1 expression by immunohistochemistry and the prognosis of patients with epithelial ovarian cancer. We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. We searched PubMed, EMBASE, Web of Science, and Scopus databases through July 2019. Reference lists of selected articles were screened for further studies. We conducted qualitative synthesis and meta-analyses of hazard ratios for overall survival and progression-free survival. Of 41 studies of BRCA1 expression using immunohistochemistry, 18 evaluated the association of BRCA1 expression with patient survival (2738 cases). The loss of BRCA1 expression was associated with improved overall survival (hazard ratio = 0.67, 95% confidence interval 0.57-0.77) and progression-free survival (hazard ratio = 0.70, 95% confidence interval 0.58-0.84). Negative BRCA1 expression assessed by immunohistochemistry was associated with a better prognosis in epithelial ovarian cancer.

Immunohistochemistry for the detection of BRCA1 and BRCA2 proteins in patients with ovarian cancer: a systematic review

Background Loss of function in either breast cancer type 1 susceptibility protein (BRCA1) or breast cancer type 2 susceptibility protein (BRCA2) is a major risk factor for epithelial ovarian cancer (EOC) development. BRCA1 or BRCA2 deficiencies are associated with short-term prognosis and might have importance for the treatment of women with the disease. However, the screening of all possible mechanisms of dysfunction is expensive, time-consuming and difficult to apply in clinical practice. On the other hand, immunohistochemistry (IHC) is a simple and reliable method to access the expression of several proteins in tumour tissues. Materials and methods This systematic review aims to evaluate the current usage of IHC to detect BRCA1 and BRCA2 deficiencies in EOC. We searched and evaluated all primary literature on the use of IHC for evaluating BRCA1 and BRCA2 proteins expression in EOC. The main concepts for the search were: ovarian neoplasms, IHC, BRCA1 and BRCA2. Results Forty-four studies from 925 unique titles were included. A total of 4206 tumour samples were evaluated for BRCA1 and 1041 for BRCA2 expression. Twelve BRCA1 primary antibodies were used in 41 studies, and the most common was the MS110 clone (75.6%). Seven BRCA2 primary antibodies were used in ten studies. Using the cut-off of 10%, 47.0% of EOCs are associated with loss of BRCA1 and 34.5% with the loss of BRCA2 expression. Conclusion IHC was effective to detect loss of BRCA1 protein expression in EOC; however, data on BRCA2 expression were heterogeneous and difficult to interpret.

Treatment delay and treatment pattern modifications among epithelial ovarian cancer patients during the COVID‐19 pandemic: A retrospective cohort study

AbstractBackground and ObjectivesThe coronavirus disease 2019 (COVID‐19) pandemic disrupted healthcare access and medical treatment, including oncological care. Treatment delay in ovarian cancer could impact survival. We aimed to assess if there were delays and treatment changes in a cohort of epithelial ovarian cancer patients.MethodsA retrospective cohort of epithelial ovarian cancer patients included cases diagnosed during the first 22 months of the COVID‐19 pandemic in the state of Sao Paulo and those diagnosed in the 22 months preceding the outbreak. Time‐to‐treat was measured in days. In each group, surgery and chemotherapy proportions were assessed according to healthcare insurance status.ResultsA 56.2% reduction in epithelial ovarian cancer diagnosis was identified during the pandemic group compared to the prepandemic group; fewer patients were diagnosed in stage I (p &lt; 0.01). Time‐to‐treat increased from 18.9 to 23 days (p &lt; 0.01). Surgery in the public sector fell from 74.6% to 65.3% during the pandemic, compared to 87.1% to 68.8% in the private sector.ConclusionThere were fewer overall diagnoses, reduced stage I diagnosis, increased time‐to‐treat, and a reduction in the proportion of patients submitted to surgery. Brazil's public healthcare system demonstrated a higher resiliency to treatment change than the private sector.

Experiences of women with advanced cervical cancer before starting the treatment: Systematic review of qualitative studies

AbstractBackgroundAdvanced stage and high mortality are characteristics of cervical cancer in developing countries. Comprehension of the diagnosis itinerary is one of the main strategies to control the disease impact.ObjectivesTo identify reasons for the delay in diagnosing symptomatic cervical cancer according to the patient's perspectives reported in qualitative studies. We searched four databases (PubMed, Embase, CINAHL, and Web of Science).Selection criteriaWe included qualitative studies of women with advanced cervical cancer that explored their experiences before treatment. We excluded unoriginal, non‐qualitative, and duplicated studies.Data collection and analysisWe selected 39 articles for a full‐text reading and included 15 in the present review. We chose the Consolidated Criteria for Reporting Qualitative Research (COREQ) for quality assessment and The Model of Pathways to Treatment to guide the codifying process.Main resultsFour main themes emerged from the synthesis: (1) Health‐seeking motivators; (2) Obstacles to seeking medical care; (3) Diagnosis delay; and (4) Coping with the disease. These themes were derived from patients' personal knowledge and beliefs, social relationships, socioeconomic status, and healthcare system characteristics.ConclusionsIndividual behavior, social factors, and healthcare organization contribute to the delay in diagnosing advanced cervical cancer.

197Works
11Papers
15Collaborators
Ovarian NeoplasmsPrognosisBreast NeoplasmsCarcinoma, Ovarian EpithelialBiomarkers, TumorNeoplasm Recurrence, LocalEndometrial NeoplasmsEndometriosis

Positions

2002–

Full Professor

Ribeirao Preto Medical School - University of Sao Paulo · Gynecology and Obstetrics

Education

1989

M.D.

Ribeirao Preto Medical School - University of Sao Paulo

Country

BR

Keywords
Pelvic painovarian cancerbreast cancer
Links & IDs
0000-0001-5758-5917

Scopus: 8584435900

Researcher Id: K-7024-2016