The treatment of ovarian cancer should be appropriate, since clinical and surgical decisions may affect the prognosis; the surgery must be performed by an expert oncological surgeon or gynecological oncologist, it's fundamental roles are cancer staging and cytoreduction. The concept of staging surgery in early stages has its justification in the fact that up to 11% of "early ovarian cancers" will have metastasis in different sites of the peritoneal cavity at the time of diagnosis. In advanced stages of epithelial ovarian cancer, the goal is the complete cytoreduction of all visible macroscopic disease, since this variable is the most strongly associated with increased overall survival and disease-free period. The ideal time for cytoreductive surgery in relation to chemotherapy (before or after) is still under debate. In 2010 a randomized trial (EORTC) was published, comparing 310 patients initially operated (followed by adjuvant chemotherapy) versus 322 patients initially treated with neoadjuvant chemotherapy (followed by cytoreductive surgery); no significant differences in overall survival between groups were found. Another important factor playing a role in survival and in the probability of surgical cytoreductive success is tumor biology; there has been described a clear difference between serous and mucinous tumors, but some groups advocate that maximal surgical effort in mucinous tumors may compensate morbidity with an increase in survival. The extension of resection in cytoreduction is still controversial; some authors have confirmed that the most important factor is the residual disease and that radical surgery is superior to non-radical surgery in terms of overall survival. The need and extent of lymphadenectomy in advanced cancer will be treated in another chapter of this issue. Undoubtedly, an important factor is to perform procedures in specialized centers.

Introduction: Breast cancer is the most common invasive neoplasm in women. When taken to mastectomy, breast reconstruction is an integral part of treatment. Objectives: The purpose of this study is to determine which factors are associated to post-operatory complications of breast reconstruction in patients with breast cancer treated with mastectomy. Methods: 306 patients taken to breast reconstruction were divided into three groups depending on technique: pedicled flaps, prosthetic material and deep inferior epigastric perforators (DIEP). Descriptive and comparative statistics were performed to find associations between the type of reconstruction and complications. Results: The factors associated to general were bleeding and reintervention. Reintervention was associated to loss of reconstruction. Factors associated to reoperation were immediate complications, late complications, and radiotherapy. Factors associated to loss of reconstruction where smoker status, presence of late complications, and reintervention. Conclusion: There is a higher percentage of immediate complications and loss of reconstruction with prosthetics. DIEP is an alternative with lower probability of loss of reconstruction. Multidisciplinary teams should establish the decision of the best type of reconstruction.

HighlightsThere is no established diagnostic and treatment approach for laryngeal chondrosarcoma due to its low frequency.90% of laryngeal chondrosarcoma are low-grade tumors and therefore conservative surgery is recommended as initial treatment.Percutaneous biopsy could save patients from a of total laryngectomy.

Background Breast cancer represents the most common malignancy in Latin America, and since 2006 it is the cancer type with the highest incidence among Mexican women. Providing multidisciplinary high-quality care for the growing population of patients with breast cancer represents a challenge to low and middle-income countries, which have limited economic resources and limited health staff and facilities. Since 2007, Seguro Popular insurance program has provided coverage for the treatment of women with breast cancer, including surgery, radiotherapy, chemotherapy, endocrine therapy and Her2-targeted treatments; before this program up to 50% of the Mexican population did not have healthcare coverage, and had to pay out of pocket for cancer care. Unfortunately, due to financial constraints, this does not include other interventions which may be relevant, such as supportive care and reconstructive surgery. National Cancer Institute of Mexico (INCan) is a part of the Mexican federal government and as such provides care to uninsured individuals with all types of malignancies, including breast cancer. Since the start of Seguro Popular insurance program (2007), INCan has provided oncological care to over 5,000 women with breast cancer. In 2012, INCan received a grant from the federal government (P017 Reproductive Health and Gender Equality in Health Grant) in order to establish the “Post-Mastectomy Program” (PMP), which aimed providing free patient navigation, supportive care and breast reconstruction for women after mastectomy. Starting on july 2016, derived from PMP, it was possible the setting of a Same-Day Surgery Facility (SDSF) at INCan: two small, fully equipped operation rooms with a small recovery area; and the hiring of 4 nurses and 2 anesthesiologists, adding all this to the one main operation room already set for breast cancer surgery. This allowed an increase in all kind of breast cancer surgery: conservative surgery, mastectomy with sentinel lymph node and breast reconstruction procedures. One of this rooms was assigned to breast reconstructive surgeries. Material and Methods Data were retrospectively collected from a 5 year period, 30 months before SDSF and 30 months after SDSF. Before SDSF an average 66.4 (54-73) of breast reconstruction surgeries were done by six month period, total of 332 breast reconstruction surgeries. After implementation of SDSF an average of 124 (107-138) by six month period, with a total 621 surgeries, which represents an 87% increase in breast reconstruction procedures for the same time period. Conclusion Same day surgery has been proven before to be safe in breast cancer surgery and in breast reconstructive surgery when co-morbidities are accounted for. This work shows that implementation of Same-Day Surgery could be a tool to increase the offer of breast reconstruction in economically restrained systems, in early or experienced breast reconstruction programs in developing economies, and even in developed ones. In our experience, this approach achieved an 87% increase in breast reconstruction procedures, in a 30 month period, which allowed us to benefit more women and offer them a better quality of life. Citation Format: Bargalló-Rocha JE, Gutiérrez-Zacarías LM, Maciel-Miranda A, Figueroa-Padilla J, Drucker-Zertuche M, Esparza-Arias N, Elizalde-Méndez A, Cabrera-Galeana PA. Same-day surgery impact on breast reconstruction program in a public healthcare system: An affordable booster [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-09.