The AfHNS Clinical Practice Guidelines for Unknown /Occult Primary Cancers (CUP) of the Head & Neck in Developing Countries and Limited Resource Settings tailor management according to diagnostic and therapeutic resources available to physicians and to their patients.
International guidelines for CUP assume availability of flexible and/or rigid nasal endoscopy, cytology, CT, MRI, PET, immunohistochemistry, IMRT, chemoradiation, etc. In developing countries these investigations and interventions are frequently not available or affordable, and follow-up may be unreliable.
Without resource appropriate guidelines for CUP, both resident and volunteer surgeons and oncologists from developed countries have little to guide them about best practice when working in resource limited settings. This might lead to inappropriate investigations, inappropriate treatment, and may compromise patients.
Methodology
The AfHNS convened a task force to enumerate resource appropriate guidelines for management of Unknown /Occult Primary Cancers (CUP) of the Head & Neck in poorly resourced settings. This collaboration between physicians from African and developed countries included members of the AfHNS and American colleagues. International guidelines were referenced and adapted for limited resources. Due to paucity of literature about management of CUP cancers in low resource settings, much of the recommendations represents expert opinion.
Contributors to AfHNS Clinical Practice Guidelines for Unknown /Occult Primary Cancers (CUP) of the Head & Neck in Developing Countries and Limited Resource Settings were: Johan Fagan (S Africa), Julie Wetter (S Africa), Anna Konney (Ghana), Kenneth Baidoo (Ghana), Khaled Twier (Libya), Rajab Mugabo (Rwanda), Victor Mashamba (Tanzania), Marco Faniriko (Madagascar), Joyce Aswani (Kenya), Chege Macharia (Kenya), Mohammed Mainasara (Nigeria), Paul Onakoya (Nigeria), Melesse Gebeheyu (Ethiopia), Getachew Melesse (Ethiopia), Andry Randriamalala (Madagascar), Celso Adriano (Mozambique), Cisia Danaude (Mozambique), Wayne Koch (USA)
Johan Fagan and Julie Wetter (Co-chairs)
Index: Clinical Practice Guidelines for Unknown /Occult Primary Cancers (CUP) of the Head & Neck
Resource Appropriate Unknown/Occult Primary Cancer (CUP) of the Head & Neck Guideline Scenarios
African Head & Neck Society (AfHNS) Clinical Practice Guidelines for Head & Neck Cancers in Developing Countries and Limited Resource Settings 