BackgroundIPARPs are the latest advance in ovarian cancer treatment and have been shown and have been shown in clinical trials to be an effective and safe treatment. The increase in life expectancy implies an increase in the age of the patients treated, so the development of effective drugs with few adverse effects is becoming more important every day. The objective of the study was to establish the clinical and toxicity differences of iPARP treatment between patients older and younger than 65 years.MethodsA retrospective, single-center study was conducted. All patients diagnosed of high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian tube cancer treated with iPARPs between 2017 and 2021 in Puerta de Hierro Hospital were included. Epidemiological and clinical data were registered.ResultsTable: 42PCharacteristics<65 years (41)>65 years (19)Comorbidities:HypertensionDiabetesHypercholesterolemiaIschemic eventHeart failure7.3%2.4%14.6%2.4%0%26.3%10.5%21.0%0%5.26%Smoking habitCurrentFormer14.6%29.3%1%36.8%Stage at diagnosisI-II: 14.6%III-IV: 86.4%I-II: 15.8III-IV: 84.4%Toxicity (any)43.9%63.2%p=0.165Grade >G314.6%5.3%P=0.293ToxicityGastrointestinalCardiologicalHematologicalOthers:33%22.2%33.4%5.5%50%25%21%4%Median treatment duration (months)11.57Discontinuation:9.8%21.0%P= 0.231Delays:9.8%15.8%P=0.498Subsequent treatment68.2%71.4%P=0.333 Open table in a new tab ConclusionsPatients >65 years treated with iPARPs did not experience higher rates of adverse events or treatment interruptions/discontinuations. iPARPs should be a valid treatment option for ovarian cancer in this increasingly frequent subgroup of patients.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest. BackgroundIPARPs are the latest advance in ovarian cancer treatment and have been shown and have been shown in clinical trials to be an effective and safe treatment. The increase in life expectancy implies an increase in the age of the patients treated, so the development of effective drugs with few adverse effects is becoming more important every day. The objective of the study was to establish the clinical and toxicity differences of iPARP treatment between patients older and younger than 65 years. IPARPs are the latest advance in ovarian cancer treatment and have been shown and have been shown in clinical trials to be an effective and safe treatment. The increase in life expectancy implies an increase in the age of the patients treated, so the development of effective drugs with few adverse effects is becoming more important every day. The objective of the study was to establish the clinical and toxicity differences of iPARP treatment between patients older and younger than 65 years. MethodsA retrospective, single-center study was conducted. All patients diagnosed of high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian tube cancer treated with iPARPs between 2017 and 2021 in Puerta de Hierro Hospital were included. Epidemiological and clinical data were registered. A retrospective, single-center study was conducted. All patients diagnosed of high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian tube cancer treated with iPARPs between 2017 and 2021 in Puerta de Hierro Hospital were included. Epidemiological and clinical data were registered. ResultsTable: 42PCharacteristics<65 years (41)>65 years (19)Comorbidities:HypertensionDiabetesHypercholesterolemiaIschemic eventHeart failure7.3%2.4%14.6%2.4%0%26.3%10.5%21.0%0%5.26%Smoking habitCurrentFormer14.6%29.3%1%36.8%Stage at diagnosisI-II: 14.6%III-IV: 86.4%I-II: 15.8III-IV: 84.4%Toxicity (any)43.9%63.2%p=0.165Grade >G314.6%5.3%P=0.293ToxicityGastrointestinalCardiologicalHematologicalOthers:33%22.2%33.4%5.5%50%25%21%4%Median treatment duration (months)11.57Discontinuation:9.8%21.0%P= 0.231Delays:9.8%15.8%P=0.498Subsequent treatment68.2%71.4%P=0.333 Open table in a new tab ConclusionsPatients >65 years treated with iPARPs did not experience higher rates of adverse events or treatment interruptions/discontinuations. iPARPs should be a valid treatment option for ovarian cancer in this increasingly frequent subgroup of patients. Patients >65 years treated with iPARPs did not experience higher rates of adverse events or treatment interruptions/discontinuations. iPARPs should be a valid treatment option for ovarian cancer in this increasingly frequent subgroup of patients.

