We've listed 885 guidelines under your selection of "Continuum of care". The most recent guidelines are first.
This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS). The guideline discusses diagnostic classification, evaluation, prognostic stratification, therapeutic options, and recommended treatment approaches for MDS. There is a particular focus on supportive care, and the guideline also provides recommendations for the management of thrombocytopenia and iron overload, the treatment of related anemia, the use of low-intensity therapy (i.e. hypomethylating agents or biologic response modifiers and immunosuppressive therapy), and high-intensity therapy.
This is a clinical practice guideline for adult patients who were diagnosed with satellite lesions or in-transit metastases (ITM) from melanoma, with or without lymph node metastases. Available management options for these patients are discussed, such as the use of intralesional, topical, and regional therapies, and the recommended sequence of treatments is also addressed. Outcomes of interest include treatment response, disease recurrence, quality of life, toxicity, and survival.
This is a clinical practice guideline for women diagnosed with epithelial ovarian cancer. The guideline examines germline and somatic tumour testing in these patients. Specific topics addressed include genetic risk evaluation, the appropriate sequencing and timing of testing, genetic counseling, and testing of relatives.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This is a clinical practice guideline for adult patients with confirmed or suspected gastric cancer. The guideline examines the diagnostic workup and treatment options for this patient population. Specific treatment options are outlined based on disease stage and tumour genomics (e.g., HER2 expression).
This is a clinical practice guideline for adult cancer patients who are receiving immunotherapy as part of their treatment. The guideline provides recommendations for the management of immune-related adverse events (irAEs) in these patients. Immunotherapy agents discussed include atezolizumab, ipilimumab, nivolumab, pembrolizumab, avelumab, durvalumab, and cemiplimab.
This is a clinical practice guideline for patients with head and neck cancers. The guideline examines workup and staging, treatment, and follow-up for various head and neck cancers including cancer of the lip, oral cavity, oropharynx, hypopharynx, nasopharynx, and larynx, as well as paranasal tumours, very advanced head and neck cancers, occult primary cancer, salivary gland tumours, and mucosal melanoma of the head and neck. Nutrition, supportive care, comorbidities, quality of life, and dental evaluation and management are also discussed.
This is a clinical practice guideline for patients with AIDS-related Kaposi sarcoma. The guideline examines diagnosis, staging, treatment, and follow-up, while also providing recommendations on HIV screening and HIV therapy during cancer treatment. Antiretroviral therapy (ART), topical therapies, intralesional chemotherapy, local incisions, radiation therapy, and systemic therapy are all discussed as treatment options.
This is a clinical practice guideline for adults and children who are receiving antineoplastic agents, as well as for adults who are undergoing radiation therapy for cancer. The guideline provides recommendations on the use of various chemotherapy regimens, while also specifically addressing the use of dexamethasone as a prophylactic antiemetic in patients receiving checkpoint inhibitors (CPIs). Low/moderate/high-emetic-risk antineoplastic agents, minimal-emetic-risk antineoplastic agents, antineoplastic combinations, cannabinoids and more are discussed.
This is a clinical practice guideline for adult patients with locally advanced esophageal adenocarcinoma or squamous cell carcinoma. The guideline provides recommendations for the treatment of these patients. Topics addressed include whether surgery alone is preferable to a combination of surgery and neoadjuvant or adjuvant therapy, and which modalities of neoadjuvant and adjuvant therapy are preferred in the specific cases of esophageal adenocarcinoma or squamous cell carcinoma.
This is a clinical practice guideline for adults with suspected or confirmed pancreatic adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. Specific recommendations are provided based on whether the patient has potentially curable pancreatic adenocarcinoma, or unresectable pancreatic adenocarcinoma, with the latter including chemotherapy, the removal of biliary obstructions, and palliative approaches.
This is a clinical practice guideline for adults with esophageal cancer, including both squamous cell esophageal cancer and adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. The treatment of potentially curable esophageal cancer, as well as palliative approaches to incurable esophageal cancer, are specifically discussed.
This is a clinical practice guideline for adults who have been diagnosed with metastatic colorectal cancer. The guideline provides recommendations on the treatment of these patients for the purposes of improving quality of life and/or prolonging life, if possible. Multiple palliative chemotherapy regimens are discussed, as are recommendations for resecting lung and liver metastases.
This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.
This is a clinical practice guideline for patients with gastric intestinal metaplasia (GIM) detected as part of routine upper endoscopy. The guideline examines the management of these patients, including the testing and treating of Helicobacter pylori infections, as well as subsequent surveillance using upper endoscopy. Outcomes of interest include early gastric cancer detection, reduced morbidity and mortality from gastric cancer, complications associated with endoscopy, and psychological outcomes.
This is a clinical practice guideline for adults with a diagnosis of non-metastatic, muscle-invasive bladder cancer, including patients with a single regional lymph node metastasis in the true pelvis. The guideline examines the staging, treatment, and follow-up of these patients. Neoadjuvant chemotherapy, radical cystectomy with bilateral pelvic lymph node dissection, bladder preservation / combined modality approaches, adjuvant chemotherapy, and adjuvant radiotherapy are all discussed as management options. The guideline also addresses special situations, including small cell carcinoma of the bladder, urachal adenocarcinomas, and non-urothelial histology.
This is a clinical practice guideline for adults who have been diagnosed with acute leukemia, including acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML). The guideline examines the clinical utility of minimal/measurable residual disease (MRD) testing as an aid for selecting treatment options in these patients. Multiparameter flow cytometry (MFC), next-generation sequencing (NGS), and polymerase chain reaction (PCR)-based methods are specifically discussed.
This is a clinical practice guideline for adults with colorectal cancer who have developed liver metastases. The guideline examines regional therapies for the management of these patients, including conventional transarterial chemoembolization (cTACE), drug-eluting bead transarterial chemoembolization (DEB-TACE), and transarterial radioembolization (TARE). Outcomes of interest include overall survival, progression-free survival, time to progression, time to hepatic progression, overall response rate, and toxicity.
This is a clinical practice guideline for adult patients with melanoma, including those with cutaneous or non-cutaneous melanoma. The guideline examines adjuvant and neoadjuvant systemic therapy options for the treatment of these patients. Recommendations are separated based on disease stage, whether the melanoma is cutaneous or non-cutaneous, and whether or not the melanoma has been resected, is illegible for resection, or is unresectable/metastatic.
This is a clinical practice guideline for adult patients with solid tumours or lymphoid blood cancers, and is especially relevant to those receiving chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) for the prevention and management of neutropenia and anemia in these patients. Specific topics addressed include red blood cell transfusion, erythropoietic therapy, as well as iron monitoring and supplementation.
This is a clinical practice guideline for patients with chronic myeloid leukemia. The guideline examines diagnosis and baseline investigations of suspected or confirmed chronic myeloid leukemia, recommended treatment options, and monitoring criteria. Outcomes of interest include risk of disease progression and survival.
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of these patients. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
This is a clinical practice guideline for patients with myeloid or lymphoid neoplasms with eosinophilia (MLN-Eo) and tyrosine kinase fusion genes. The guideline provides recommendations for the diagnosis, staging, and treatment of these patients. Specific topics discussed include cytogenic and molecular testing, the role of next-generation sequencing, the evaluation of organ involvement, as well as various chemotherapy regimens.
This is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.
This is a clinical practice guideline for adult cancer survivors with, or at risk for developing, chemotherapy-induced peripheral neuropathy (CIPN). The guideline examines prevention and treatment approaches in the management of chemotherapy-induced neuropathies. Various agents and interventions are assessed in the prevention of CIPN. Treatment recommendations are divided between patients who are receiving neurotoxic chemotherapy and patients who have completed neurotoxic chemotherapy.
This is a clinical practice guideline on the role of bronchoscopy during the COVID-19 pandemic, including for the diagnosis, staging, or characterization of known or suspected lung cancer. The guideline focuses on the optimal protection of patients and healthcare workers in these settings. The use of personal protective equipment by healthcare workers, and COVID-19 testing in patients undergoing bronchoscopy, are discussed, as is the timing of bronchoscopy in patients with a high suspicion of lung cancer. The impact of delayed care on the survival of lung cancer patients is also considered.
This is a clinical practice guideline for adult cancer patients who have received or are being considered for hematopoietic cell transplantation (HCT), including autologous or allogenic HCT. The guideline discusses pre-transplant recipient evaluation, as well as the management of acute and chronic graft-versus-host disease (GVHD) in these patients. Specific recommendations are provided pertaining to the diagnosis and staging, first line treatment, and additional therapy for GVHD.
A clinical practice guideline on the diagnosis, workup, and treatment of patients who have been diagnosed with or are suspected of having primary cutaneous B-cell lymphomas (PCBCLs). The guideline focuses on the three main types of PCBCLs: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle-center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, leg type). Recommendations for treatment are provided based on lymphoma type and whether treatment is for initial, relapsed, or refractory disease.
This is a clinical practice guideline for patients with Waldenström macroglobulinemia or lymphoplasmacytic lymphoma. The guideline examines the diagnosis, workup, primary treatment regimens, assessment of response to primary treatment, and follow-up after primary treatment. Regimens not toxic to stem cells and regimens with potential or unknown toxicity to stem cells are considered. Treatment of Immunoglobulin M (IgM) related peripheral neuropathy, maintenance therapy, and therapy for previously treated Waldenström macroglobulinemia are also discussed.
This is a clinical practice guideline for patients with basal cell carcinoma (BCC) or cutaneous squamous cell carcinoma (cSCC). The guideline examines the use of definitive and postoperative radiation therapy (RT) in these patients. Specific topics discussed include the appropriate indications for RT, preferred dose-fractionation schedules and radiation techniques, and the appropriate use of chemotherapy, biologic and immunotherapy agents before, during, or after RT.
This is a clinical practice guideline for patients with limited-stage (LS) and extensive-stage (ES) small cell lung cancer (SCLC). The guideline examines thoracic radiation therapy (RT) and prophylactic cranial irradiation (PCI) for these patients, including indications, appropriate dose-fractionation schedules, techniques and timing. Stereotactic body radiation therapy (SBRT) for stage I and II node-negative SCLC is also discussed.
This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.
This is a clinical practice guideline for patients undergoing potentially cardiotoxic oncological treatment, including chemotherapy, targeted therapy and radiotherapy. The guideline examines various prevention, detection, treatment and monitoring strategies available for reducing cardiovascular toxicity in these patients. Outcomes of interest include cardiovascular morbidity, and mortality.
This is a clinical practice guideline for adults with squamous cell carcinomas arising in the oropharynx, larynx, hypopharynx, nasopharynx, sinonasal tract, oral cavity subsites or an unknown primary head and neck site. The guideline examines routine testing for human papillomavirus (HPV) status in these patients, as well as the relationship between HPV positivity and cancer outcomes.
This is a clinical practice guideline for the management of rectal cancer. The guideline provides recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, and patient surveillance. Outcomes of interest include safety and efficacy of treatment, adverse outcomes, and overall survival.
This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.
This is a clinical practice guideline for adults with a diagnosis, or suspected diagnosis of renal cell carcinoma (RCC). The guideline examines the appropriate diagnostic tests for RCC, as well as management and follow-up strategies for those who are diagnosed. Surgical options, systemic therapy and radiotherapy are specifically discussed.
This is a clinical practice guideline for patients with stage IV non-small cell lung cancer (NSCLC) without effectively targeted driver alterations. The guideline examines systemic therapy treatment options that are available for this patient population, taking into consideration the subtype of cancer. Treatment options discussed include single-agent pembrolizumab, pembrolizumab/carboplatin/pemetrexed, and atezolizumab/carboplatin/nab-paclitaxel.
This is a clinical practice guideline for cancer patients in need of bone marrow and blood cell transplantation. Different types of cancer are discussed, including acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), myelodysplastic syndromes (MDS), and chronic myelogenous leukemia. Specific transplant recommendations are provided based on cancer type.
This is a clinical practice guideline for men with advanced prostate cancer, including newly diagnosed clinical high-risk disease, suspected or confirmed metastatic disease, recurrent disease, or progressive disease while under treatment. Recommendations are provided for the optimal use of imaging in this patient population. Conventional imaging (e.g. computed tomography (CT), bone scans, and/or prostate magnetic resonance imaging (MRI)) and next-generation imaging (e.g. positron emission tomography (PET), PET/CT, PET/MRI, and whole-body MRI) are discussed.
