Why local guidelines?

Abstract

In this issue of the journal we present the locally agreed management guidelines of the four most common urologic cancers: renal cell cancer, bladder cancer, prostate cancer and testicular cancer. Medical practitioners in Saudi Arabia are either multicultural or trained in different parts of the world. This usually results in different treatment approaches and management plans for patients of similar problems. Under the direction of the Saudi Oncology Society, a committee of experts from the medical oncology, urology and radiation oncology was established. The mission of the genitourinary guidelines committee was to oversee the development of guidelines for the common genitourinary cancers that will improve the practice of medicine for urologic cancers in Saudi Arabia and to establish minimum recommendations that can be used by health authorities in their decision making when coming across cancer management. This committee is one of the different committees that was established for the development of management guidelines in all cancer sites, of which the first to be published was the lung cancer guidelines.[1] Ongoing goals of the committee are to improve the dissemination of these guidelines, ensure annual updates and act as a nucleus for collaborative research. Members of the genitourinary guidelines committee represented major institutions from all different parts of the kingdom and are listed in Table 1. Table 1 Genitourinary guidelines members and their affiliations The committee agreed to use the established bulleted format used by the lung cancer committee. The committee nominated different members to present a draft of the guidelines on each cancer site that takes into account available evidence for each item. The draft is finalized during one or two sessions. Each recommendation is either referenced and level of evidence is indicated. Final draft was circulated for approval by all members. The committee also agreed to use the evidence level (EL) categories used by the lung cancer committee which are summarized as follow: EL-1 (high level): well-conducted phase III randomized studies or meta-analysis EL-2 (intermediate level): good phase II data or phase III trials with limitations EL-3 (low level): observational/retrospective studies/expert opinion Finally, committee members agreed that clinical research is integral part of patients care and is the only way to advance and improve patient care, increase cure rate and decrease the presence of adverse effects from medical and surgical therapies.