IntroductionCancer healthcare has been affected by Coronavirus disease 2019 (COVID-19) pandemic, interfering the normal function of oncology units and increasing diagnostic delay. Nevertheless, the rising incidence of respiratory infections led to an increase in medical consultations and chest imaging explorations. . The aim of the study was to assess whether the increase in medical evaluations in the context of the pandemic led to an increase in the detection of early-stage thoracic tumours.MethodsWe performed a retrospective single-institution study, collecting data from patients diagnosed with thoracic tumours between March, 1, 2020 and December, 31, 2021. We analysed their demographic and clinical data, symptoms at diagnosis and those who were diagnosed due to SARS-CoV-2 infection.ResultsTabled 1Total (N = 378)SexMale: 256 (67.7%) Female: 122 (32.3%)Age67.0 (21.0-87.0)Smoking habitNever smoker: 42 (11.1%)Former smoker: 189 (50.0%)Current smoker: 137 (36.2%)Unknown: 10 (2.7%)Stage at diagnosisI: 130 (34.4%) II: 37 (9.8%) III: 98 (25.9%) IV: 109 (28.8%) Unknown: 4 (1.1%)HistologyAdenocarcinoma: 192 (50.8%)Squamous carcinoma: 92 (24.3%) Small cell carcinoma: 39 (10.3%) Adenosquamous: 2 (0.5%) Large cell carcinoma: 3 (0.8%) Neuroendocrine large cell carcinoma: 11 (2.9%) Sarcomatoid: 1 (0.3%)NOS: 12 (3.2%) Carcinoid: 16 (4.2%) Mesothelioma: 2 (0.5%)Others: 8 (1.6%)Symptoms reported at diagnosisAsymptomatic: 131 (34.7%) Anorexia: 23 (6.1%) Asthenia: 34 (9.0%) Dyspnoea: 66 (17.5%) Pain: 64 (16.9%) Haemoptysis: 27 (7.1%) Weight loss: 57 (15.1%) Cough: 65 (17.2%) Others: 60 (15.9%)Diagnosis due to SARS-CoV-2 suspicion/disease20 (5.3%)Causes of diagnosis in asymptomatic patientsFollow-up of a non-oncological pathology: 56.6% Follow-up of another tumour: 17.5% Preoperative study: 7.0%Extension study of another tumour: 6.3% Rutinary revision: 6.3%Symptoms not related with thoracic cancer: 6.3% Open table in a new tab ConclusionsKeywordsCOVID19, Lung Cancer, Diagnosis IntroductionCancer healthcare has been affected by Coronavirus disease 2019 (COVID-19) pandemic, interfering the normal function of oncology units and increasing diagnostic delay. Nevertheless, the rising incidence of respiratory infections led to an increase in medical consultations and chest imaging explorations. . The aim of the study was to assess whether the increase in medical evaluations in the context of the pandemic led to an increase in the detection of early-stage thoracic tumours.

A significant portion of patients operated of non-small cell lung cancer (NSCLC) will relapse eventually. Strategies to identify these relapses are necessary, in order to propose an earlier oncological treatment. There is currently no consensus regarding the best program for postoperative follow-up and surveillance after a curative resection for non-small-cell lung cancer (NSCLC) patients. The objective of this study is to analyse the diagnostic capability of the diagnostic tests performed in our centre during the follow-up of patients with non-small cell lung cancer after surgical resection.

The brain is a frequent site of metastases in non-small cell lung cancer (NSCLC), specially in those with driver gene mutations. Treatment strategies include surgical resection, central nervous system (CNS) radiotherapy (RT), what includes: whole-brain radiation therapy (WBRT) and stereotactic radiotherapy, and drug therapy like tyrosine kinase inhibitors (TKIs).