This is a clinical practice guideline for patients with renal cell carcinoma. The guideline examines the role of percutaneous ablation in management, and comparisons are made to nephrectomy. Outcomes of interest include renal function, perioperative complications, and overall survival.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This is a clinical practice guideline for women who have been diagnosed with endometrial cancer. The guideline examines the appropriateness of various imaging techniques during the pre-treatment evaluation and follow-up of these patients. Specific situations discussed include the initial staging of endometrial cancer, the surveillance of asymptomatic patients with treated low- or intermediate-risk endometrial
cancer, as well as the post-therapy evaluation of clinically suspected recurrence of known endometrial cancer.
This is a clinical practice guideline for adults who have been diagnosed with locally advanced/metastatic bladder cancer (i.e. T4bNxM0, TxN2-3M0, TxNxM1). The guideline provides recommendations for staging of these patients, as well as treatment and follow-up options based on disease stage. Treatment modalities discussed include surgery, systemic therapy, and radiotherapy. For patients with metastatic cancer, palliative approaches are also discussed.
This is a clinical practice guideline for adult patients with advanced cancer who are experiencing loss of appetite, body weight, and/or lean body mass (i.e. skeletal muscle). The guideline examines nutritional, pharmacologic, and other (e.g. exercise) interventions for managing these patients. Outcomes of interest include body weight, lean body mass, appetite, physical function, and quality of life.
This is a clinical practice guideline for adults with squamous cell carcinoma of unknown primary origin (SCCUP) in the head or neck. The guideline discusses the preoperative evaluation for patients with a neck mass suspicious for malignancy, appropriate surgical diagnostic and therapeutic procedures for SCCUP, treatment considerations and appropriate techniques for surgical management of the neck, and treatment considerations for radiotherapy and systemic therapy in SCCUP. Outcomes of interest include survival, local and regional disease control, and quality of life.
This is a clinical practice guideline for patients with any type of cancer who are experiencing or are at high risk for experiencing nausea and/or vomiting due to treatment. The guideline examines treatment options for nausea and/or vomiting induced by radiation therapy (RT), chemotherapy, targeted therapy, and immunotherapy. In addition to antiemetic treatment options, the guideline discusses the emetogenic potentials of different anticancer therapies.
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of these patients. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
This is a clinical practice guideline for patients with chronic myeloid leukemia (CML). The guideline discusses diagnosis and workup, staging, and management options for these patients, and includes specific considerations for children with CML. The guideline separates treatment options based on characteristics such as genetic profile, and phase (i.e. chronic phase, accelerated phase, and blast phase). Topics discussed include toxicities and response milestones for different treatment options.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This clinical practice guideline is an endorsement of the American Society for Radiation Oncology, American Society of Clinical Oncology, and American Urological Association's 2018 guideline titled Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline. The guideline examines the use of hypofractionated radiation therapy compared to conventional fractionation in men with localized prostate cancer. Outcomes of interest include prostate control, toxicity, and quality of life.
This is a clinical practice guideline for adult men with a suspicion or recent diagnosis of localized prostate cancer. The guideline provides recommendations for the staging, management, and follow-up of these patients. Different management options are provided for patients with low-risk, intermediate-risk, or high-risk disease, and include active surveillance, radiotherapy, and surgery.
This is a clinical practice guideline for patients with diagnosed or suspected advanced/metastatic prostate cancer. The guideline examines the appropriate staging, treatment and follow-up for this patient population. Management, monitoring, systemic therapy, and radiotherapy are also discussed.
This is a clinical practice guideline for the management of squamous cell carcinoma (SCC) of the penis. The guideline examines the diagnosis, treatment, and follow-up for patients with this form of cancer. Outcomes of interest include optimizing therapeutic efficacy and minimizing treatment-related morbidity.
This is a clinical practice guideline for adults with squamous cell carcinoma arising within the anal canal. The guideline provides recommendations for the diagnosis and staging of these patients, as well as specific treatment recommendations based on disease stage. Specific topics addressed include the treatment of patients who have undergone curative therapy, those with locally recurrent cancer, and those with metastatic cancer.
This is a clinical practice guideline for adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines the clinical presentation, workup, primary treatment, and pathologic diagnoses of these patients. Separate recommendations are provided for different stages of pure seminomas and nonseminomas, and the guideline also discusses second-line and subsequent therapies for metastatic GCTs.
This is a clinical practice guideline for children and young adults with aggressive mature B-cell lymphomas, including Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). The guideline discusses the pathology and diagnosis, staging, initial treatment, disease reassessment, surveillance, therapy for relapsed/refractory disease, and supportive care for these patients. Specific recommendations are provided based on disease type and stage.
This is a clinical practice guideline for adults with classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The guideline discusses the clinical management of patients with CHL and NLPHL, focusing on patients who do not have serious intercurrent disease. Treatment options examined include chemotherapy, high dose therapy and autologous stem cell rescue (HDT/ASCR), and involved site radiation therapy (ISRT).
This clinical practice guideline discusses pandemic planning for patients with cancer. The guideline examines a systematic approach for prioritizing consultations and treatment of patients with cancer in Ontario during a pandemic, and is intended to augment other provincial and local strategies by providing clinical guidance. Specific programs addressed within the guideline include cancer screening programs, familial oncology clinics, palliative care programs, radiation treatment programs, surgical oncology programs, and systemic treatment programs.
This clinical practice guideline is an endorsement of the National Institute for Health and Care Excellence and the Society for Immunotherapy of Cancer's guidelines for the treatment of patients with non-small cell lung cancer (NSCLC). The guideline specifically examines different treatment options for patients with clinical stage III N2 NSCLC. Primary outcomes of interest include overall survival and quality of life.
This is a clinical practice guideline for patients with colorectal lesions. The guideline provides recommendations to optimize the endoscopic removal of lesions for the prevention of colorectal cancer (CRC). Specific topics addressed include lesion assessment and description, marking, surveillance after removal, and equipment considerations.
This is a clinical practice guideline for adults with early or advanced stage breast cancer who carry germline mutations in breast cancer susceptibility genes. The guideline discusses the management of these patients, including surgical management of the index malignancy, therapeutic mastectomy, nipple-sparing mastectomy, contralateral prophylactic mastectomy, contralateral risk-reducing mastectomy, radiation therapy, platinum chemotherapy, and neoadjuvant platinum chemotherapy. The increased risk of contralateral breast cancer and new ipsilateral breast cancer in these patients is specifically highlighted.
This is a clinical practice guideline for the diagnosis and treatment of polycythemia vera (PV) in adults. The guideline examines changes to the World Health Organization's major and minor diagnostic criteria for PV, prognoses for patients with PV, as well as the use of acetylsalicylic acid, cytoreductive therapy, phlebotomy, hydroxyurea, interferon, or ruxolitinib as potential therapies for PV. Treatment recommendations are stratified by thrombosis risk.
This is a clinical practice guideline for adults with suspected or confirmed myelofibrosis (MF). The guideline provides recommendations for the diagnosis and management of these patients, with specific recommendations for those with primary myelofibrosis (PMF) as well as those with MF secondary to polycythemia vera (PV) or essential thrombocytosis (ET). The role of bone marrow and genetic investigations during diagnosis are addressed, as are various systemic drug therapies.
This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC), with specific recommendations for patients with very early stage, early stage, intermediate stage, advanced stage, and terminal stage HCC. The guideline examines the diagnostic work-up, management, and follow-up of these patients. For each HCC stage, the patient requirements, tumour requirements, goals of treatment, and specific management options are discussed.
This is a clinical practice guideline for adult patients who have been diagnosed with or who are at a high risk of developing colorectal cancer (CRC). Topics examined include the prevention of CRC in patients with Lynch syndrome, management of local disease, and management of metastatic disease. Specific recommendations are provided based on disease location (e.g., the rectum or colon).
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
This is a clinical practice guideline for men who have been diagnosed with invasive breast cancer. The guideline examines management strategies for these patients. Specific topics discussed include adjuvant endocrine therapy, targeted therapies, management of treatment-related adverse effects, genetic testing, and post-treatment surveillance.
This is a clinical practice guideline for adult patients with Merkel cell carcinoma. The guideline examines the staging and work-up, treatment, follow-up, and management of recurrence in these patients. Treatment options discussed include surgery, radiation, chemotherapy, and immunotherapy. Clinical scenarios including clinical node-negative, clinical node-positive, and metastatic are considered, as is sentinel lymph node biopsy protocol.
This clinical practice guideline focuses on the early detection of colorectal cancer and the management of polyps found during colorectal cancer screening among those at average risk, as well as the workup and diagnosis of colorectal cancer. The guideline discusses the optimal strategies for population-level early detection of colorectal cancer in high-incidence and resource-constrained settings, the optimal reflex testing strategy for people with positive screening results, the optimal strategy for people with premalignant polyps or other abnormal screening results, and the optimal methods for diagnosing patients who have signs and symptoms of early colorectal cancer. Recommendations are resource-stratified and are tailored to basic, limited, enhanced and maximal resource settings.
This is a clinical practice guideline for patients with primary cutaneous melanoma. The guideline provides treatment recommendations for this patient population, including recommendations for surgical margins. Specific topics discussed include biopsy techniques for lesions that are clinically suggestive of melanoma, histopathologic interpretation of cutaneous melanoma, the use of laboratory, molecular, and imaging tests during initial work-up or follow-up, as well as the concept of staged excision.
This is a clinical practice guideline for patients undergoing radiation treatment for localized prostate cancer. The guideline examines the use of biodegradable spacers for prostate cancer treatment. A topic of interest is biodegradable spacer insertion as a technology that may be used to decrease toxicity and maintain quality of life (QOL) in appropriately selected patients.
This is a clinical practice guideline for adults with appendiceal neoplasms, excluding GI stromal tumours, lymphomas, and neural proliferations. The guideline provides recommendations on the management of these patients. Specific topics discussed include colonoscopy, pre-operative assessment, appendectomy, biochemical testing, and post-operative surveillance. Outcomes of interest include recurrence rate of neoplasms and disease-free survival.
This clinical practice guideline is for patients with castration-resistant prostate cancer (CRPC). The guideline examines the management options available for these patients. Specific topics addressed include androgen-deprivation therapy (ADT), the addition or change of first-generation androgen receptor antagonists, and non-metastatic CRPC (nmCRPC).
This is a clinical practice guideline for adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).
This is a clinical practice guideline for patients with pancreatic cancer. The guideline examines radiation therapy (RT) and stereotactic body radiation therapy (SBRT) in these patients, and provides guidance for treatment planning and the management of RT-associated toxicities. Specific topics discussed include the indications for conventionally fractionated RT and SBRT, appropriate dose-fractionation and target volumes, sequencing of chemotherapy and RT, indications for palliative RT, and prophylactic medications for mitigating toxicity.
This is a clinical practice guideline for bowel preparation prior to colonoscopy procedures. The guideline examines appropriate preparation methodologies for adult patients, including special populations such as patients who are pregnant/lactating, patients with inflammatory bowel disease (IBD) and elderly people. Outcomes of interest include adverse events, postoperative complications and postoperative morbidity.
This is a clinical practice guideline for adult patients who are at an increased risk of developing gastric adenocarcinoma, specifically those with gastric atrophy (GA), gastric intestinal metaplasia (GIM), gastric epithelial dysplasia or early gastric adenocarcinoma limited to the mucosal or superficial submucosal layers. The guideline provides recommendations for the diagnosis and management of these patients, while addressing specific topics such as Helicobacter pylori eradication, endoscopic screening, and endoscopic
mucosal resection.
This is a clinical practice guideline for the management of infusion reactions (IR) caused by cancer medication. The guideline examines prophylaxis, acute management of IRs, as well as re-start and re-challenge protocols. Outcomes of interest include treatment toxicity, adverse events, and the incidence and severity of IRs.
This is a clinical practice guideline for patients with non-small cell or small cell lung cancer. The guideline provides recommendations on diagnosis, management, follow-up, and palliative care for these patients. Outcomes of interest include length of stay in hospital and intensive care units, quality of life, and overall survival.
This is a clinical practice guideline for patients with suspected or confirmed prostate cancer. The guideline provides recommendations for diagnosis, including the use of magnetic resonance imaging (MRI) and biopsy, treatment (i.e. radical treatment), follow-up, and active surveillance using multiparametric MRI.
This is a clinical practice guideline for women with advanced or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas), or uterine papillary serous carcinoma. The guideline examines chemotherapeutic and hormonal therapy options for these patients. Outcomes of interest include response rate, toxicity, quality of life, and survival.
