Background: Patients with Multiple-primary Malignancies are usually excluded from clinical trials. Clinical information re-distribution, associations, response to treatment and prognosis are scared. Collecting information will help us to expect the impact of prior therapies and to teach us how to best treat them. This study aims to report cases in our society and to see if we have a special predilection of certain Multiple-primary Malignancies in our region based on different geographic and environmental risk factors. Our retrospective study aims to collect these cases and follow their prognosis and treatment response as well as looking for any relation to cancer therapy. Methods: A retrospective study included patients who have two or more histologically diverse primary malignancy, either as synchronous or metachronous malignancy. The study was conducted in King Abdullah Medical City, Saudi Arabia over 7 years period from 2012 to 2019. We collected all patient’s clinicopathological information, treatment, and modalities. Results: We collected 53 cases of multiple primary malignancies 26were synchronous (48%) and 27 were metachronous (52%). Out of 53 patients, 29 (60 %) were females and 14 (40 %) were males. The most common sites for synchronous are breast and endometrial cancer. Curative treatment could be offered in 19 patients (73%). For metachronous tumours, the most common primary tumour was breast cancer, while the most common second malignancy was colorectal cancer. Curative treatment could be offered in 15 patients (53%). Conclusion: Multiple primary malignancies represent a small proportion of our cases, with no special predilection in our society. Multiple primary malignancies did not signify a poor prognosis; besides nonmetastatic cases showed a good response to therapy. We should not forget the possibility of a second primary tumour as these cases can be reasonably treated with curative intent. 

while high-risk endometrial cancer includes women with stage III or higher Endometrial Cancer, regardless of histology or grade. A Serous Carcinoma, Clear Cell Carcinoma, and Carcinosarcoma are considered at high risk, regardless of the stage. An Intermediate risk includes all others (Colombo et al., 2016). The use of Pelvic external beam radiotherapy has been for many years the standard treatment for high-risk Endometrial Cancer. Patients treated with pelvic radiotherapy showed a delay

Background: The WHO has declared the coronavirus disease 2019 (COVID-19) pandemic in March 2020. Cancer patients are considered a highly susceptible group. The effect of this pandemic on cancer mortality is still unknown. Aim: Our aim is to know whether or not we need to postpone cancer treatment during viral pandemics in the future. Materials and Methods: A retrospective observational study from March 1, 2020 to June 1, 2020, included cancer patients on active treatment, who have been admitted to our oncology center through the emergency unit, and patients who received oncology treatment in the outpatient treatment unit. COVID-19 positive cases were identified based on polymerase chain reaction testing of nasopharyngeal swab. Results: A total of 1300 patients was included in the study, 1096 patients attended the outpatient clinics, 204 patients were admitted to our oncology floor for emergency care. The cancer diagnosis was mainly breast cancer, followed by colon cancer. The main cause of emergency room visit was mainly fever followed by pain. Admission diagnosis was mainly disease progression followed by symptom control, COVID-19 infection, and febrile neutropenia. 1288 cycles of anticancer therapy were provided to 513 patients in the outpatient treatment unit. Three out of the nineteen patients who had a confirmed COVID-19 infection (16%) died not only due to infection, but also disease progression. Conclusion: Cancer treatment is not a risk factor for COVID-19 infection or its complications. Cancer treatment should not be interrupted during viral pandemics and every effort should be made to give cancer patients the standard of care.

Background: Lymphovascular invasion (LVI) is known to be associated with a poor outcome in breast cancer patients. It indicates a highly proliferative cancer. Few studies examined the value of LVI as a predictor for outcome after neoadjuvant chemotherapy (NAC). The aim of this study to look for an association between survival outcomes and clinicopathological features in locally advanced breast cancer patients treated with NAC and to identify the predictors of nodal pathologic complete response (PCR). Methods:This study is a retrospective analysis of 224 women with locally advanced breast cancer who underwent NAC between 2011-2020. Kaplan-Meier analyses were used to assess the associations between disease-free survival (DFS) and overall survival (OS) and all clinicopathological variables including LVI in breast surgical specimens following NAC. Associations between nodal PCR and all clinicopathologic variables were assessed Results:Median follow-up was 29.9 months. Absence of nodal PCR (p.000), positive family history (p .027), clinical T4 (p.049), pathological TNM staging (p.016), high tumor grade (p .020),triple negative disease(p .016) and absence of tumor PCR (p.001) were associated with worse disease free survival. Absence of nodal PCR (p.002), high BMI (p.039), multicentric disease (p.026), high tumor grade, triple negative disease (p.018), and absence of tumor PCR (p.005) were associated with worse overall survival. LVI was found in 53 of surgical specimens (23.7%). It was associated with worse DFS (HR) (2.967) 95% CI (1.7-4.9), p.000 and overall survival (HR) (3.05) 95% CI (1.525-6.09), p.002). Nodal PCR significantly correlated with T stage (p .013), LVI (p.000), ER status (p.004), PR status (p.003), Her2neu status and IHC score (p.000), tumor subtype (p.000), tumor PCR (p.000), DFS (p.000), and OS (p.000). Conclusion:LVI is significantly associated with worse DFS and OS in locally advanced breast cancer patients treated with NAC. This data confirmed the previously published recommendation to add LVI to the pathological staging system. LVI may be further explored as a guide for adjuvant treatment options in clinical trials. Nodal PCR is another significant predictor of outcome and is associated significantly with tumor PCR and LVI. Both tumor PCR and LVI can be used as criteria for axillary surgery omission in future trials. Citation Format: Omima Elemam, Khaled Elnaghi, Ziad Emarah, Hossam Alghanami, Seham Abdelkhalek. Residual lymphovascular invasion: Predicts the outcome of neoadjuvant chemotherapy in locally advanced breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-07-30.