BackgroundImmunotherapy (IO) represents one of the most promising therapeutic approaches in systemic cancer treatment. However, its broad clinical application revealed several important cardiovascular side effects which can limit treatment options, decrease patients' prognosis and quality of life. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) and the incidence of cardiovascular events (CVE) in patients treated with IO. This has been little researched, and the information we have is scarce.MethodsWe conducted a retrospective study in a single institution including oncological patients treated with IO from 2014 to 2020. We analyzed their CVRF and the CVE developed during IO treatment.ResultsTable: 78PSexMale 64.5%Female 35.5%Median age61.0Hypertension40.7%Diabetes13.2%Hypercholesterolemia30.4%Smoking habit81.2%Coronary syndrome5.0%Congestive heart failure0.5%Chronic renal failure4.5%Arrythmia6.4%Peripheral arterial disease17.2%Type of tumorLung cancer 62.4%Melanoma 12.7%Renal cell carcinoma 5.0%Bladder cancer 4.8%Head and neck tumors 4.2%Hepatocellular carcinoma 2.4%Lymphoma 2.1%Gastrointestinal tumors 3.2 %Gynecological tumors 0.8%Breast cancer 0.8%Thymoma 0.5%Previous cardiotoxic treatmentsAnthracyclines: 3.4%Cisplatin: 23.0%Antiangiogenic therapy: 13.0%HER2 targeted therapy: 0.5%Thoracic radiotherapy: 25.1% Open table in a new tab ConclusionsAlmost one fifth of the patients in our study experienced some kind of CVE but its association with IO remains unclear, as only 1% of the events were clearly related to IO. Prospective studies with cardiovascular comprehensive follow-up protocols are needed to assess if there is a real casuistic relationship between the cardiac events in this population and IO treatment.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest. BackgroundImmunotherapy (IO) represents one of the most promising therapeutic approaches in systemic cancer treatment. However, its broad clinical application revealed several important cardiovascular side effects which can limit treatment options, decrease patients' prognosis and quality of life. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) and the incidence of cardiovascular events (CVE) in patients treated with IO. This has been little researched, and the information we have is scarce. Immunotherapy (IO) represents one of the most promising therapeutic approaches in systemic cancer treatment. However, its broad clinical application revealed several important cardiovascular side effects which can limit treatment options, decrease patients' prognosis and quality of life. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) and the incidence of cardiovascular events (CVE) in patients treated with IO. This has been little researched, and the information we have is scarce. MethodsWe conducted a retrospective study in a single institution including oncological patients treated with IO from 2014 to 2020. We analyzed their CVRF and the CVE developed during IO treatment. We conducted a retrospective study in a single institution including oncological patients treated with IO from 2014 to 2020. We analyzed their CVRF and the CVE developed during IO treatment. ResultsTable: 78PSexMale 64.5%Female 35.5%Median age61.0Hypertension40.7%Diabetes13.2%Hypercholesterolemia30.4%Smoking habit81.2%Coronary syndrome5.0%Congestive heart failure0.5%Chronic renal failure4.5%Arrythmia6.4%Peripheral arterial disease17.2%Type of tumorLung cancer 62.4%Melanoma 12.7%Renal cell carcinoma 5.0%Bladder cancer 4.8%Head and neck tumors 4.2%Hepatocellular carcinoma 2.4%Lymphoma 2.1%Gastrointestinal tumors 3.2 %Gynecological tumors 0.8%Breast cancer 0.8%Thymoma 0.5%Previous cardiotoxic treatmentsAnthracyclines: 3.4%Cisplatin: 23.0%Antiangiogenic therapy: 13.0%HER2 targeted therapy: 0.5%Thoracic radiotherapy: 25.1% Open table in a new tab ConclusionsAlmost one fifth of the patients in our study experienced some kind of CVE but its association with IO remains unclear, as only 1% of the events were clearly related to IO. Prospective studies with cardiovascular comprehensive follow-up protocols are needed to assess if there is a real casuistic relationship between the cardiac events in this population and IO treatment. Almost one fifth of the patients in our study experienced some kind of CVE but its association with IO remains unclear, as only 1% of the events were clearly related to IO. Prospective studies with cardiovascular comprehensive follow-up protocols are needed to assess if there is a real casuistic relationship between the cardiac events in this population and IO treatment.

In the last decade, immunotherapy (IT) has become a key therapeutic tool in lung cancer treatment. The number of elderly patients with this pathology in Spain has been progressively increased in recent years, becoming a representative subgroup nowadays. Studies carried out with IT in these patients are a minority and controversial, generating a need in clinical practice. The aim of the study is to establish clinical and toxicity differences between patients older and younger than 65 years, treated with IT.

Malignant pleural mesothelioma (MPM) is a rare but aggressive tumour whose clinical and pathological diagnosis represents a challenge, due to delayed diagnosis and poor prognosis. The aim of this study is to describe the demographic and clinical characteristics of patients with malignant pleural mesothelioma, as well as their subsequent treatments and outcomes in Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Survival and outcomes of lung cancer patients have dramatically improved in recent years due to early diagnoses and personalized treatments. Nevertheless, lung cancer patients suffer from long-term health problems that can lead to a reduced quality of life that can negatively impact their prognosis and survival. The aim of this study is to identify patients with elevated risk of diminished quality of life by using objective data obtained from a wearable device.

