Management of Early-Stage Resected Non-Small Cell Lung Cancer: Consensus Statement of the Lung cancer Consortium

BACKGROUND

Management of early-stage non-small cell lung cancer (ES-NSCLC) has evolved over the last few years especially in terms of work-up and the use of systemic therapy. This consensus statement was developed to present updated guidelines for the management of this disease.

METHODS

Multidisciplinary team (MDT) of lung cancer experts convened to discuss a set of pertinent questions with importance relevance to the management of ES-NSCLC. ES-NSCLC includes stages I, II and resected stage III. The experts included consultants in chest imaging, thoracic surgery, radiation oncology, and medical oncology. Questions were discussed in virtual meetings and then a written manuscript with supporting evidence was drafted, reviewed, and approved by the team members.

RESULTS

The Consensus Statement included 9 questions addressing work-up and management of ES-NSCLC. Background information and literature review were presented for each question followed by specific recommendations to address the questions by oncology providers. The Statement was endorsed by various oncology societies in the Gulf region.

CONCLUSION

The Consensus Statement serves as a guide for thoracic MDT members in the management of ES-NSCLC. Adaptation of these to the local setting is dictated usually by available resources and expertise, however, all efforts should be excreted to provide the optimal care to all patients whenever possible.

Prevalence and risk factors of burnout among female oncology professionals from the Middle East and North Africa (MENA)

11016

Background: Burnout (BO) is a recognized challenge among oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among women in oncology from the Middle East and North Africa (MENA). Methods: An online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors. Results: Between February 10 and March 15, 2020, 545 responses were submitted by female professionals. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged < 44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Two-thirds worked in medical oncology, worked for < 10 years and 35% worked in academia. The majority (73%) spent > 25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk are listed in Table. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists form MENA. Conclusions: High BO prevalence was reported among female oncology professionals from MENA. The majority of women oncology workforce were young and early- to mid-career in this cohort. Younger age, practicing in North African countries, high administrative load and the recurring thought of quitting were associated with increased risk of burnout. Whereas, practicing a hobby and enjoying oncology communication decreased the BO risk. Burnout support and education specifically for women in oncology is needed.[Table: see text]

Addressing reproductive health needs of cancer patients: The pilot experience of pioneering oncofertility clinic in Saudi Arabia

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Background: Fertility and reproductive health issues are commonly encountered in cancer patients and survivors and unfortunately, they are not systematically addressed in many cancer care centers. We are reporting the initial experience in our dedicated Oncofertility Clinic that was established to address all reproductive and fertility issues for all oncology patients at our cancer center. Methods: We launched the first dedicated oncofertility clinic in the region on April 2018, staffed by a consultant of obstetrics and gynecology with the help of a team from in vitro fertilization (IVF) unit and a medical oncologist. It is held on a weekly basis and receives referral from medical oncology, hematology, stem cell transplant and radiation oncology. Eligible patients are males and premenopausal females going for chemotherapy or radiation therapy aiming for fertility preservation or cancer survivors who completed treatment and complaining of infertility problems. The clinic provides fertility preservation through the following procedures: Oocytes freezing (OF), in-vitro fertilization (IVF), sperm freezing, and ovarian transposition. Oncofertility care also includes management of sexual and hormonal dysfunction, and contraception methods. We are capturing the demographic, clinical data of all patients who were served in the clinic and the number of interventions and procedures that they underwent. Results: Between April 2018 and April of 2020, the clinic served 100 patients 60% were female, Median age was 35 years (16 -39). Diagnoses were distributed between breast cancer (36%), lymphoma (10%), and sickle cell anemia patients undergoing hematopoietic stem cell transplant (10%). The table depicts the types and number of procedures performed on these patients. Conclusions: Our pilot experience revealed the critical need of such clinic to help patients in fertility preservation, management of symptoms of gonadal toxicity. Future plans include implementation of systematic screening approach cancer populations who will benefit from the services and monitor the long- term impact of the clinic on the served patients. [Table: see text]