This is a clinical practice guideline for patients with small bowel adenocarcinoma. The guideline discusses the clinical presentation and workup, pathology, staging, and treatment of these patients. Treatment options are specifically addressed for stage I-III and distant metastatic (stage IV) small bowel adenocarcinomas. Risk factors, post-treatment surveillance and survivorship are also examined.
This is a clinical practice guideline for patients with gastric cancer. The guideline examines the pathology, initial workup, staging, treatment, follow-up, and supportive care of these patients. Treatment options discussed include lymph node dissection, laparoscopic resection, endoscopy, radiation therapy, combined modality therapy, chemotherapy (preoperative, perioperative, and postoperative), and targeted therapies.
This is a clinical practice guideline for patients with primary bone cancer. The guideline examines systemic therapy agents and radiation therapy for chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and giant-cell tumours of bone (GCTB). The guideline also discusses the management of relapsed disease.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This clinical practice guideline is for the management of squamous cell anal carcinoma. The guideline provides recommendations on staging, treatment, and follow-up. The effectiveness of treatment options such as surgery, chemotherapy, and radiation therapy are compared. Guidance is also provided on dosing regimens, treatment of recurrence, and surveillance following treatment of recurrence.
This is a clinical practice guideline for adult patients with suspected or confirmed colorectal carcinoma. Recommendations are provided for the diagnosis and treatment of these patients. Specific topics addressed include preoperative local staging, local ablation methods, and the diagnosis of distant metastases.
This is a clinical practice guideline for patients with acute promyelocytic leukemia (APL). The guideline examines the diagnostic workup and management of these patients, including the identification and management of the most important complications. The management of APL in children, elderly patients and pregnant women is also discussed, as well as the management of molecular and hematologic relapse.
This is a clinical practice guideline for adults with primary sclerosing cholangitis (PSC) or those presenting with similar cholangiopathies which may mimic PSC, such as IgG4-related sclerosing cholangitis. The guideline examines the diagnosis and management of these patients, including the role of liver biopsy, non-invasive assessment of liver fibrosis, overlap syndromes, the role of endoscopy, ERCP and endotherapy, specialist referral, liver transplantation, and the management of complications. Screening for cancer in PSC, pregnancy in women with PSC, patient perspectives and support groups, and service standards, are also discussed.
This is a clinical practice guideline for women undergoing mastectomy for the treatment of breast cancer. The guideline examines breast reconstruction in these patients, and the impact of radiotherapy. The timing of breast reconstruction, implant-based versus autologous tissue-based reconstruction, and decision-making in the context of radiotherapy are specifically discussed.
This is a clinical practice guideline for patients with primary urethral carcinoma. The guideline discusses, diagnostic evaluation and staging, prognosis, treatment, and follow-up. Specific diagnostic techniques examined include pelvic magnetic resonance imaging (MRI), computed tomography (CT) of the thorax and abdomen, urethrocystoscopy, biopsy, and urinary cytology. Treatment options are compared to those for penile cancer, and include distal urethrectomy, radiotherapy, and chemotherapy.
This is a clinical practice guideline for the nutritional management of adult patients with head and neck cancer. The guideline examines appropriate access to nutritional care (screening and assessment), quality nutrition care and nutrition monitoring and evaluation. Outcomes of interest include treatment response, reduced adverse related consequences of malnutrition, and quality of life. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of August 30th, 2019.
This is a clinical practice guideline for adult patients with lung cancer. Key areas discussed include screening and early detection, diagnostic procedures for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), staging, and management strategies. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with vulvar cancer. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Stages of vulvar cancer addressed include microinvasive (stage IA), early stage (> stage IA), and advanced stage (≥ stage 3). Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with gynecological sarcomas. The guideline examines the staging, treatment, and follow-up of these patients. Surgical and adjuvant treatment options are discussed, as is the management of metastatic and recurrent disease. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for adult patients with neuroendocrine tumours. The guideline examines diagnosis using histological markers and imaging, management of tumours through appropriate treatment strategies, and appropriate time periods for follow-up. Recommendations are presented for both non-pancreatic and pancreatic neuroendocrine tumours. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for the use of proton beam radiation therapy in the management of pediatric, adolescent, and adult patients with cancer. The guideline examines factors that should be taken into account when assessing whether to refer patients for proton bean radiotherapy, including which tumour sites should be considered for referral. At the time of publication, facilities capable of treating a broad range of tumour sites with proton beam radiation therapy are not currently available in Canada, therefore recommendations focus on which patients are appropriate candidates to receive out-of-country treatment.
This is a clinical practice guideline for adult cancer patients who are receiving chemotherapy, who are at risk for or are experiencing chemotherapy-induced nausea and vomiting (CINV). The guideline discusses prevention strategies for patients who are receiving different regimens of chemotherapy, including single day intravenous chemotherapy, high-dose chemotherapy for stem cell transplantation (SCT), and multiple day intravenous chemotherapy. Another topic of interest examined is the potential role of cannabinoids for the prevention of CINV.
This is a clinical practice guideline for adult patients with hepatocellular carcinoma (HCC). Specifically, the guideline provides recommendations for the non-surgical management of patients with locally advanced or advanced HCC, Barcelona Clinic Liver Cancer (BCLC) Stage B and higher, who are not suitable for transplant or surgery. The guideline compares transarterial chemoembolization (TACE) to other local therapies, including transarterial ethanol ablation (TEA), bland transarterial embolization (TAE), radiofrequency ablation (RFA), transarterial radioembolization (TARE), stereotactic body radiation therapy (SBRT) and drug eluting bead transarterial chemoembolization (DEB-TACE). The addition of systemic treatment regimens, such as sorafenib, is also discussed.
This is a clinical practice guideline for adolescent, young adult (AYA), and adult patients with acute lymphoblastic leukemia (ALL). The guideline reviews the classification of ALL subtypes based on immunophenotype and cytogenetic/molecular markers, and provides recommendations on risk assessment and stratification for risk-adapted therapy, as well as treatment strategies for Philadelphia chromosome (Ph)-positive and Ph-negative ALL. The guideline also provides recommendations for supportive care.
This is a clinical practice guideline for patients with localized prostate cancer who have undergone radical prostatectomy. The guideline focuses on the use of radiotherapy to reduce the risk of prostate cancer recurrence and clinical progression of cancer in these patients, and provides specifications concerning the timing of radiotherapy while emphasizing the importance of communicating the potential risks and benefits to patients.
This is a clinical practice guideline for patients who have been operated on for sporadic colorectal cancer (CRC) and for those in whom a low risk T1 CRC has been completely removed at endoscopy. The guideline discusses the endoscopic surveillance of these patients, and provides recommendations on the appropriate timing of endoscopy (i.e. in specific intervals following surgery), and the age at which to halt the use of surveillance endoscopy. Outcomes of interest include overall survival, CRC-specific survival, relapse-free survival, and adverse effects.
This clinical practice guideline is an endorsement of two 2019 guidelines published by the Congress of Neurological Surgeons on the use of anticonvulsant prophylaxis and steroids in adults with metastatic brain tumours. Specific topics addressed include the choice of steroid, steroid dose and duration of administration, and primary outcomes of interest were decreases in frequency of seizures, as well as increases in quality of life and survival.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline focuses on non-standard or 'emerging' techniques for the treatment of these patients. Outcomes of interest include local response, progression-free survival, and local recurrence.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the impact of steroids on neurological symptoms and/or quality of life in these patients, compared to supportive care alone or other treatment options. The choice of steroid, steroid dose and duration of administration are also discussed. Recommendations provided are stratified by severity of symptoms related to mass effect.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines treatment options specifically for patients with multiple metastatic brain tumours. Treatment options discussed include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS).
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline discusses the use of chemotherapy for the treatment of these patients, and examines the use of chemotherapy alone, chemotherapy in addition to whole brain radiation therapy (WBRT), and chemotherapy in addition to stereotactic radiosurgery (SRS). The sequence of treatments and number of chemotherapeutic regimens are also considered.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the use of stereotactic radiosurgery for the treatment of these patients. Stereotactic radiosurgery (SRS) is compared with other treatment modalities, and the guideline also discussed the role of SRS after open surgical resection of brain metastasis, and the role of SRS alone for the management of patients with one to four brain metastases.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline provides recommendations on the surgical management of these patients. Surgery alone, surgery with stereotactic radiosurgery (SRS), and surgery with whole brain radiation therapy (WBRT) are all discussed.
This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.
This is a clinical practice guideline for women who have been diagnosed with uterine cervical cancer. The guideline discusses the treatment of these patients, and recommendations are separated based on disease type/stage. Specific topics examined include the primary treatment for cervical precancerous lesions and IA cervical cancer, the primary treatment for stage IB-II cervical cancer, postoperative therapy for stage IB–II cervical cancer, the primary therapy for stage III-IV cervical cancer, therapies for relapsed cervical cancer, and the management of cervical cancer during pregnancy.
This is a clinical practice guideline on the use of intraoperative radiation therapy (IORT) in cancer patients. The guideline examines the appropriateness of IORT by treatment site, including the breast, thorax, head and neck, pancreas, colon, rectum, and brain. The appropriateness of IORT is also considered for patients with sarcoma, as well as gynecologic cancers. Outcomes of interest include shortened courses of therapy, lower costs, reduced toxicities, and improved patient satisfaction.
This is a clinical practice guideline for adults with cancer, and specifically those with cancer of the breast, skin, or gynecologic cancers. The guideline examines the use of electronic brachytherapy (EB) in these patients. Dosimetric concerns, process details, and the appropriateness of EB in different body sites are discussed.
This is a clinical practice guideline for patients with hematological or solid tumour malignancies who are receiving chemotherapy and are at risk for hepatitis B virus (HBV) reactivation. The guideline discusses who to test for HBV infection, when to start antiviral agents, when to stop antiviral agents, and how to monitor patients during treatment.
This is a clinical practice guideline for patients with brain tumours. The guideline provides recommendations for the management of brain tumour-related epilepsy (BTE) in these patients. Specifically, the guideline provides recommendations for the diagnosis and treatment of BTE, including which anti-epileptic medications should be used.
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines the clinical presentation, workup, primary treatment, and pathologic diagnoses of these patients. Separate recommendations are provided for different stages of pure seminomas and nonseminomas, and the guideline also discusses second-line and subsequent therapies for metastatic GCTs.
This clinical practice guideline is an endorsement of the National Institute for Health and Care Excellence's 2019 guideline titled Lung cancer: diagnosis and management. The guideline provides recommendations on prophylactic cranial irradiation and consolidative radiation for patients with small cell lung cancer.
This is a clinical practice guideline for the prevention and treatment of venous thromboembolism (VTE) in adult patients with cancer. The guideline discusses the prophylaxis of VTE in patients who have undergone surgery, prophylaxis of catheter-related thrombosis, treatment of established VTE, and maintenance treatment (both early and long-term). Risk-stratification schemes for the prophylaxis of VTE in patients with cancer, are also examined.
This is a clinical practice guideline for the management of colon cancer. Recommendations are made for diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, and management of recurrence. Principles for the management of metastatic disease are also provided.
This is a clinical practice guideline for men with suspected or confirmed seminoma (clinical stages I, IIA, and IIB) or nonseminomatous germ cell tumours (NSGCTs). The guideline provides recommendations for the diagnosis, staging, treatment selection, and post-treatment surveillance of theses patients. The guideline's primary objective is to limit the burden of therapy and treatment-related toxicity without compromising cancer control. Specific outcomes of interest include treatment-related toxicity, disease recurrence, and survival.
This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.
This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.
This is a clinical practice guideline for malignant pleural mesothelioma (MPM). The guideline examines the clinical management options for these patients, which include surgery, radiation therapy (RT), and chemotherapy. The potential for multimodal therapy is also addressed.
This is a clinical practice guideline for patients with non-muscle-invasive bladder cancer. The guideline examines the diagnosis, staging and classification, prediction of disease recurrence and progression, management, and follow-up of these patients. Specific management topics discussed include adjuvant treatment, treatment for failure of intravesical therapy, and radical cystectomy. Counselling of smoking cessation is also discussed.
