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Management of patients with high-risk and advanced prostate cancer in the Middle East: resource-stratified consensus recommendations.
- Source :
-
World journal of urology [World J Urol] 2020 Mar; Vol. 38 (3), pp. 681-693. Date of Electronic Publication: 2019 Jul 11. - Publication Year :
- 2020
-
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.<br />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.<br />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.<br />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.
- Subjects :
- Abiraterone Acetate therapeutic use
Antineoplastic Agents therapeutic use
Benzamides
Biopsy, Large-Core Needle
Bone Neoplasms secondary
Bone Neoplasms therapy
Docetaxel therapeutic use
Endosonography
Humans
Iraq
Kallikreins metabolism
Kuwait
Lebanon
Lymph Node Excision
Magnetic Resonance Imaging
Male
Margins of Excision
Middle East
Neoplasm Metastasis
Nitriles
Phenylthiohydantoin analogs & derivatives
Phenylthiohydantoin therapeutic use
Positron-Emission Tomography
Prostate-Specific Antigen metabolism
Prostatic Neoplasms diagnosis
Prostatic Neoplasms epidemiology
Prostatic Neoplasms pathology
Prostatic Neoplasms, Castration-Resistant diagnosis
Prostatic Neoplasms, Castration-Resistant epidemiology
Prostatic Neoplasms, Castration-Resistant pathology
Prostatic Neoplasms, Castration-Resistant therapy
Risk
Salvage Therapy
Saudi Arabia
Syria
Androgen Antagonists therapeutic use
Antineoplastic Agents, Hormonal therapeutic use
Health Resources
Health Services Accessibility
Prostatectomy
Prostatic Neoplasms therapy
Radiotherapy, Adjuvant
Subjects
Details
- Language :
- English
- ISSN :
- 1433-8726
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- World journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 31297628
- Full Text :
- https://doi.org/10.1007/s00345-019-02872-x