with a diagnosis of germ-line BRCA ½ mutation and who underwent breast cancer risk-reducing surgery. The occurrence of occult carcinoma was analysed. A descriptive study of these patients was performed. All statistical analysis was performed with Stata/IC 13.0 for Windows. Result(s)* During the study period a total of 168 patients with BRCA ½ mutation were diagnosed and breast risk-reducing surgery was performed in 81 of them (48.2%).In 61.7% (n=50) of the cases, prophylactic surgery was performed after the diagnosis of bilateral breast cancer. Bilateral breast and in 7.4 (n=6) ovarian cancer. In 58.0% (n=47) the mutation was BRCA 1 and in 42% (n=34) BRCA 2. In 39.5% (n=32) the mastectomy performed was nipple sparing and in 60.5% (n=49) simple. Breast reconstruction was performed after surgery in 93.8% (n=76) of cases. Definitive histopathological examination showed ductal carcinoma insitu in 3.7% (n=3) of cases, and infiltrating carcinoma in 1.2% (n=1). Conclusion* In our case series, approximately half of the patients carrying BRCA mutation have opted for breast cancer risk-reducing surgery, with a proportion of incidental carcinomas between 1-3% in the mastectomy surgical specimens. Therefore, we can conclude that in patients carrying BRCA1/2 mutation, prophylactic mastectomy is effective in reducing the risk of breast cancer.

apatinib combined with chemotherapy plus PD-1 antibody drug (2/26), and apatinib combined with PD-1 antibody drug (9/26) and apatinib combined with chemotherapy plus radiotherapy (1/26). The median follow-up time was 5 months. The ORR and DCR were 47.3%(9/19) and 94.7%(18/19). The median PFS was not reached.In addition, 23 pts with ovarian cancer were enrolled in this study. Among them 15 pts were platinum-sensitive, 8 pts were platinum-resistant. The treatment regimens were: apatinib combined with chemotherapy (19/23), apatinib monotherapy (1/23), apatinib combined with chemotherapy drugs plus PD-1 antibody drug (1/23), apatinib combined with PD-1 antibody drug (1/23) and apatinib combined with PARPi (1/23). The median follow-up time was 6 months.The median PFS was 4 months.The ORR and DCR was 14.3%(3/21) and 85.7%(18/ 21).In this real-world study, the incidence of adverse reactions of ovarian cancer and cervical cancer was 79.6%. Grade 3 neutropenia, leukopenia, anemia, proteinuria and thrombocytopenia were observed in 2, 1, 5, 2 and 3 pts. Conclusion* In this real-world study, apatinib showed a favorable efficacy and safety profile in pts with gynecological cancer. It might lead to better survival benefit in treatment for gynecological cancer pts.

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Methodology We retrospectively reviewed the all cases of abdominal surgery open or laparoscopically from 2017-2020. Patients that was included in the Enhanced Recovery After Surgery Protocol were excluded in order to avoid bias in our outcomes. The parameters that were documented were intraoperative complications, complications during the hospitalization of the patient, readmission of patients, reoperation of patients, patients' comorbidities, the charlson comorbidity index (CCI) and body mass index(BMI) . Secondary events were classified according to the Clavien Dindo classification. Result(s)* In total 1006 patients records were reviewed. 438 (43,3%) were in patients with advanced stage disease. Mean CCI was 3,5 and BMI 28,78. Class 1 and 2 complication rates were documented in 193 patients (19,1%) . The mean hospitalization times of these patients were 13,1 days in contrast to the uncomplicated patients that was 3,53 days.Class 3 complications were documented in 54 cases (5,36%). 19 cases were reoperated. The reasons for reoperation were massive hemorrhage in 3 cases, urinary tract complication in 6 cases, surgical wound dehiscence in 5 cases and 5 cases of gastrointestinal tract leakage.Totally, 12 patients succumbed after surgery. 4 of the patients were emergency operations due to peritonitis, 2 patients succumbed due to complications from respiratory tract infections, in 3 cases from sepsis due to leakage from the gastrointestinal tract and 3 patients from cardiovascular events. Conclusion* The increased radicality of gynecological oncology procedures increase hospitalization days as well as the perioperative morbidity and mortality.