This is a clinical practice guideline for patients with non-melanoma skin cancer. The guideline discusses prevention, staging, treatment, and follow-up for these patients. Specific diseases discussed include basal cell carcinoma, squamous cell carcinoma, keratoacanthomas, Merkel cell tumours, Kaposi's sarcoma, extramammary Paget's disease (EMPD), and other non-melanoma skin cancers. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This clinical practice guideline for patients with suspected or confirmed non-epithelial ovarian cancer. The guideline discusses the prevention, diagnosis, staging, management, and follow-up of these patients. Specific conditions discussed include sex cord stromal tumours (SCSTs), and germ cell tumours (GCTs). Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients who are at risk for developing, or who have been diagnosed with, colon cancer. The guideline examines the screening, diagnosis, treatment and follow-up of this patient population. Treatment options are presented based on the stage of cancer, and include surgical options, surveillance, and much more. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with melanoma who have developed in-transit metastases. The guideline discusses the treatment of in-transit disease, and provides recommendations on primary treatment, second-line treatment, adjuvant treatment, and radiation therapy. The primary outcomes of interest are progression-free survival and overall survival.
This is a clinical practice guideline for patients with acute lymphoblastic leukemia (ALL) who are being treated in a pediatric oncology setting; the guideline focuses on children, however, recommendations may apply to those up to 30 years of age. Recommendations are provided for the diagnosis, workup, treatment, and supportive care of these patients. Specific topics addressed include risk stratification, treatment in vulnerable populations, as well as the evaluation and treatment of extramedullary disease.
This is a clinical practice guideline for women with early stage breast cancer. The guideline examines the use of adjuvant bisphosphonate therapy in these patients. The appropriate choice of bisphosphonates and patient eligibility criteria are discussed. Menopausal status is also specifically addressed.
This is a clinical practice guideline for men with localized prostate cancer. The use of molecular biomarkers for the management of these patients is examined. The guideline specifically discusses patient selection, active surveillance, the identification of clinically significant disease, choosing postprostatectomy adjuvant versus salvage radiotherapy, and emerging questions such as the relative value of tissue biomarkers compared to magnetic resonance imaging (MRI).
This is a clinical practice guideline for patients with chemotherapy-induced peripheral neuropathy (CIPN). The guideline provides a framework for the screening, assessment and management of CIPN. Assessment tools, rehabilitation strategies, pharmacologic management options, and referral to specialists are addressed.
This is a clinical practice guideline for patients with hematological malignancies who have not had a hematopoietic cell transplantation. The guideline examines the use of vaccinations as a means to prevent infections (e.g. influenza and invasive pneumococcal disease) in this patient population. Additional outcomes of interest include decreasing the severity of acquired infections, avoiding hospitalisations, and improving survival.
This is a clinical practice guideline for patients with primary amyloid light-chain (AL) amyloidosis who are being considered for treatment regimens that include either bone marrow or stem cell transplantation (SCT). The guideline compares chemotherapy (CT) and both autologous and allogeneic SCT. Side effects evaluated include cytomegalovirus or Pneumocystis carinii infections, as well as neutropenia and mucositis.
A clinical practice guideline on the diagnosis, workup, treatment and surveillance of B-cell lymphoma (BCL) in pediatric and adult patients. The guideline focuses on the most common B-cell lymphomas: follicular lymphoma (FL), marginal zone lymphomas (MZL), nodal MZL, splenic MZL, gastric MALT lymphoma, mantle cell lymphoma (MCL), diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), AIDS-related B-cell lymphoma, post-transplant lymphoproliferative disorders, and Castleman's disease. Additional consideration is paid to the classification systems used in NHL, the role of PET scans in assessment and staging, principles of radiation therapy, and supportive care considerations.
This is a clinical practice guideline for patients who are at an increased risk of developing colorectal cancer (CRC), due to hereditary factors. The guideline examines the management of these patients, including the prevention of CRC, diagnosis of CRC, endoscopic management, and surgical care. Specific hereditary conditions discussed include Lynch syndrome, Lynch-like syndrome, serrated polyposis syndrome, familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Outcomes of interest include decreasing the lifetime risk of developing CRC, decreasing morbidity due to CRC or its treatment, as well as improving the identification of hereditary CRC syndromes.
This is a clinical practice guideline for adult patients with cancer who are being treated with bone-modifying agents (BMAs). The guideline discusses the prevention and management of medication-related osteonecrosis of the jaw (MRONJ), and specific recommendations are provided for reducing the risk of MRONJ, as well as for the diagnosis and staging of MRONJ. The potential discontinuation of BMA use after a diagnosis of MRONJ, is also addressed.
This is a clinical practice guideline for adult patients with cancer and immunotherapy-related toxicities. The guideline examines the management of immune-related adverse events (irAEs) resulting from cancer immunotherapy, including immune checkpoint inhibitor (ICI) therapy and chimeric antigen receptor (CAR) T-cell therapy. Immune checkpoint inhibitors are discussed, and managing irAEs in specific patient populations, as well as specific irAE management, are considered.
This is a clinical practice guideline for adult patients with solid tumors or lymphoid blood cancers, and is especially relevant to those receiving chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) for the prevention and management of neutropenia and anemia in these patients. Specific topics addressed include red blood cell transfusion, erythropoietic therapy, as well as iron monitoring and supplementation.
This is a clinical practice guideline for patients with thymomas and thymic carcinomas. The guideline examines the diagnosis, staging, and treatment these mediastinal tumours. Surgical resection and radiation therapy are discussed as treatment options.
This is a clinical practice guideline for patients with cancer of the uterine cervix, including those with squamous cell carcinomas, adenocarcinomas and adenosquamous carcinomas. The guideline examines screening, diagnosis, staging, treatment, and follow-up of these patients. Specific topics discussed include investigations of abnormal pap smears, investigations for staging, estrogen replacement therapy, and much more. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a guideline for the prevention, screening/early detection, diagnosis, staging, and management of breast cancer. Management options for early invasive breast cancer, stage I or II tumours, locally advanced breast cancer, inflammatory breast cancer, locoregional recurrence, metastatic breast cancer and special circumstances in breast cancer patients are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with acute myeloid leukemia. The guideline examines the diagnosis of these patients, as well as management options including chemotherapy, hematopoietic stem cell transplantation, and palliative approaches. Diagnostic tests and criteria, ancillary tests, definition of CNS status, prognosis/risk stratification, age and cytogenetics are some of the specific aspects of diagnosis addressed.
This is a clinical practice guideline for adult patients with oropharyngeal cancer. The guideline discusses the diagnostic investigations and baseline assessments that should be used for patients with suspected or confirmed oropharyngeal cancer, as well as treatment options for early (stage I and II), locally advanced (stage III and IV), metastatic, and recurrent oropharyngeal cancer. Post-treatment rehabilitation and follow-up strategies are also examined.
This is the standard practice manual for the Alberta bone marrow and blood cell transplant program . The manual provides different recommendations for the use of bone marrow and blood cell transplantation based on disease type. Acute myeloid lymphoma, acute lymphoblastic leukemia, and myelodysplastic syndromes are all discussed.
This is a clinical practice guideline for patients with acute myeloid leukemia (AML), including those with acute promyelocytic leukemia (APL). The guideline examines the initial evaluation of AML, risk stratification based on cytogenetics and molecular markers, management options, as well as supportive care. Management strategies are separated based on whether patients are above or below sixty years of age.
This is a clinical practice guideline for patients with resected biliary tract cancer, including cancers of the intrahepatic bile ducts, perihilar and distal extrahepatic bile ducts, and the gallbladder. The guideline provides recommendations on adjuvant therapy, including fluoropyrimidine-based or gemcitabine-based chemotherapy and/or radiation therapy. Outcomes of interest include relapse-free survival (RFS) and overall survival (OS), as well as quality of life (QOL).
This is a clinical practice guideline for patients with multiple myeloma. The guideline provides recommendations for the treatment of both newly diagnosed and relapsed patients. Outcomes of interest include overall survival, progression-free survival, response rate, and quality of life.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the role of prophylactic anticonvulsants during the treatment of these patients. Reducing the number of seizures experienced by these patients is the primary outcome of interest.
This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the role of whole brain radiation therapy (WBRT) for the treatment of these patients. Topics of interest include optimal dose/fractionation schedule, the impact tumour histopathology or molecular status has on the decision to use WBRT, and the dose fractionation scheme utilized.
This is a clinical practice guideline for pediatric and adolescent patients with ovarian masses. The guideline provides recommendations for the preoperative evaluation and operational management of these patients. Patients with benign-appearing ovarian lesions who are candidates for ovarian preservation, situations in which formal staging procedures or more extensive resections are warranted, and the safety of ovarian preservation in the setting of suspected malignant disease are specifically discussed.
This is a clinical practice guideline for adult patients who are undergoing liver transplantation, and is specifically targeted towards Asian patients. The guideline provides recommendations for the immunosuppression of these patients, and includes a discussion of several immunosuppressants. Specific topics addressed include the effects of various agents on renal toxicity, hepatocellular carcinoma recurrence, and the impact of non-adherence to immunosuppressive therapy.
This is a clinical practice guideline for adult cancer patients who are at risk for developing chemotherapy-induced neutropenia and sepsis. The guideline examines the management of sepsis and septic shock in these patients, as compared to non-neutropenic patients. Topics of interest include risk factors associated with neutropenic sepsis, screening criteria for sepsis, and various treatment strategies.
This is a clinical practice guideline for the management of gynecological cancers in women with Lynch syndrome. The guideline examines women with gynecological cancer who would benefit from Lynch syndrome screening, as well as how to best manage the risk of gynecological cancer in women with Lynch syndrome. The appropriate methods for screening for Lynch syndrome, and preventive measures for women with Lynch syndrome to reduce their risk of gynecological cancer, are specifically addressed.
This is a clinical practice guideline for adults with rectal cancer. The guideline discusses the treatment of rectal cancer using local excision (LE), with or without neoadjuvant radiation therapy or chemoradiation. Outcomes of interest include anorectal function, tumour recurrence and overall quality of life.
This is a clinical practice guideline for adult patients with chronic radiation proctopathy resulting from radiation therapy received for the treatment of pelvic neoplasms. The guideline provides recommendations on endoscopic therapy in these patients to manage bleeding. Specific endoscopic modalities discussed include argon plasma coagulation (APC), bipolar electrocoagulation, heater probe, radiofrequency ablation (RFA), and cryoablation.
This is a clinical practice guideline for the assessment of patients who are at high risk for colorectal cancer due to genetic or familial factors. The guideline provides recommendations for the management of patients with high-risk syndromes, including Lynch syndrome, familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome (PJS), Juvenile Polyposis Syndrome (JPS), Serrated Polyposis Syndrome (SPS), and other high-risk syndromes associated with colorectal cancer risk.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia, or small lymphocytic lymphoma. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Prognosis and treatment algorithms are presented based on patient characteristics such as age, and genetic profile.
This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC). The guideline provides recommendations for the diagnosis and management of these patients. Recommendations are separated based on whether a patient has very early stage HCC, early stage HCC, intermediate stage HCC, advanced stage HCC, or terminal stage HCC. Biopsy in patients without cirrhosis is also addressed.
This is a clinical practice guideline for patients with central nervous system cancers. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Surgical options, adjuvant therapy, and postoperative staging are specifically considered.
This is a clinical practice guideline for patients with metastatic prostate cancer. The guideline examines various therapies for the treatment of metastatic castration-naive and castration-sensitive prostate cancer, including androgen-deprivation therapy, as well as local and external therapies. The prevention of osteoporosis, as well as opportunities for multidisciplinary consultation, are also discussed.
This is a clinical practice guideline for adult patients with lymphoma, including Hodgkin lymphoma (HL) and non-Hodgkin lymphomas (NHLs). The guideline provides recommendations for staging and re-staging, treatment, as well as follow-up. Outcomes of interest include disease progression, treatment toxicity, quality of life, progression-free survival, and overall survival.
This is a clinical practice guideline for adult patients with chronic lymphocytic leukemia (CLL). The guideline provides recommendations on diagnosis, staging, treatment, follow-up, and supportive care. Patients with newly diagnosed, relapsed, or refractory CLL are all addressed. Outcomes of interest include treatment toxicity, quality of life, progression-free survival, and overall survival.
This is a clinical practice guideline for adult patients who are receiving treatment for non-metastatic cancer, as well as adult cancer survivors. Recommendations are provided for the management of osteoporosis and osteoporotic fractures in these patients. The guideline specifically discusses which patients are at an increased risk for developing osteoporotic fractures, how these patients should be screened for, which patients should be treated for their osteoporosis, and which interventions should be used (i.e. which interventions are effective at reducing the risk of fracture).
