1. Management of patients with high-risk and advanced prostate cancer in the Middle East: resource-stratified consensus recommendations
- Author
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Hero K. Hussain, H. Dbouk, Khaled Ibrahim, Bassel G. Bachir, Walid Alameh, Rami Nasr, Christelle Dagher, Saad Al Dousari, Clement El Khoury, Wassim Wazzan, Ali Shamseddine, Khaled Sayyid, Raja Ashou, Yousuf Al Hallaq, Danny M. Rabah, Georges Assaf, Mohammad Haidar, Michel Jabbour, Fadi Farhat, George Farha, F. Geara, Silke Gillessen, Sally Temraz, Aurelius Omlin, Ghazi Sakr, Deborah Mukherji, Sami Faddoul, Hassan Ghazal, Elie Nemer, Bassem Youssef, Nicolas Zouain, Muhammad Bulbul, Albert El-Hajj, Nizar Bitar, Nibras Al Hamdani, Fadi Abbas, Rabih Said, and Raja B. Khauli
- Subjects
Male ,030232 urology & nephrology ,Abiraterone Acetate ,Docetaxel ,Health Services Accessibility ,Endosonography ,Prostate cancer ,0302 clinical medicine ,Resource (project management) ,Medicine ,Lebanon ,Neoplasm Metastasis ,610 Medicine & health ,Radiation oncologist ,Resource-stratified recommendations ,Middle East ,Multidisciplinary ,Manchester Cancer Research Centre ,Consensus conference ,Margins of Excision ,Magnetic Resonance Imaging ,Prostatic Neoplasms, Castration-Resistant ,Kuwait ,030220 oncology & carcinogenesis ,Benzamides ,Iraq ,Health Resources ,Kallikreins ,Original Article ,Risk ,medicine.medical_specialty ,Consensus ,Referral ,Antineoplastic Agents, Hormonal ,Urology ,Locally advanced ,Saudi Arabia ,Antineoplastic Agents ,Bone Neoplasms ,Diagnostic modalities ,03 medical and health sciences ,Nitriles ,Phenylthiohydantoin ,Humans ,Prostatectomy ,Salvage Therapy ,Syria ,business.industry ,ResearchInstitutes_Networks_Beacons/mcrc ,Prostatic Neoplasms ,Androgen Antagonists ,Prostate-Specific Antigen ,medicine.disease ,Family medicine ,Positron-Emission Tomography ,Lymph Node Excision ,Radiotherapy, Adjuvant ,Biopsy, Large-Core Needle ,business - Abstract
Purpose Prostate cancer care in the Middle East is highly variable and access to specialist multidisciplinary management is limited. Academic tertiary referral centers offer cutting-edge diagnosis and treatment; however, in many parts of the region, patients are managed by non-specialists with limited resources. Due to many factors including lack of awareness and lack of prostate-specific antigen (PSA) screening, a high percentage of men present with locally advanced and metastatic prostate cancer at diagnosis. The aim of these recommendations is to assist clinicians in managing patients with different levels of access to diagnostic and treatment modalities. Methods The first Advanced Prostate Cancer Consensus Conference (APCCC) satellite meeting for the Middle East was held in Beirut, Lebanon, November 2017. During this meeting a consortium of urologists, medical oncologists, radiation oncologist and imaging specialists practicing in Lebanon, Syria, Iraq, Kuwait and Saudi Arabia voted on a selection of consensus questions. An additional workshop to formulate resource-stratified consensus recommendations was held in March 2019. Results Variations in practice based on available resources have been proposed to form resource-stratified recommendations for imaging at diagnosis, initial management of localized prostate cancer requiring therapy, treatment of castration-sensitive/naïve advanced prostate cancer and treatment of castration-resistant prostate cancer. Conclusion This is the first regional consensus on prostate cancer management from the Middle East. The following recommendations will be useful to urologists and oncologists practicing in all areas with limited access to specialist multi-disciplinary teams, diagnostic modalities and treatment resources. Electronic supplementary material The online version of this article (10.1007/s00345-019-02872-x) contains supplementary material, which is available to authorized users.
- Published
- 2019
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