title: Multidisciplinary management of clear-cell renal cell carcinoma in Africa and the Middle East: current practice and recommendations for improvement.
abstract: The management of renal cell carcinoma (RCC) has evolved considerably in recent years. This report represents the consensus of 22 relevant medical specialists from Africa and the Middle East region engaged in the management of RCC. Partial or radical nephrectomy is the standard of care for most patients with localized RCC. It is essential that patients are followed up appropriately after surgery to enable local and distant relapses to be identified and treated promptly. The treatment of advanced/metastatic disease has changed dramatically with the introduction of targeted therapies. Follow-up of these patients enables therapy optimization and assessment of response to treatment. There was universal agreement on the importance of management of RCC by a multidisciplinary team supported by a multidisciplinary tumor board. Barriers hindering this approach were identified. These included lack of awareness of the benefits of multidisciplinary team role, poor communication among relevant disciplines, time constraints, and specifics of private practice. Other challenges include shortage of expert specialists as urologists and oncologists and lack of local management guidelines in some countries. Solutions were proposed and discussed. Medical educational initiatives and awareness activities were highlighted as keys to encouraging cooperation between specialties to improve patients' outcome. Establishing combined genitourinary cancer clinics and formal referral systems should encourage a culture of effective communication. Joining forces with professionals in peripheral areas and the private sector is likely to help standardize care. Sustained action will be required to ensure that all patients with RCC in the region benefit from up-to-date care.
authors.affiliation: College of Medicine, King Faisal Specialist Hospital and Research Centre, Alfaisal University, Jeddah, Saudi Arabia.
authors.forename: Jamal
authors.initials: J
authors.lastname: Zekri
authors.affiliation: Department of Medical Oncology, University of Pretoria, Pretoria, South Africa.
authors.forename: Lydia M
authors.initials: LM
authors.lastname: Dreosti
authors.affiliation: Faculty of Medicine Hematology, Oncology Department, Saint Joseph University, Beirut, Lebanon.
authors.forename: Marwan
authors.initials: M
authors.lastname: Ghosn
authors.affiliation: Faculty of Medicine, Cairo University, Kasr Alainy, Cairo, Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Hamada
authors.affiliation: Oncology Hematology Department, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jaloudi
authors.affiliation: National Cancer Institute, Cairo University, Kasr El Ainy, Cairo, Egypt.
authors.forename: Ola
authors.initials: O
authors.lastname: Khorshid
authors.affiliation: Oncology Service, Université Djillali Liabés, Sidi Bel Abbés, Algeria.
authors.forename: Blaha
authors.initials: B
authors.lastname: Larbaoui
keywords: Africa-Middle East; education; multidisciplinary; renal cell carcinoma