This is a clinical practice guideline for the prevention and treatment of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in adult patients with cancer. The guideline discusses whether anticoagulation is appropriate for the prophylaxis of VTE in hospitalized patients with cancer, ambulatory patients with cancer who are receiving systemic chemotherapy, and patients who are undergoing surgery (i.e. preoperatively). Risk prediction, awareness of VTE among patients, and the optimal methods for treating established VTE, are also discussed.
This is a clinical practice guideline for patients with small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.
This is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.
This is a clinical practice guideline for adults with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M HNSCC). The guideline examines the use of immunotherapy for the treatment of these patients, while specifically addressing the use of the anti programmed cell death protein (PD-1) monoclonal antibodies, nivolumab and pembrolizumab. Primary outcomes of interest are overall survival and quality of life.
This is a clinical practice guideline for adult patients with completely resected cutaneous or mucosal melanoma, who are at a high risk for recurrence. The guideline examines the use of adjuvant systemic therapy for the prevention of recurrence in these patients. Molecular testing is discussed, and different recommendations are made based on the presence or absence of BRAF V600E or V600K mutations.
This is a clinical practice guideline for patients with metastatic testicular cancer, T3b, T4 or node-positive metastatic renal cell cancer (mRCC), as well as T3, T4 or node-positive upper tract urothelial carcinoma (UTUC). The guideline examines complex retroperitoneal surgical techniques, including the extent of resection and timing of surgery with respect to chemotherapy. Outcomes of interest include adverse events, hospital readmissions, and mortality.
This is a clinical practice guideline for adults with any type of cancer. The guideline focuses on the screening, assessment, and treatment of cancer-related pain. Specific topics discussed include universal pain screening, management of pain in both opioid-naïve and opioid-tolerant patients, management of opioid-induced adverse effects, procedure-related pain and anxiety, management strategies for specific cancer pain syndromes, adjuvant analgesics for neuropathic pain, psychosocial support, and education for both patients and caregivers.
This is a clinical practice guideline for patients with prostate cancer. The guideline examines various treatment options including active surveillance, radical prostatectomy, radiation therapy, other local therapies, androgen deprivation therapy, chemotherapy, and immunotherapy. It also discusses risk stratification, imaging, and estimates of life expectancy. Recommendations are provided for the initial diagnosis, clinical assessment, and staging evaluation, as well as for treatment, which are based on both the level of risk, and specific disease present.
This is a clinical practice guideline for patients with multiple myeloma. The guideline examines the primary therapy and surveillance/follow-up tests for both solitary plasmacytoma and smoldering (asymptomatic) myeloma, and the primary therapy and monitoring for active (symptomatic) myeloma. Stem cell transplants (SCT), including autologous SCT, tandem SCT, and allogeneic SCT, as well as follow-up after stem cell transplants, are also discussed. In addition, the guideline considers diagnostic tests, response criteria, maintenance therapy, treatment of progressive or relapsed myeloma, and supportive care treatment.
This is a clinical practice guideline for patients with head and neck cancers. The guideline examines workup and staging, treatment, and follow-up for various head and neck cancers including cancer of the lip, oral cavity, oropharynx, hypopharynx, nasopharynx, and larynx, as well as paranasal tumours, very advanced head and neck cancers, occult primary cancer, salivary gland tumours, and mucosal melanoma of the head and neck. Nutrition, supportive care, comorbidities, quality of life, and dental evaluation and management are also discussed.
This is a clinical practice guideline for patients with hairy cell leukemia. The guideline provides recommendations regarding diagnosis, initial treatment, response assessment and additional therapy, second-line therapy for relapsed/refractory or progressive disease, and supportive care. The impact of infections, such as hepatitis B (HBV) is also discussed.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia, or small lymphocytic lymphoma. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Prognosis and treatment algorithms are presented based on patient characteristics such as age, and genetic profile.
This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.
This is a clinical practice guideline for adults with renal cell carcinoma (RCC). The guideline provides recommendations for the diagnosis and staging, treatment, and follow-up of these patients. Diagnostic methods compared include physical examination, laboratory testing, as well as imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). The guideline also examines nephron-sparing surgery, radical nephrectomy, surveillance, ablative therapies, and adjuvant therapy, as potential treatment options.
This is a clinical practice guideline for patients with upper urinary tract urothelial cell carcinoma. The guideline examines the diagnosis, staging and classification systems, prognosis, management, and follow-up of these patients. Management options discussed include kidney-sparing surgery, radical nephroureterectomy, perioperative chemotherapy as an adjunct to radical nephroureterectomy, adjuvant radiotherapy after radical nephroureterectomy, adjuvant bladder instillation, metastasectomy, and systemic treatments.
This is a clinical practice guideline for patients with stage IV non-small cell lung cancer. The guideline provides recommendations for the treatment of these patients using chemotherapy, including first-line and second-line options. Recommendations are separated based on the patient's level of programmed death-ligand 1 (PD-1) expression, and whether or not they are driver oncogene-positive.
This is a clinical practice guideline for patients with basal cell carcinoma (BCC). The guideline examines the diagnosis, treatment and follow-up of these patients. Treatment options discussed include surgical therapy, topical therapies, destructive therapies, photodynamic therapy, combined therapies, medical therapy and radiotherapy, and options are stratified by a proposed disease classification system that is based on the difficulty of successful treatment.
This is a clinical practice guideline for patients with suspected or confirmed adenocarcinoma in situ (AIS) of the uterine cervix. Recommendations are provided for the diagnosis, treatment, and follow-up of these patients. The guideline discusses excisional treatment under colposcopic guidance, treatment for women who desire to preserve fertility, hysterectomy, and more.
This is a clinical practice guideline for asymptomatic women with suspected or confirmed adnexal masses. The guideline provides recommendations on various imaging procedures used to confirm the presence of adnexal masses, and to determine whether they are benign or malignant. The appropriateness of procedures indicated in specific clinical scenarios (measured by validity, reliability/reproducibility, clinical applicability, relative radiation levels, etc.) is examined. Recommendations are separated based on menopausal status.
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline examines the appropriate preoperative staging tests and the role of postoperative radiotherapy (RT) and/or chemotherapy (CT) for patients with resected stage II or III rectal cancer. The primary outcomes of interest are increase in overall survival and delaying local recurrence.
This is a clinical practice guideline for adults with squamous cell carcinoma of oral cavity (SCCOC) and oropharynx (SCCOP). The guideline provides recommendations for the management of the neck in these patients, with the goal of reducing disease-specific and overall mortality. The comparative efficacy of neck dissection and radiotherapy, and when and how to incorporate systemic therapy on the basis of nodal characteristics, are specifically discussed.
This is a clinical practice guideline for physicians who work on the prevention and treatment of colorectal cancer in the ambulatory and inpatient sector. The guideline provides recommendations for prevention, screening in asymptomatic populations as well as high risk populations, the role of endoscopy in the diagnosis of polyps and colorectal cancer, pre-operative diagnostics and surgery, adjuvant and neoadjuvant therapy, management of patients with metastases, palliative care and follow-up care.
This is a clinical practice guideline for patients with primary mediastinal B-cell lymphoma. The guideline examines the staging, therapy, response assessment, relapse or refractory disease, and follow-up of these patients. The effect of chemotherapy on fertility and pregnancy is discussed, as well as thrombotic complications of superior vena cava obstruction (SVCO).
This is a clinical practice guideline for older patients with cancer. The guideline provides recommendations for comprehensive geriatric assessments, as well as treatment modalities such as surgery, radiation therapy (RT), chemotherapy, and targeted therapy. Disease-specific issues are also addressed for breast cancer, central nervous system cancers, gastrointestinal cancers, genitourinary cancers, gynecological cancers, head and neck cancers, lung cancers, melanoma, and hematologic malignancies.
This is a clinical practice guideline for patients who have been diagnosed with melanoma, and those who are at high risk for melanoma. The guideline provides recommendations on prevention, screening of high risk individuals, diagnosis, staging, treatment, and follow-up. Treatment strategies explored include surgery, radiation therapy, and adjuvant chemotherapy, and recommendations are separated based on disease type. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a guideline for the prevention, screening/early detection, diagnosis, staging, and management of endometrial cancer. Management options examined include surgery, adjuvant therapy (e.g. pelvic radiotherapy, chemotherapy), and estrogen replacement therapy. Recommendations for follow-up are presented based on the type of treatment chosen. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This clinical practice guideline provides recommendations for the management of gastric cancer across most components of the cancer care continuum. Topics of discussion include risk factors for stomach cancer, indicated diagnostic tests, staging criteria, recommended treatment options for each stage (including palliative radiation therapy and chemotherapy), and recommended surveillance methods for follow-up. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients who are at risk for developing, or who have been diagnosed with, rectal cancer. The guideline examines the screening, diagnosis, treatment and follow-up of this patient population. Treatment options are presented based on the stage of cancer, and include surgical options, surveillance, and much more. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for adult patients with cholangiocarcinoma or gallbladder cancer. The guideline discusses the diagnosis, staging, and treatment of these patients, with the overall goals of rendering patients free of disease, delaying or preventing recurrence, and/or improving survival. Different recommendations are provided for patients with proximal cholangiocarcinoma and gallbladder carcinoma, as well as distal cholangiocarcinoma.
This is a clinical practice guideline for women with endometrial carcinoma (EC). The guideline provides recommendations on the use of biomarkers to assess prognosis and predict response to therapy, and to identify patients carrying germline mutations associated with an increased risk of EC. Immunohistochemistry (IHC), ploidy analysis, and microsatellite instability (MSI) are specifically discussed.
This is a clinical practice guideline for women with estrogen receptor (ER)-positive breast cancer. The role of CYP2D6 genotyping in these patients, in the context of tamoxifen therapy, is discussed. The guideline examines which patients should undergo CYP2D6 genotyping, which variants should be included in CYP2D6 tests, and which biological samples should be used for genotyping.
This is a clinical practice guideline for patients with Hodgkin and non-Hodgkin lymphoma, who have undergone autologous hematopoietic cell transplantation (auto-HCT). The guideline examines the use of various maintenance therapies used to mitigate disease relapse in these patients. In additional to disease recurrence, outcomes of interest include progression-free and overall survival.
This is a clinical practice guideline for the diagnosis and treatment of anal intraepithelial neoplasia (AIN). Diagnostic elements discussed include clinical evaluation with associated digital rectal examination (DARE), as well as brushing and viral typing, anoscopy, and biopsy. For the treatment of AIN, the guideline examines topical treatments such as imiquimod, 5-fluorouracil (5-FU), cidofovir and trichloroacetic acid (TCA), as well as ablative methods, including electrocautery, radiofrequency ablation (RFA), CO2 laser therapy, infrared coagulation (IRC), photodynamic therapy and surgery. The primary outcome of interest is the prevention of squamous cell carcinoma (SCC).
This is a clinical practice guideline for patients who have been diagnosed with or who are at high risk for hepatocellular carcinoma (HCC). The guideline provides recommendation for the primary, secondary, or tertiary prevention of HCC, the surveillance of patients who are at high risk for developing HCC, the diagnosis and staging of HCC, as well as the treatment and follow-up of patients with HCC. Surgery and radiation therapy are the primary treatment modalities discussed.
This is a clinical practice guideline for adults with suspected or confirmed Merkel cell carcinoma (MCC). The guideline discusses the main techniques used for initial diagnosis and staging of MCC, as well as treatment options available for localized MCC. Specific topics addressed include the appropriateness of the AEIOU acronym (Asymptomatic, Expanding Rapidly, Immune suppression, Older than 50 years, UV-exposed site) for diagnosis, and the use of sentinel lymph node (SLN) biopsy during treatment.
This is a clinical practice guideline for patients with nasopharyngeal carcinoma (NPC). The guideline provides recommendations on the treatment of these patients using radiation therapy. Dose distribution, optimal setting of dose targets, and dose prioritization are specifically discussed. Outcomes of interest include treatment toxicity and tumour control.
This is a clinical practice guideline for patients with suspected or confirmed esophageal cancer. The guideline examines the diagnosis, staging, and treatment of these patients, and includes a discussion of multiple treatment modalities. Outcomes of interest include morbidity, local recurrence, and survival.
