ABSTRACT
A lung cancer committee from the Middle East and North Africa (MENA) region was established to modify the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) on Non-Small Cell Lung Cancer to create a platform for standard care in the region. The committee comprised different experts in thoracic oncology from the region, including the disciplines of medical and clinical oncology, radiation oncology, thoracic surgery, pulmonary medicine, radiology, and pathology. The committee reviewed version 2 of the 2009 NCCN Guidelines on Non-Small Cell Lung Cancer and identified recommendations requiring modification for the region using published evidence and relevant experience. These suggested modifications were discussed among the group and with a United States-based NCCN expert for approval. The recommended modifications, with justification and references, were categorized based on the NCCN Guidelines flow. This article describes these recommended modifications. The process of adapting the first NCCN-based guidelines in the region is a step toward helping to improve lung cancer care in the region and encouraging networking and collaboration.
Subject(s)
Arabs/statistics & numerical data , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Africa, Northern/epidemiology , Bronchoscopy , Carcinoma, Non-Small-Cell Lung/epidemiology , Carcinoma, Non-Small-Cell Lung/pathology , Chemotherapy, Adjuvant , Diagnosis, Differential , Evidence-Based Medicine , Humans , International Cooperation , Karnofsky Performance Status , Lung Neoplasms/epidemiology , Lung Neoplasms/pathology , Lymphatic Metastasis , Middle East/epidemiology , Neoplasm Staging , Palliative Care , Radiotherapy, Adjuvant , Tomography, X-Ray Computed , United StatesABSTRACT
OBJECTIVE: To review the medical records of patients diagnosed with sarcoidosis for sociodemographic characteristics, clinical presentation, mode of diagnosis, and stage of disease at a tertiary care centre of Pakistan. METHOD: The medical records of 47 patients consecutively diagnosed with sarcoidosis from 2003 to 2008 were reviewed retrospectively. The sociodemographic characteristics, clinical presentation, mode of diagnosis, organs involved, stage of disease and follow up were reviewed. RESULTS: Out of 47 patients, 26 (55%) were female and 21 male. Cough and shortness of breath were the main presenting symptoms. Mode of diagnosis was gallium scan in 27 patients, biopsy in 16 patients and High Resolution CT scan in 3 patients. Asymptomatic patients at presentation did not require any treatment and did well on follow up. Eighteen patients required steroid therapy which was slowly tapered off. Two patients required azathioprin in addition to steroids. CONCLUSION: Sarcoidosis is a diagnostic challenge in countries where tuberculosis is endemic, however physicians still need to keep sarcoidosis in the differential diagnosis due to clinical, histological and radiological similarities between the two conditions
