Abdul Rahman Jazieh1,2,3, Adda Bounedjar4, Foad Al Dayel5, Shamayel Fahem5, Arafat Tfayli6, Kakil Rasul7, Hassan Jaafar8, Mohammad Jaloudi8, Turki Al Fayea9, Hatim Q Almaghrabi9, Hanaa Bamefleh1,2,10, Khaled AlKattan5,11, Blaha Larbaoui12, Taha Filalli13, Mufid Al Mistiri7, Hamed Alhusaini5. 1. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 2. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 3. Department of Oncology, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. 4. Department of Medical Oncology, Blida I, Algeria. 5. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 6. American University of Beirut, Beirut, Lebanon. 7. Weill Cornell Medical College, Doha, Qatar. 8. Tawam Hospital, Al-Ain, United Arab Emirates. 9. Princess Noorah Oncology Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia. 10. Department of Pathology and Laboratory Medicine, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. 11. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 12. Department of Medical Oncology, Anti Cancer Center, Oran, Algeria. 13. Department of Medical Oncology, CHU Constantine, Algeria.
Abstract
BACKGROUND: Accurate pathological diagnosis is the first critical step in the management of lung cancer. This step is important to determine the histological subtype of the cancer and to identify any actionable targets. Our study aimed at evaluating the patterns of procedures used to obtain pathological diagnosis of lung cancer in the Middle East and North Africa (MENA) Region. METHODS: Data of consecutive patients with the diagnosis of non-small cell lung cancer (NSCLC) were collected from participating centers from different countries in the MENA Region. Methods of obtaining tissue diagnosis and workup were analyzed to determine the practice patterns of obtaining tissue diagnosis of lung cancer. RESULTS: A total of 566 patients were recruited from 10 centers in 5 countries including Saudi Arabia, United Arab Emirates (UAE), Qatar, Lebanon and Algeria. Majority of patients were males (78.1%) with a median age of 61 years (range, 22-89 years). Obtaining tissue diagnosis was successful in the first attempt in 72.3% of patients, while 16.4% and 6.3% of patients required 2nd and 3rd attempt, respectively. The success in first attempt was as follows: image guided biopsy (91%), surgical biopsy (88%), endobronchial biopsy (79%) and cytology (30%). The success in the second attempt was as follows; surgical biopsy (100%), image guided biopsy (95%), endobronchial biopsy (65%), cytology (25%). CONCLUSIONS: More than quarter of the patients required repeated biopsy in the MENA Region. Image guided biopsy has the highest initial yield. Implementing clear process and multidisciplinary guidelines about the selection of diagnostic procedures is needed. 2019 Journal of Thoracic Disease. All rights reserved.
BACKGROUND: Accurate pathological diagnosis is the first critical step in the management of lung cancer. This step is important to determine the histological subtype of the cancer and to identify any actionable targets. Our study aimed at evaluating the patterns of procedures used to obtain pathological diagnosis of lung cancer in the Middle East and North Africa (MENA) Region. METHODS: Data of consecutive patients with the diagnosis of non-small cell lung cancer (NSCLC) were collected from participating centers from different countries in the MENA Region. Methods of obtaining tissue diagnosis and workup were analyzed to determine the practice patterns of obtaining tissue diagnosis of lung cancer. RESULTS: A total of 566 patients were recruited from 10 centers in 5 countries including Saudi Arabia, United Arab Emirates (UAE), Qatar, Lebanon and Algeria. Majority of patients were males (78.1%) with a median age of 61 years (range, 22-89 years). Obtaining tissue diagnosis was successful in the first attempt in 72.3% of patients, while 16.4% and 6.3% of patients required 2nd and 3rd attempt, respectively. The success in first attempt was as follows: image guided biopsy (91%), surgical biopsy (88%), endobronchial biopsy (79%) and cytology (30%). The success in the second attempt was as follows; surgical biopsy (100%), image guided biopsy (95%), endobronchial biopsy (65%), cytology (25%). CONCLUSIONS: More than quarter of the patients required repeated biopsy in the MENA Region. Image guided biopsy has the highest initial yield. Implementing clear process and multidisciplinary guidelines about the selection of diagnostic procedures is needed. 2019 Journal of Thoracic Disease. All rights reserved.
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