This is a clinical practice guideline for patients diagnosed with pancreatic adenocarcinoma. The main focus of the guideline is on adjuvant therapy for these patients who have undergone an R0 or R1 resection of their primary tumour, however the guideline also examines the general management of pancreatic cancer patients including initial assessment before therapy, which patients should be offered a potentially curative strategy with resection, when palliative care services should be initiated, and the frequency of follow-up care/surveillance.
This is a clinical practice guideline for patients with completely resected stage 3 colon cancer. The guideline examines the optimal duration of oxaliplatin-containing chemotherapy for these patients. Specifically, comparisons in disease-free survival and adverse events are discussed for 3-month treatment versus 6-month treatment durations.
This is a clinical practice guideline for patients with ovarian cancer. Recommendations are provided for the diagnosis and management of these patients. The guideline specifically discusses how to determine the site of origin of extrauterine high-grade serous carcinomas (HGSC), which morphological criteria are useful for separating borderline from invasive ovarian neoplasias, as well as various aspects of treatment including exceptions to standard surgical management.
This clinical practice guideline is an endorsement of the American Society of Clinical Oncology’s 2017 guideline titled Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update. The guideline discusses the use of antiemetics for the prevention and management of nausea and vomiting in adult patients undergoing chemotherapy and/or radiotherapy. Various treatment regimens are examined based on the frequency of emesis. Other topics of interest include the use of adjunctive drugs, cannabinoids, as well as other complementary and alternative therapies.
This is a clinical practice guideline for adults with curatively treated stage I-III non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC). The guideline examines radiographic imaging and biomarker surveillance strategies for these patients. The frequency of surveillance imaging, optimal imaging modalities, patient factors that would preclude surveillance, the role of circulating biomarkers in surveillance, and the appropriateness of using magnetic resonance imaging (MRI) for NSCLC and SCLC are all specifically discussed.
This is a clinical practice guideline for adult patients with keratinocyte cancer (KC). The guideline examines the prevention, screening, diagnosis, treatment, and follow-up of these patients. Treatment options considered include surgery, radiotherapy, cryotherapy, topical treatments, and photodynamic therapy. Organ transplantation and conditions associated with immunosuppression are also discussed, as are systemic therapies for metastatic disease, the role of primary care, the economics of KC, and common concerns raised by patients. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of January 15, 2020.
This is a clinical practice guideline for older patients (i.e., over 70 years of age) with HER2-positive breast cancer. The primary objective of the guideline is to reduce the risk of cardiac events resulting from treatment-related cardiotoxicity, while still effectively reducing cancer-related morbidity and mortality. The guideline examines various anti-HER2 agents, and discusses their use in both adjuvant and neoadjuvant regimens.
This is a clinical practice guideline for patients with muscle-invasive bladder cancer. The guideline examines the diagnosis, staging, treatment, follow-up, supportive care, and palliative care for these patients. Treatment methods discussed include chemotherapy, surgical management and radiotherapy. Cystectomy pathology, as well as unresectable and oligometastatic disease are also addressed.
This is a clinical practice guideline for the surgical management of nonmelanoma skin cancer (NMSC) in adult patients. This guideline specifically focuses on the indications for Mohs micrographic surgery (MMS) to treat basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Clinical parameters such as location, size, borders, and site(s) of prior radiation therapy, as well as pathologic parameters such as growth pattern, degree of differentiation, and depth, are considered for risk-stratifying BCC and SCC patients.
This is an organizational guideline for adult patients with brain metastases who are eligible to receive stereotactic radiosurgery (SRS) in Ontario. Topics of discussion include qualifications for the practice team, the determination of patient eligibility, appropriate technologies for the delivery of SRS, as well as pre- and post-intervention imaging.
This is a clinical practice guideline for patients with myeloproliferative neoplasms. The guideline specifically examines the diagnosis, risk-stratification, treatment, and supportive care for patients with polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF). Risk-stratified treatment algorithms are provided for each disorder.
This is a clinical practice guideline for asymptomatic adults. The guideline discusses the appropriateness of pancreatic cancer screening in this general population. Outcomes of interest include diagnostic accuracy, harms of screening, morbidity, and mortality.
This is a clinical practice guideline for patients who have undergone hematopoietic stem cell transplantation (HSCT), and/or those who are receiving other types of therapy for hematological malignancies. The guideline examines the prevention, diagnosis, and management of cytomegalovirus (CMV) infection in these patients. The primary outcomes of interest are CMV serostatus and survival.
This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.
This is a clinical practice guideline for the management of squamous cell carcinoma (SCC) of the penis. The guideline examines the diagnosis, treatment, and follow-up for patients with this form of cancer. Outcomes of interest include optimizing therapeutic efficacy and minimizing treatment-related morbidity.
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
A clinical practice guideline on the diagnosis, workup, treatment and surveillance of B-cell lymphoma (BCL) in pediatric and adult patients. The guideline focuses on the most common B-cell lymphomas: follicular lymphoma (FL), marginal zone lymphomas (MZL), nodal MZL, splenic MZL, gastric MALT lymphoma, mantle cell lymphoma (MCL), diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), AIDS-related B-cell lymphoma, post-transplant lymphoproliferative disorders, and Castleman's disease. Additional consideration is paid to the classification systems used in NHL, the role of PET scans in assessment and staging, principles of radiation therapy, and supportive care considerations.
This is a clinical practice guideline for adults with classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The guideline discusses the clinical management of patients with CHL and NLPHL, focusing on patients who do not have serious intercurrent disease. Treatment options examined include chemotherapy, high dose therapy and autologous stem cell rescue (HDT/ASCR), and involved site radiation therapy (ISRT).
This is a clinical practice guideline for adults with esophageal or esophagogastric junction cancer. The guideline examines the initial workup, histological staging, primary treatment, and follow-up of both squamous cell carcinoma and adenocarcinoma. Treatment modalities discussed include surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies.
This is a clinical practice guideline for patients with testicular cancer. The guideline examines the staging and classification, diagnosis, prognosis, management, and follow-up of these patients. Treatment methods for stage 1 germ cell tumours and metastatic germ cell tumours, the impact of treatment on fertility, as well as restaging and further treatment, are specifically discussed.
This is a clinical practice guideline for patients with muscle-invasive and metastatic bladder cancer. The guideline examines recommendations for diagnostic evaluation and disease management, guidance for assessing comorbidities, and options for follow-up based on site of recurrence and level of evidence. Outcomes of interest are overall survival, mortality and quality of life.
This is a clinical practice guideline for patients with prostate cancer. The guideline examines the diagnostic evaluation, classification and staging, treatment, and follow-up of these patients. Treatment for metastatic prostate cancer and castration-resistant prostate cancer are specifically discussed, as is the management of prostate-specific antigen-only recurrence after treatment with curative intent.
This is a clinical practice guideline for adult patients who are undergoing surgery for gynecological cancers. The guideline provides preadmission, preoperative, intraoperative and postoperative recommendations. Patient education and counselling, pre-habilitation, surgical site infection (SSI) reduction bundles, and opioid sparing postoperative analgesia are some of the topics discussed. The primary outcomes of interest are reductions in perioperative morbidity and mortality, as well as improvements in recovery and decreased duration of hospital stays after surgery.
This is a clinical practice guideline for the work-up of suspicious colorectal masses following screening, as well as for the treatment of patients with diagnosed colorectal cancer. Treatment options discussed include surgery, adjuvant chemotherapy, and adjuvant radiotherapy. Recommendations are separated based on location and stage of disease, with the guideline specifically addressing localized rectal cancer, localized colon cancer, locally advanced unresectable colorectal cancer, up-front resectable metastatic colorectal cancer, and more.
This is a clinical practice guideline for patients with sarcoma or connective tissue tumours, including bone tumours. The guideline provides recommendations addressing prevention, diagnosis, staging, management, and follow-up. Diagnostic pathology, as well as treatment through chemotherapy, radiotherapy, and surgery are specifically discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This guideline provides recommendations on the management of adult and pediatric patients who are experiencing febrile neutropenia as a result of cancer treatment. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This clinical practice guideline is focused on the prevention, classification, diagnosis, staging, and management of ovarian epithelial carcinoma. Management options considered include surgery, chemotherapy, radiation therapy (for palliation), and approaches for fertility management. This guideline also discusses hereditary cancer syndromes, tumours of low malignant potential, estrogen replacement therapy, management of serous tubal intraepithelial carcinoma (STIC), and follow-up of patients after treatment. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with cancer of the fallopian tubes. The guideline examines the staging of these patients, and includes classification criteria and a staging diagram. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.
This is a clinical practice guideline for patients with polycythemia vera (PV). The guideline provides recommendations on the management of specific situations encountered in PV and the management of the other types of secondary erythrocytosis. Other topics discussed include the specific situations of surgery and pregnancy, as well as the management of pruritus.
This is a clinical practice guideline for adults with breast cancer. The guideline provides recommendations on the assessment and management of radiation-induced skin toxicities in these patients. Outcomes of interest include quality of life, treatment compliance, and minimized patient burden regarding dressings (e.g. cost, frequency, and difficulty of dressing changes).
This is a clinical practice guideline for the prevention and treatment of cancer-related infections. The guideline examines external risk factors for infection, major host factors that predispose patients to infectious diseases, prevention of infectious complications (including the use of antimicrobial prophylaxis and pre-emptive therapy), management of neutropenic fever, and management of site-specific infections such as pneumonia, abdominal infections, and catheter-associated infections.
A clinical practice guideline on the diagnosis, workup, and treatment of patients who have been diagnosed with or are suspected of having primary cutaneous B-cell lymphomas (PCBCLs). The guideline focuses on the three main types of PCBCLs: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle-center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, leg type). Recommendations for treatment are provided based on lymphoma type and whether treatment is for initial, relapsed, or refractory disease.
This is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.
This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.
This is a clinical practice guideline for adult patients with cancer requiring treatment for fever and neutropenia. The guideline examines which patients can be treated as outpatients, as well as appropriate interventions for these patients. Initial diagnostic approach, eligibility of patients at low risk for medical complications, and psychosocial and logistic recommendations for eligibility are discussed. Types of antimicrobial agents and locations for initial dose(s) in these patients are also considered, as are recommended courses of action if patients do not defervesce after 2 to 3 days of treatment.
This is a clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment options, including different chemotherapy regimens, and metastasectomy. Other topics of discussion include palliative chemotherapy regimens, and treatment of liver metastasis. Outcomes of interest include adverse effects, overall survival, and quality of life.
This is a clinical practice guideline for adults with solid tumours and non-myeloid malignancies who are receiving myelosuppressive chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) in these patients as a method for reducing the incidence of neutropenia. Topics of interest include the benefits and risks of MGFs, as well as their use in prophylactic, therapeutic, and post-transplant settings.
This is a clinical practice guideline for adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).
This is a clinical practice guideline for patients with thymomas and thymic carcinomas. The guideline examines the diagnosis, staging, and treatment these mediastinal tumours. Surgical resection and radiation therapy are discussed as treatment options.
This is a clinical practice guideline for patients with pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.
This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS). The guideline discusses diagnostic classification, evaluation, prognostic stratification, therapeutic options, and recommended treatment approaches for MDS. There is a particular focus on supportive care, and the guideline also provides recommendations for the management of thrombocytopenia and iron overload, the treatment of related anemia, the use of low-intensity therapy (i.e. hypomethylating agents or biologic response modifiers and immunosuppressive therapy), and high-intensity therapy.
This is a clinical practice guideline for patients with multiple myeloma. The guideline examines the primary therapy and surveillance/follow-up tests for both solitary plasmacytoma and smoldering (asymptomatic) myeloma, and the primary therapy and monitoring for active (symptomatic) myeloma. Stem cell transplants (SCT), including autologous SCT, tandem SCT, and allogeneic SCT, as well as follow-up after stem cell transplants, are also discussed. In addition, the guideline considers diagnostic tests, response criteria, maintenance therapy, treatment of progressive or relapsed myeloma, and supportive care treatment.
This is a clinical practice guideline for adults with classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The guideline discusses the clinical management of patients with CHL and NLPHL, focusing on patients who do not have serious intercurrent disease. Treatment options examined include chemotherapy, high dose therapy and autologous stem cell rescue (HDT/ASCR), and involved site radiation therapy (ISRT).