Breast cancer in Young patients (≤45 years) is about 15% of all new diagnosis. At Young age, fertility is often an important issue, especially when there is no offspring. The average age of the first time mothers is increasing in the last years in Spain. A 30% of the Spanish mothers have their first birth older than 35 years old. Pregnancy after breast cancer is still very uncommon. A retrospective review of breast cancer patients under 45 years treated at the Oncology department in HUPHM in Madrid-SPAIN between 2009-2019 was performed. The number of pregnancies and births prior to the administration of any treatment was collected. The subgroup of nulliparous patients under 40 years of age who were candidates for fertility preservation was selected and these data have been analyzed. A total of 555 patients were analysed in the period selected. The number of pregnancies and births in our patients at the moment of diagnosis are described in the table.Table: 143P<35 years35-40>40No pregnancy39% (22)26% (37)17% (61)No births35% (25)30% (43)19% (68)No births or just one60% (18)37% (37)27% (79) Open table in a new tab A total of 74 patients under 40 years with no births were evaluated for fertility preservation. 14 patients (20%) were not candidates for fertility preservation due the need of a fast treatment or just local treatment. The selected 60 candidates were handle as follows: 20% refused preservation, 52% (31 Patients) performed oovocyte cryopreservation and the remaining 28% were not offered. Of the total, only 3 pregnancies were obtained, only one per transfer after preservation. More than 30% of the YBCP ≤40 have no births at the moment of diagnosis. All of them should be referred to a fertility unit and informed about options. Women with just one child might be also informed about options. Very few pregnancies occur after breast cancer diagnosis and this a new challenge with a great area of improvement.

Methods: This retrospective analysis of nationwide hospital discharge data in Germany between 2013 and 2016 comprises 121837 patients of whom 36051 (29.5%) underwent surgical anatomic resection.Hospital volumes were defined according to the number of patient resections for lung cancer in each hospital, and patients were categorized into 5 quintiles based on hospital caseload volume.A logistic regression model accounting for death according to sex, age, comorbidity, and resection volume was calculated, and effect modification was evaluated using the ManteleHaenszel method.Results: In-house mortality ranged from 2.1% in very highvolume centers to 4.0% in very low-volume hospitals (p<0.01).In multivariable logistic regression analysis, lower in-house mortality in very high-volume centers performing > 140 anatomic lung resections per year was compared with very low-volume centers performing < 27 resections (OR, 0.58; CI, 0.46 to 0.72; p<0.01).This relationship also held for failure to rescue rates (12.9 vs 16.7%, p¼0.01), although a greater number of extended resections were performed (23.1 vs. 14.8%,p<0.01).Conclusion: Hospitals with high volumes of lung cancer resections performed surgery with a higher ratio of complex procedures and achieved reduced in-house mortality, fewer complications, and lower failure to rescue rate.

Immunotherapy (IO) has become one of the leading treatments for advanced lung cancer. The number of elderly patients treated in routine clinical practice contrasts with the low representation of these in clinical trials. The aim of the study is to establish clinical differences between patients older and younger than 65 years treated with IO. We conducted a single centre retrospective review including 137 patients treated with IO in Puerta de Hierro University Hospital (Madrid) between 2014 and 2019. We collected information regarding epidemiology, treatments, response and survival patterns and we performed a comparative analysis between patients <65 and ≥ 65 years. Clinical data, toxicities, treatments and survival are shown in the table. There were no differences in high grade toxicities (9.1% vs 10.4%) or treatment interruption (20.3% vs 17.6%, p=0.576). We didn´t find difference in OS (16.0 vs 17.0) between both groups. Table: 59P<65 (69)>65 (68)Long rank (p)Sex M F54.5% 45.6%74.6% 25.4%Age5872ECOG 0-1 ≥293.2% 4.5%97.0% 3.0%Histology Adenocarcinoma Squamous Small cell Others59.1% 27.3% 2.3% 11.4%56.7% 25.4% 4.5% 13.4%Toxicity type Asthenia Pneumonitis Thyroid disorders Skin Others11.4% 14.8% 10.2% 9.1% 24.9%13.4% 11.9% 11.9% 9.0% 19.5%Grade 1-2 ≥323.8% 9.1%28.3% 10.4%0.99Treatments (CI, 95%)Median OS16.0 (9.1-22.9)17.0 (7.5-26.5)0.8251° lineMedian PFS3.0 (0-6.8)7.0 (1.2-12.8)0.164Duration (median)3.03.02° lineMedian PFS11.0 (9.6-12.4)11.0 (5.1-16.9)0.837Duration (median)9.54.03° lineMedian PFS2.0 (1.2-2.8)2.0 (0.1-3.9)0.338Duration (median)2.02.0 Open table in a new tab Our results show that IO has an adequate safety profile in patients ≥65 years and survival results are similar to young patients. Therefore, in our opinion, IO represents a valid and safe option for advanced lung cancer treatment in patients ≥65 years.

