Orencio Tarrío Fernández’s research while affiliated with Complejo Hospitalario de Navarra and other places

Introduction/Background Nowadays, the use of the Internet and social networks, as tools for searching information after an oncological diagnosis, are a constant fact.The information, based on truthful and scientific evidence, allows patients and their relatives to improve their understanding of the entire oncological process. Methodology From the Multidisciplinary Gynecological Oncology Unit of ’Hospital Universitario de Navarra’, the computer application for mobile devices and tablets – APP UMD360- is created to offer a digital solution that allows:- Integration of general information about gynecological cancer. - Facilitate access to information. - Improve communication between health-care professionals, patients, and family members, allowing digital interaction too. The digital development company Anasinf® has an APP for patients and a Web application for healthcare professionals. There are different sections ’Who we are’, ’psychosocial support’, ’information’ that includes general and personalized documents, ’frequently asked questions’…To prepare the information available in the APP, a web application for healthcare professionals has been developed, a content manager in which information material can be created and edited autonomously. Results In testing phase of the APP, the user rating was very positive, with a general average score of 47/50, highlighting that it is an easy-to-use tool.The implementation phase began in March 2022 with 32 new users. Until December 2023 there are 2514 searches registered. It has been determined: - 4847 accesses to general information. - 3387 accesses to ’Who we are’ - 1593 to ’Frequently asked questions’ - 1675 to ’Support Unit’ By type of tumor, uterine cancer has the most consultations (229), followed by cervical cancer (104 accesses). Regarding type of treatment, the most frequent consultation is chemotherapy (403 consultations). Conclusion The use of mobile technologies and the Internet can be integrated into clinical practice, in a way that contributes to modernizing and adapting the care process to today’s society. Disclosures None.

Introduction/Background The treatment of vulvovaginal cancer sometimes requires the excision of large areas of tissue that generate complex defects, with functional and aesthetic repercussions, both on the patients‘ quality of life and on their body image.Small defects can be repaired with direct closure, but those caused by large, extensive surgeries will require reconstruction using other intervening tissues. Methodology We present a video that includes a selection of neoplastic cases with the use of vulvovaginal reconstructive techniques: • Simple vulvectomy, radical vulvectomy with V-Y advancement flaps • Perineal resection and extended anterior pelvic exenteration with VRAM (rectus abdominis muscle) flap • Extended perineal resection and pelvic exenteration • Right hemicolpectomy with Gracilis muscle flap with skin graft • Resection of the posterior wall of the vagina with the fasciocutaneous Malaga flap • Vaginal stenosis (unilateral Malaga flap) • Partial reconstruction of the vagina and perineum (Malaga flap and V-Y advancement flaps) • Complete vaginal reconstruction (Malaga flaps and V-Y advancement flap). Results Principles of reconstructive surgery that we follow: • Multidisciplinary team approach. • Appropriate selection of the procedure for each patient, ‘à la carte’. • Immediate reconstruction in a single surgical procedure. • Prevent complications that delay adjuvant treatment. • Use of well vascularized tissues. • Avoid using irradiated tissues. • Minimize morbidity in donor areas. • Quality of life (aesthetic and functional result). Conclusion • Vulvoperineal reconstruction is a challenge in vulvar cancer surgeries, since it involves the oncological approach and the consideration of the consequences at a functional and aesthetic level, impacting the quality of life. • In these interventions, knowledge of various reconstructive techniques is required, through the use of flaps. • A multidisciplinary approach is recommended, with the participation of Plastic Surgery and teams with experience in different techniques, to limit the potential morbidity associated with the treatments. Disclosures None.