This is a clinical practice guideline for patients with head and neck cancers. The guideline examines workup and staging, treatment, and follow-up for various head and neck cancers including cancer of the lip, oral cavity, oropharynx, hypopharynx, nasopharynx, and larynx, as well as paranasal tumours, very advanced head and neck cancers, occult primary cancer, salivary gland tumours, and mucosal melanoma of the head and neck. Nutrition, supportive care, comorbidities, quality of life, and dental evaluation and management are also discussed.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia, or small lymphocytic lymphoma. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Prognosis and treatment algorithms are presented based on patient characteristics such as age, and genetic profile.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This is a clinical practice guideline for the diagnosis and management of plasma cell dyscrasias (PCD) other than multiple myeloma (MM). These disorders are rare, and include Waldenström's macroglobulinemia (WM), primary systemic AL-amyloidosis, monoclonal immunoglobulin deposition disease (MIDD), POEMS-syndrome, and primary plasma cell leukemia (PPCL). Recommendations in this guideline are focused on diagnosis and treatment options for each type of PCD.
This is a clinical practice guideline for patients with hairy cell leukemia. The guideline provides recommendations regarding diagnosis, initial treatment, response assessment and additional therapy, second-line therapy for relapsed/refractory or progressive disease, and supportive care. The impact of infections, such as hepatitis B (HBV) is also discussed.
This clinical practice guideline is an endorsement of the College of American Pathologists' 2018 guideline titled Human Papillomavirus Testing in Head and Neck Carcinomas. The guideline examines the optimal way to test, apply, interpret, and report HPV and surrogate marker tests in head and neck carcinomas. Specific types of cancer discussed include oropharyngeal squamous cell carcinoma (OPSCC), oropharyngeal non-squamous cell carcinoma, and cervical nodal metastatic carcinomas of unknown primary site.
This is a clinical practice guideline for women with ductal carcinoma in situ (DCIS) of the breast. The guideline examines the optimal surgical management of these patients, as well as radiotherapy in patients who have undergone breast-conserving surgery. The role of tamoxifen in the management of these patients is also discussed.
This is a clinical practice guideline for patients with Barrett's esophagus (BE), which is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC). The guideline examines endoscopic eradication therapy (EET) and its role in the management of BE-related neoplasia. Outcomes of interest include progression to cancer, cancer-specific and all-cause mortality, adverse events, and recurrence rates.
This is a clinical practice guideline for patients aged 16 or older who have primary brain tumours or brain metastases. Specifically, the guideline examines the diagnoses and management of radiologically identified glioma, meningioma, and brain metastases. Follow-up care after treatment and supportive care are also discussed, and additional recommendations are provided on the referral of adults with primary brain tumours or brain metastases for neurological rehabilitation assessment.
This is a clinical practice guideline for patients with solid tumours or hematological malignancies, and those with myelodysplastic syndromes (MDS). The guideline examines the management of anemia and iron deficiency in these patients using erythropoiesis-stimulating agents (ESAs), iron preparations for intravenous or oral administration, red blood cell transfusions, or combinations of these treatments. When and for whom treatment should be considered, as well as appropriate dose, are discussed.
This is a clinical practice guideline for patients with pancreatic ductal adenocarcinoma (PDAC). The guideline examines the screening, diagnosis, treatment and follow-up of these patients, with recommendations separated based on extent of disease (i.e. operable PDAC, locally advanced PDAC, or metastatic PDAC). Diagnostic methods examined include imaging and the use of serum tumour markers such as carbohydrate 19-9 antigen (CA19-9), and various treatment options are also discussed, including surgery and chemotherapy.
This is a clinical practice guideline for patients with primary liver cancer (PLC). The guideline examines the integrative use of traditional Chinese medicine (TCM) and Western medicine for PLC. Early treatment by TCM after surgery, TCM combined with transcatheter arterial chemoembolization for advanced PLC, TCM drugs for external use, and acupuncture and moxibustion therapy are among the topics discussed.
This is a clinical practice guideline for patients with cervical cancer. The guideline examines the staging, management, and follow-up of these patients. Specific management recommendations are made for stage T1a, T1b1/T2a1 cancer, clinically occult cervical cancer diagnosed after simple hysterectomy, early and locally advanced cervical cancer (LACC), primary distant metastatic disease, cervical cancer in pregnancy (CCIP), and recurrent disease. The use of fertility sparing treatment (FST) is also discussed.
This is a clinical practice guideline for patients with non-small cell lung cancer (NSCLC). The guideline provides recommendations on the use of immunotherapy as treatment for these patients, using the immune checkpoint inhibitors pembrolizumab, nivolumab and atezolizumab. Specific topics discussed include appropriate patient selection, sequencing of therapies, response monitoring, adverse event management, and biomarker testing.
This is a clinical practice guideline on the use of erythropoiesis-stimulating agents (ESAs) and biosimilars for the management of cancer-associated anemia in adult patients. Outcomes of interest include mortality, frequency of RBC transfusion, thromboembolic risk, quality of life, fatigue, progression-free survival and overall survival. In the case of biosimilars, hemoglobin (HgB) response and immunogenicity were additional outcomes of interest. Patient counselling and talking tips are also included to help clinicians implement the guideline's recommendations.
This is a clinical practice guideline for the prevention and treatment of clostridium difficile infection (CDI) in children and adolescents with cancer as well as in pediatric hematopoietic stem-cell transplantation (HSCT) patients. The guideline provides initial treatment recommendations for non-severe, severe and recurrent CDI. The efficacy and appropriateness of probiotics, monoclonal antibodies and fecal microbiota transplantation are also considered.
This is a clinical practice guideline for patients who have or are suspected of having primary central nervous system diffuse large B-cell lymphoma (PCNSL) located in the brain, spinal cord, cranial nerves, eyes or meninges. Specific topics discussed include diagnosis and imaging, treatment of primary CNS lymphoma, remission induction, consolidation treatment, follow-up, relapsed and refractory PCNSL, and neuropsychological assessments.
This is a clinical practice guideline for adult and pediatric patients with suspected or diagnosed well-differentiated neuroendocrine tumours (NETs). The guideline discusses the clinical utility of Gallium-68 positron emission tomography (PET) compared with PET / computed tomography imaging for the initial diagnosis, staging, re-staging, response evaluation, and routine surveillance of patients with NETs.
This is a clinical practice guideline for adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.
This is a clinical practice guideline for adult patients with cancer and immunotherapy-related toxicities. The guideline examines the management of immune-related adverse events (irAEs) resulting from cancer immunotherapy, including immune checkpoint inhibitor (ICI) therapy and chimeric antigen receptor (CAR) T-cell therapy. Immune checkpoint inhibitors are discussed, and managing irAEs in specific patient populations, as well as specific irAE management, are considered.
This is a clinical practice guideline for adults and children with cancer-induced anemia (CIA). The guideline discusses the etiology of CIA, and examines the screening, evaluation, and treatment methods for reducing CIA in affected patients. Red blood cell transfusion, erythropoietic therapy, and iron monitoring and supplementation are discussed as treatment options.
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
This is a clinical practice guideline for the management of colon cancer. Recommendations are made for diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, and management of recurrence. Principles for the management of metastatic disease are also provided.
This is a clinical practice guideline for patients with AIDS-related Kaposi sarcoma. The guideline examines diagnosis, staging, treatment, and follow-up, while also providing recommendations on HIV screening and HIV therapy during cancer treatment. Antiretroviral therapy (ART), topical therapies, intralesional chemotherapy, local incisions, radiation therapy, and systemic therapy are all discussed as treatment options.
This is a clinical practice guideline for the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. The guideline examines whether geriatric assessment (GA) should be used in older adults with cancer to predict adverse outcomes from chemotherapy, which GA tools should be used, and which general life expectancy data should be considered in order to estimate mortality and best inform treatment decision-making.
This is a clinical practice guideline for patients with multiple myeloma. The guideline examines the role of bone-modifying agents (BMAs) in this patient population. Topics of interest include indications to initiate treatment with a BMA, dosing and selection of BMAs, duration of therapy, and monitoring response.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 adaptation of Cancer Care Ontario's guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer. New recommendations are provided on the addition of adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy, the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab, and the use of neratinib as extended adjuvant therapy in patients with early-stage human epidermal growth factor receptor 2 (HER2)-amplified or HER2-overexpressed breast cancer.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology / College of American Pathologists 2013 guideline on human epidermal growth factor receptor 2 (HER2) testing in breast cancer. Recommendations are provided around what the most appropriate definition is for immunohistochemistry (IHC) 2+, whether HER2 testing should be repeated on surgical specimens if initial core biopsy results are negative, and which invasive cancers should be considered in situ hybridization (ISH) positive. In addition, appropriate diagnostic workup is discussed for invasive cancers based on the HER2 signals present.
This is a clinical practice guideline for women with breast cancer. The guideline examines fractionation for whole-breast irradiation (WBI), including appropriate dose-fractionation schemes for patients based on various disease and demographic factors. Treatment planning and delivery for WBI and a sequential tumour bed boost are also considered.
This is a clinical practice guideline for patients with multifocal recurrent or metastatic retroperitoneal sarcoma (RPS). The guideline provides recommendations on patient assessment, diagnostic processes, local and systemic treatments, as well as palliation. Specific subtypes of RPS discussed include well-differentiated/de-differentiated liposarcoma (WD/DD LPS), leiomyosarcoma (LMS), solitary fibrous tumours (SFTs), malignant peripheral nerve sheath tumours (MPNSTs), synovial sarcoma (SS), and undifferentiated pleomorphic sarcoma (UPS).
This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.
This is a clinical practice guideline for patients with high-risk prostate cancer (PCa), defined as PCa patients who have a high probability of relapse, progression, and death from PCa. The guideline discusses the diagnosis and classification of these patients as high risk, as well as various treatment approaches, including external radiotherapy plus androgen deprivation therapy, radical prostatectomy with extended lymphadenectomy, external radiotherapy plus brachytherapy, hormone therapy, observation, and chemotherapy. Primary outcomes of interest include reductions in morbidity, cancer progression, recurrence, and mortality.
This is a clinical practice guideline for premenopausal patients with hormone receptor-positive early breast cancer. The guideline examines adjuvant ovarian function suppression (OFS) during the treatment of these patients. The addition of OFS to tamoxifen therapy is discussed for low-risk and high-risk patients, as well as the use of aromatase inhibitors instead of tamoxifen in high-risk patients.
This is a clinical practice guideline for patients with epithelial ovarian cancer (EOC). The guideline discusses the surgical management of these patients, and specifically examines the institutions and surgeons that should be performing surgery, imaging tools appropriate for use prior to surgery, approaches to patient selection, objectives of surgery, and quality assessment criteria. Major technical issues of surgery, genetic counselling, the role of surgery in EOC recurrence, indications for palliative surgery, and the role of adjuvant chemotherapy are also addressed.
This is a clinical practice guideline for adult patients with symptomatic endobronchial disease in non-small cell lung cancer. The guideline examines the use of high dose rate endobronchial brachytherapy (HDREB) for the palliation of respiratory symptoms in these patients. Specific topics discussed include the appropriate dose of HDREB, toxicity, and fatal hemoptysis.
This is a clinical practice guideline for patients with castration-resistant prostate cancer (CRPC). The guideline examines treatment options for six index patients that represent the most common clinical scenarios. Recommendations are based on the presence or absence of metastatic disease, the degree of symptoms, the patient's performance status, and whether or not their has been prior treatment with docetaxel-based chemotherapy. A scale for defining patient performance status is also provided.
This is a clinical practice guideline for patients with squamous cell cancers (SCC) of the anal canal and perianal region. The guideline specifically examines management options for premalignant and malignant squamous neoplasms of the anus and perianal region. Recommendations are provided regarding screening options, primary treatment, and surveillance for SCC and perianal squamous cell cancers.
This is a clinical practice guideline for patients with malignant pleural mesothelioma (MPM). The guideline provides recommendations on the investigation of suspected MPM, and the subsequent care and management of individuals with proven MPM. Topics of interest include the preferred investigation pathway of suspected cases of MPM, biomarkers, and the role of different treatments including chemotherapy.
This is a clinical practice guideline for the diagnosis and management of early and locally advanced breast cancer. The guideline provides recommendations on referral, diagnosis, preoperative assessment, genetic testing, surgical procedures, breast reconstruction, psychological support, and adjuvant therapies such as endocrine therapy and bisphosphonate therapy.
This is a clinical practice guideline for adult patients with chronic lymphocytic leukemia. The guideline examines the diagnostic and staging criteria, treatment strategies, and follow-up and supportive care practices for these patients. First and second line treatment options are discussed for newly diagnosed, relapsed, and refractory disease.
