Cancer during pregnancy is a challenge for multi- and interdisciplinary collaboration due to the diagnostic, prognostic and therapeutic implications, the need for an integrated harmonization of medical action for the pregnant patient and the embryo or foetus and the characteristics of each gestational period, which will determine the protocol to be proposed and its limitations. For this reason, a group of experts appointed by participating scientific societies, which includes the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica—SEOM), the Spanish Association of Surgeons (Asociación Española de Cirujanos—AEC), the Spanish Society of Gynaecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia—SEGO), the Spanish Society of Nuclear Medicine and Molecular Imaging (Sociedad Española de Medicina Nuclear e Imagen Molecular—SEMNIM), the Spanish Society of Oncological Radiotherapy (Sociedad Española de Oncología Radioterápica—SEOR) and the Spanish Society of Medical Radiology (Sociedad Española de Radiología Médica—SERAM), have worked together to establish consensus recommendations that allow the harmonization of management and ultimately the optimization of the healthcare of pregnant patients with cancer. When cancer is detected in a pregnant woman, the week of gestation in which the diagnosis is made must be considered, as well as the characteristics of the tumour. It is strongly recommended that a multidisciplinary team assesses the situation and guides the patient and her family during the informing, diagnosis and treatment process. Likewise, the foetus should be monitored and managed by specialized obstetricians who are part of a multidisciplinary cancer committee.

Background: Polytrauma remains a leading cause of mortality and disability worldwide. Although trauma-related deaths have declined in recent decades, the drivers of this trend remain incompletely understood. Traumatic brain injury (TBI) is the principal cause of death and long-term disability in polytrauma, making it a critical determinant of outcomes. This study aimed to examine long-term trends in clinical characteristics, management strategies, and outcomes of polytraumatized patients with TBI (PTBI), with a particular focus on factors influencing overall and cause-specific mortality. Methods: We conducted a retrospective observational study of a prospectively maintained trauma registry over a 25-year period (1993–2018) at the Gregorio Marañón University General Hospital (Madrid, Spain). Adult patients with PTBI were included. Epidemiological, clinical, and outcome data were analyzed globally and across four time periods. Results: Among 768 patients with PTBI, mean age was 43 years (±20), and 29% were female. Most sustained closed TBIs (96%) with concomitant severe injuries to the head, chest, and extremities (median Injury Severity Score [ISS] 27; median New Injury Severity Score [NISS] 34). Emergency surgery was required in 51%, and 84% were admitted to intensive care. Over time, the incidence of polytrauma decreased, mainly reflecting fewer traffic-related injuries following advances in prevention and legislation. Despite an increasingly older and comorbid population, ISS/NISS and early mortality declined, largely due to improvements in prehospital care and hemorrhage control. Although crude TBI-related mortality appeared unchanged (28%), this pattern likely reflects offsetting influences, including an older and more comorbid patient population, a higher relative burden of severe cases, and the limitations of mortality alone to capture gains in functional outcomes. Conclusions: Advances in trauma systems and preventive policies have substantially reduced the burden of polytrauma and improved survival. However, severe TBI remains the principal unresolved challenge, highlighting the urgent need for innovative neuroprotective strategies and greater emphasis on functional recovery.