Applied evidence-based medicine. Guidelines for the diagnosis and management of lung cancer
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RE VIE W AR T I CL E
Applied Evidence-Based Medicine. Guidelines for the Diagnosis and Management of Lung Cancer S. Nikolouzos, G. Zacharia, A. Mouzakiti, N. Kapodistrias, E. Douvelis, K. Kagouridis, I. Papanikolaou, K. Pagratis, M. Kanakis, M. Boscolo, N. Gatsoulis, A. Lioulias, M. Mitsis, E. Apostolakis Abstract Aim-Background: The aim of this study was to evaluate the application of evidence-based medicine (EBM) to the
diagnosis, staging and treatment of lung cancer. These guidelines were drawn up by special committees of the American College of Chest Physicians (ACCP). The guidelines are useful but should not be taken as dogma. Differences exist among guidelines concerning the same subject as written by experts of different disciplines and guidelines drawn up by the same committee that may be reviewed whenever new data emerge. The main objective of these guidelines is to enable informed clinical decisions to be made jointly by physicians and patients when developing diagnostic, treatment and management plans so that they can enhance the benefits and reduce the harm associated with various options. These guidelines are intended for multidisciplinary readership, including primary care, medical, and surgical specialists, plus nursing and allied health professionals. Methods: A systematic literature search was performed to identify relevant reports. Studies and articles were identified using online searches of the U.S. National Library of Medicine via www.pubmed.com. We limited our bibliographic search to include only articles from 2010 onward. Results: The ACCP grading system was used to evaluate and validate the different methods and techniques. New terms, such as pure ground glass nodule, multifocal lung cancer, bronchial intraepithelial neoplasia, quality of life and best supportive care, were introduced. The latest stage classification system (seventh edition) of the International Association for the Study of Lung Cancer was used in these guidelines. Conclusions: Evidence-based guidelines are intended to make the process of providing up-to-date care easier. These guidelines are based on the third edition of the American College of Chest Physicians (ACCP) Lung Cancer Guidelines (LC III) and represent a systematic, extensive, comprehensive review of the literature, a structured interpretation of the data, and practical patient management recommendations. Nevertheless, implementation of the guidelines requires some effort. They cannot provide a simple recipe for treatment. Clinical judgment is needed to assess and balance the many factors that go into clinical decision-making. Key words: NSCLC; SCLC; lobectomy; chemotherapy; radiotherapy
Introduction-aim S. Nikolouzos, N. Gatsoulis Division of Surgery, Corfu General Hospital, Corfu, Greece G. Zacharia Department of Anaesthesiology, Corfu General Clinic, Corfu, Greece A. Mouzakiti Oncology Unit, Corfu General Hospital, Corfu, Greece N. Kapodistrias, E. Douvelis Oncologist, Corfu, Greece K. Kagouridis 2nd Pulmonary Department, Attikon University Hospital, Athens
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