Introduction/Background* The surgical management of advanced epithelial ovarian cancer (AEOC) is controversial in fragile subjects like elderly patients. The aim of this study was to report the global survival of primary and interval debulking surgery (PDS/IDS) over 65 years and to compare the outcomes with younger patients. Methodology Between 2005 and 2016, 145 patients with ovarian cancer in FIGO stages IIIC or IV and PDS or IDS were included. We compared patient characteristics, type of surgery, major postoperative complications, hospital length of stay, disease free survival (DFS) and ovarall survival (OS) for patients under and over 65 years. Result(s)* 93 patients were up to 65 years and 60 patients were over. There were no difference between the two groups for performance status, CA 125, tumors hystotypes and FIGO stage. Charlson comorbidity index and tumor grade were higher among aged patients. The proportion of PDS and the surgical complexity score did not show statiscally signficative differences, as well as the rate of major postoperative complications or length of stay.Patients over 65 years had optimal cytorreduction in 78.3%, the progression free survival was 19.1months and overall survival was the 48.7 months compared with patients up to 65 years, which had 87.1% of optimal debulking surgery, 24.6 months of DFS and 52.7 months. None of these outcomes revealed any statistical significant difference between groups. • Download figure • Open in new tab • Download powerpoint Abstract 49 Figure 1 Kaplan Meier curves. Overall survival in advance ovarian cancer after bebulking surgery View this table: • View inline • View popup • Download powerpoint Abstract 49 Table 1 Characteristics and outcomes of advanced ovarian cancer patients undergone to debulking surgery by age groups Conclusion* The survival outcomes in elderly ovarian cancer patients are the same as younger patients. The age should not be the main factor to decide the upfront treatment of AEOC.

The incidence of neoplasia of vulva round 1-2 per 100,000 women with predominance in ranges age of diagnosis between 65-75years. This type of cancer pathology is tackled with surgical techniques summarized in simple vulvectomy or vulvectomy with unilateral or bilateral lymphadenectomy according to staging of cutaneous involvement. The morbidity of this surgical process is mainly grouped in skin moisture, dehiscence and infection. The use of Nobecutan® as a plastic dressing aerosol barrier reduces cutaneous surgical comorbidity.

Background: Endometrial adenocarcinoma is the most frequent gynaecological neoplasia after breast cancer and represents 6% of cancers in women. The treatment for this disease is surgery. The majority of cases are diagnosed in their initial stages and surgery is curative; on other occasions it is necessary to add radiotherapy and chemotherapy. The classical treatment for endometrial adenocarcinoma is hysterectomy with double adnexectomy by laparotomy, with the addition of pelvic and para-aortic lymphadenectomy and omentectomy according to the characteristics of the case. During the last 10-15 years laparoscopy has been introduced in the surgical treatment of endometrial adenocarcinoma. The main aim of this study is to analyze the cases of endometrial adenocarcinoma treated surgically in the former Virgen de Camino Hospital (nowadays the Hospital Complex of Navarra) during 2001-2009. Methods: Historical cohort of 444 patients with endometrial adenocarcinoma during 2001-2009 who received surgical treatment, followed four years. Conclusions: The results confirm that laparoscopy is a safe alternative to classical laparotomy as it does not affect either survival or time free of disease, in both endometrioid adenocarcinoma and non-endometrioid adenocarcinoma.

Fundamento. El adenocarcinoma de endometrio es la neoplasia ginecológica más frecuente tras el cáncer de mama y representa el 6% de todos los cánceres de la mujer. El tratamiento fundamental de dicha enfermedad es la cirugía. La mayoría de los casos se diagnostican en estadios iniciales y la cirugía será curativa; en otras ocasiones es necesario añadir radioterapia o quimioterapia. El tratamiento clásico del adenocarcinoma de endometrio es la histerectomía con doble anexectomía por vía laparotómica, añadiendo según las características del caso la linfadenectomía pélvica, paraaórtica y omentectomía. Durante los últimos 10-15 años se ha introducido la laparoscopia en el tratamiento quirúrgico del adenocarcinoma de endometrio. El objetivo principal de este trabajo es analizar los casos de adenocarcinoma de endometrio intervenidos quirúrgicamente en el antiguo hospital Virgen de Camino (hoy Complejo Hospitalario de Navarra) durante el periodo 2001-2009. Material y métodos. Se ha recogido una cohorte histórica de 444 pacientes con diagnóstico de adenocarcinoma de endometrio durante el periodo 2001-2009, que recibieron tratamiento quirúrgico, así como su seguimiento durante 4 años. Conclusiones. Los resultados confirman que la vía laparoscópica es una alternativa segura a la laparotomía clásica ya que no afecta a la supervivencia ni al tiempo libre de enfermedad tanto en el adenocarcinoma endometrioide como en el no endometrioide.