Madrid has been the epicenter of the SARS-CoV2 pandemic in Spain. We analyzed the experience at our hospital with SARS-CoV2 infection and cancer patients (p). We analyzed our experience from March 1 to April 30 at the Puerta de Hierro University Hospital in Madrid. Diagnosis of SARS-CoV2 infection was made by RT-PCR, suspected cases not confirmed were excluded. Overall in-hospital mortality cancer p with COVID-19 was 15.2% (95%CI, 6.3; 5.2), similar to 12.7% (95%CI,11.1;4.4) with p=0.615 of the global COVID-19 hospitalised population and greater than that of patients admitted without SARS-CoV-2 infection during the same period 4.3% (95%CI; 3.6;5.2) p<0.001. Among 653 patients receiving active cancer therapy during this period, 24 (3.7%) developed COVID-19 and required admission, 4.2% of were receiving chemotherapy, 9.5% immunotherapy and 2.1% targeted therapies. Lung and breast cancer were the most frequent (26.1%), followed by colorectal (19.6%) and breast cancer. No significant differences due to the cancer treatment received were observed. Mortality in lung cancer patients was the highest (25%). The univariate analysis (between p who developed serious event vs. those who did not), showed that higher Brescia, CURB-65 scale, lactate dehydrogenase (LDH) or C-reactive protein (CRP) levels at admission, the greater risk of developing severe complications (p<0.05)Table: 1733PVARIABLEOTHER CANCER N=34 (%)LUNG CANCER N=12 (%)Male52.950Age mean63.963.5Active Smoking016.7Ex-smokers35.350COMORBIDITIESCoronary heart disease8.816.7Hypertension35.341.7COPD8.816.7Dyslipidemia23.525STAGEIV52.950SYMPTOMSpNeutropenia6.101.0Cough67.641.7.17Temperature37.137.3.36Dyspnoea4791.7.007Diarrhea8.88.31.0Lymphopenia68.736.4.08PROGNOSTIC CRITERIAIL6.41D-DIMER0.9 (0.6; 2.2)0.9 (0.5; 2.7).57PCR107.7.44LDH266 (207; 326)290 (238; 352).19FERRITIN562 (358; 933)1111 (392; 2672).15CHARLSON INDEX*8 (6; 9)8 (6; 9).80CURB65 SCALE **.31BRESCIA SCALE.17 Open table in a new tab . Patients with cancer, especially lung cancer, and SARS-CoV2 infection have a worse overall prognosis than the general population. Objective parameters such as LDH, CRP at admission, Brescia index or CURB-65 should alert us to a more serious evolution and suggest early an early intensive care unit (ICU) admission.

Breast cancer (BC) in young patients (<45 years) is an infrequent disease but current evidence suggest that there is an increase incidence in the last decades. After finishing adjuvant therapy, the risk of relapse or death does not increase with pregnancy. Under 40 years, fertility preservation could be an option because pregnancy after 40 usually requires in vitro fertilization techniques. We conducted a retrospective study selecting patients ≤45 years with BC diagnosis in the Breast Cancer Unit of the Puerta de Hierro Hospital between 2014 and 2019. Epidemiological, information was collected. All patients was registered at the National Tumor Registry. We have 2270 women diagnosed of BC; we analysed 385 women ≤45 years with information about pregnancies and births. 153 were ≤40 years (7%) and 33 were ≤35 years (1,5%). We also classified patients according to the age for different fertility strategies, determinate by success rate:Table:Patients (n) frequency cumulateNo pregnancy 78 20.26 20.261 pregnancy 70 18.18 38.442 pregnancies 124 32.21 70.763 or more 103 29,34 100TOTAL 385 100No births 92 24.08 24.081 births 92 24.08 48.172 births 145 37.96 86.133 or more 54 13.87 100No births 0-1 birth ≥2 births≤35 years 51% 77% 23%years 29% 54% 46%≥41 years 17% 40% 60%Total 25% 48% 27% Open table in a new tab . 48% of patients ≤45 years old had between 0-1 births, were unable to complete their reproductive plans, so we must offer fertility advice. 77% of our patients ≤35 years (8,6% of YBCP) could benefit from cryopreservation before treatments, selection of less gonadotropic toxic schemes and ovarian suppression. Women ≥ 41 years (60% of YBCP) will need in vitro fertilization, being fertilization with oocyte donation the technique with the highest success rate. There is an urgent need to stratify patients according to their desire of offspring, risk of infertility and options of fertility preservations.