This is a clinical practice guideline for adult patients with acute myeloid leukemia (AML). The guideline examines the diagnostic criteria and prognostic markers of acute myeloid leukemias. Different management options for acute myeloid leukemia are discussed, including chemotherapy, hematopoietic stem cell transplantation, and palliation.
This is a clinical practice guideline for patients who have been diagnosed with or are suspected of having advanced/metastatic prostate cancer. The guideline provides guidance on the staging, treatment, and follow up procedures for these patients. Topics of interest include radiotherapy techniques, the use of bone scans to assist in staging, and follow-up using active surveillance within a cancer clinic.
This is a clinical practice guideline for patients with diagnosed or suspected thyroid carcinoma. The guideline discusses the initial workup, diagnosis, staging, treatment, and follow up of patients with differentiated, papillary, follicular, medullary, and anaplastic thyroid carcinoma, as well as Hürthle cell carcinoma. Surgery, radiation therapy, and systemic therapy are discussed as treatment options.
This is a clinical practice guideline for patients with small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.
This is a clinical practice guideline for the management of squamous cell carcinoma (SCC) of the penis. The guideline examines the diagnosis, treatment, and follow-up for patients with this form of cancer. Outcomes of interest include optimizing therapeutic efficacy and minimizing treatment-related morbidity.
This is a clinical practice guideline for adult patients with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. Recommendations are provided for screening, staging, diagnosis, treatment, and follow-up. Treatment options discussed include debulking surgery, chemotherapy, and radiation therapy. Management of drug reactions is also discussed.
This is a clinical practice guideline for patients with T-cell lymphoma. The guideline examines the diagnostic workup, staging, treatment, follow-up, and supportive care for the most common subtypes of T-cell lymphoma. These subtypes include peripheral T-cell lymphomas (PTCLs), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), mycosis fungoides (MF) and Sézary syndrome (SS), primary cutaneous CD30+ T-cell lymphoproliferative disorders, T-cell large granular lymphocytic leukemia (TGLL), adult T-cell leukemia/lymphoma (ATLL), T-cell prolymphocytic leukemia (TPLL), and extranodal NK/T-cell lymphomas (ENKL), nasal type.
A clinical practice guideline on the diagnosis, workup, treatment and surveillance of B-cell lymphoma (BCL) in pediatric and adult patients. The guideline focuses on the most common B-cell lymphomas: follicular lymphoma (FL), marginal zone lymphomas (MZL), nodal MZL, splenic MZL, gastric MALT lymphoma, mantle cell lymphoma (MCL), diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), AIDS-related B-cell lymphoma, post-transplant lymphoproliferative disorders, and Castleman's disease. Additional consideration is paid to the classification systems used in NHL, the role of PET scans in assessment and staging, principles of radiation therapy, and supportive care considerations.
This is a clinical practice guideline for the management of colon cancer. Recommendations are made for diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, and management of recurrence. Principles for the management of metastatic disease are also provided.
This is a clinical practice guideline for women with breast cancer. The guideline examines staging, pathology assessment, and treatment approaches for pure noninvasive carcinomas, stage I, IIA, IIB, IIIA, or III invasive breast cancer, and stage IV metastatic or recurrent breast cancer. Special situations considered include Paget's disease, phyllodes tumours of the breast, breast cancer during pregnancy, inflammatory breast cancer, and axillary breast cancer.
This is a clinical practice guideline for patients with primary bone cancer. The guideline examines systemic therapy agents and radiation therapy for chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and giant-cell tumours of bone (GCTB). The guideline also discusses the management of relapsed disease.
This clinical practice guideline is for the management of squamous cell anal carcinoma. The guideline provides recommendations on staging, treatment, and follow-up. The effectiveness of treatment options such as surgery, chemotherapy, and radiation therapy are compared. Guidance is also provided on dosing regimens, treatment of recurrence, and surveillance following treatment of recurrence.
This is a clinical practice guideline for adolescent, young adult (AYA), and adult patients with acute lymphoblastic leukemia (ALL). The guideline reviews the classification of ALL subtypes based on immunophenotype and cytogenetic/molecular markers, and provides recommendations on risk assessment and stratification for risk-adapted therapy, as well as treatment strategies for Philadelphia chromosome (Ph)-positive and Ph-negative ALL. The guideline also provides recommendations for supportive care.
This clinical practice guideline discusses the prevention and management of chemotherapy induced nausea and vomiting (CINV) in pediatric cancer patients. Acute, delayed, anticipatory, breakthrough and refractory CINV are discussed. Recommendations are provided on assessment as well as pharmacological and non-pharmacological interventions. Antiemetic dosing recommendations are also provided.
This is a clinical practice guideline for adult cancer patients. The guideline examines the management cancer-related pain, and provides recommendations on treatment options such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and medical cannabis. The principles of pain management, and the treatment of mild, moderate, and severe pain are discussed, as is the invasive management of refractory pain.
This is a clinical practice guideline for children undergoing treatment for leukemia, or other forms of cancer. The guideline examines strategies for the prevention, assessment, and treatment of venous thromboembolism (VTE). Management of thrombocytopenia and coagulopathy, as well as therapy options for menstrual suppression, are also discussed.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia (CLL). The guideline provides recommendations on treatment and supportive care for these patients. Specific topics discussed include the initial approach to patient management, clinical and molecular assessment prior to treatment, front-line therapies, treatment of extremely frail patients, maintenance therapy, management of relapsed or refractory CLL, and management of side-effects during targeted therapy.
This is a clinical practice guideline for adult patients who have been diagnosed with or are suspected of having lymphoma. The guideline discusses Hodgkin lymphoma, as well as the most common non-Hodgkin lymphomas (T-cell and B-cell). Recommendations are provided on diagnosis, staging, treatment, management, and follow up care.
This is a clinical practice guideline for adults and children who have undergone hematopoietic stem cell transplantation (HSCT). The guideline provides recommendations for the prevention, diagnosis, and treatment of BK polyomavirus-associated (BKPyV-associated)hemorrhagic cystitis. Outcomes of interest include post-HSCT morbidity, mortality, and quality of life.
This is a clinical practice guideline for patients with non-pedunculated colorectal lesions. The guideline examines the use of endoscopic mucosal resection (EMR) for the treatment of these patients. Indications for EMR, patient requirements and preparation, patient information, identification and characterization of the lesion, technical aspects, intra-and post-operative complications, and efficacy and monitoring are discussed. The competence of the individual performing the EMR is also considered.
This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.
This is a clinical practice guideline for adult patients with RAS wild-type unresectable metastatic colorectal cancer (mCRC) who are undergoing first-line or second-line chemotherapy. The guideline provides recommendations on the role of primary tumour location (PTL) in the selection of epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) and vascular endothelial growth factor (VEGF) inhibitors, in addition to chemotherapy for the treatment of unresectable mCRC.
This is a clinical practice guideline for patients with diagnosed or suspected thyroid carcinoma. The guideline discusses the initial workup, diagnosis, staging, treatment, and follow up of patients with differentiated, papillary, follicular, medullary, and anaplastic thyroid carcinoma, as well as Hurthle cell carcinoma. Surgery, radiation therapy, and systemic therapy are discussed as treatment options.
This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.
This is a clinical practice guideline for the management of squamous cell carcinoma (SCC) of the penis. The guideline examines the diagnosis, treatment, and follow-up for patients with this form of cancer. Outcomes of interest include optimizing therapeutic efficacy and minimizing treatment-related morbidity.
This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.
This is a clinical practice guideline for patients with multiple myeloma. The guideline examines the primary therapy and surveillance/follow-up tests for both solitary plasmacytoma and smoldering (asymptomatic) myeloma, and the primary therapy and monitoring for active (symptomatic) myeloma. Stem cell transplants (SCT), including autologous SCT, tandem SCT, and allogeneic SCT, as well as follow-up after stem cell transplants, are also discussed. In addition, the guideline considers diagnostic tests, response criteria, maintenance therapy, treatment of progressive or relapsed myeloma, and supportive care treatment.
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline specifically examines the initial evaluation, staging, diagnosis, clinical management options, and follow-up of patients with clear cell carcinoma and non-clear cell carcinoma. Pharmacologic agents discussed include pazopanib, sunitinib, and nivolumab.
This is a clinical practice guideline for patients with acute myeloid leukemia (AML), including those with acute promyelocytic leukemia (APL). The guideline examines the initial evaluation of AML, risk stratification based on cytogenetics and molecular markers, management options, as well as supportive care. Management strategies are separated based on whether patients are above or below sixty years of age.
This is a clinical practice guideline for patients who have been diagnosed with or are suspected of having malignant pleural mesothelioma. Recommendations are provided on diagnosis, staging, chemotherapy, surgical cytoreduction, radiation therapy, and multimodal therapy. Outcomes of interest include overall survival, progression-free survival, response rate, toxicity, quality of life (QoL), surgical complications, and diagnostic accuracy.
This is a clinical practice guideline for adult patients who are experiencing immune suppression or increased susceptibility to infection as a result of cancer or and/or its treatment. The guideline discusses antimicrobial prophylaxis and the potential impacts on reducing the incidence of and mortality from febrile neutropenia (FN). Fluoroquinolone, oral triazole, antivirals, and neutropenic diets are all examples of management options that are discussed.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. The guideline specifically examines whether extended adjuvant therapy, including the use of aromatase inhibitors (AIs), improves clinically meaningful outcomes (e.g. disease-free survival, overall survival, quality of life, toxicity) after 5 years of sequential endocrine therapy in postmenopausal women with hormone receptor-positive early breast cancer.
This is a quick reference guide for adjuvant systemic therapy for early stage breast cancer. The guide examines the treatment options for lymph node negative and positive breast cancer. Treatment options discussed include hormonal therapy, and chemotherapy such as trastuzumab-based adjuvant chemotherapy.
This is a clinical practice guideline for adults with newly-diagnosed or recurrent oesophago-gastric cancer. The guideline discusses clinical assessment, radical and palliative treatment, follow-up, nutritional support, and service organization. The primary outcomes of interest are increases in quality of life and survival.
This is a clinical practice guideline for the management of critically ill cancer patients. The guideline examines multiple aspects of patient care in intensive care units (ICUs), including ICU eligibility criteria, indications and screening for organ dysfunction, interprofessional collaboration, and treatment within ICUs. Infection prevention (including immunization), and the treatment of infections are both discussed, as is the selective use of Granulocyte colony stimulating factor (GCSF).
This is a clinical practice guideline for the optimal preoperative management of patients undergoing thoracic surgery, and primarily, lung resection. Topics covered in the guideline include preoperative counselling, nutritional screening, smoking cessation, prehabilitation for high-risk patients, avoidance of fasting, carbohydrate loading, avoidance of preoperative sedatives, venous thromboembolism prophylaxis, prevention of hypothermia, short-acting anesthetics to facilitate early emergence, regional anesthesia, nausea and vomiting control, opioid-sparing analgesia, euvolemic fluid management, minimally invasive surgery, early chest drain removal, avoidance of urinary catheters and early mobilization after surgery.
This is a clinical practice guideline for patients with small cell lung cancer. The guideline examines the diagnosis, staging, prognostic factors, treatment, and surveillance of these patients. Treatment options discussed include systemic therapy, radiotherapy, and surgical resection. Systemic therapy is further examined in elderly patients, and as a second-line (and beyond) treatment. Radiotherapy treatments considered include thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy.
This is a clinical practice guideline for patients undergoing treatment for breast cancer and for survivors of breast cancer. The guideline examines the use of complementary integrated therapies for the management of symptoms of disease as well as for the management of adverse effects associated with treatment. Recommendations are grouped within the following categories: acute radiation skin reaction, anxiety and stress reduction, chemotherapy-induced nausea and vomiting, depression and mood disturbances, fatigue, lymphedema, neuropathy, pain, quality of life, sleep disturbances, and vasomotor/hot flashes.
This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.
This is a clinical practice guideline for adults with any type of cancer. The guideline focuses on the screening, assessment, and treatment of cancer-related pain. Specific topics discussed include universal pain screening, management of pain in both opioid-naïve and opioid-tolerant patients, management of opioid-induced adverse effects, procedure-related pain and anxiety, management strategies for specific cancer pain syndromes, adjuvant analgesics for neuropathic pain, psychosocial support, and education for both patients and caregivers.
This is a clinical practice guideline for patients with prostate cancer. The guideline examines various treatment options including active surveillance, radical prostatectomy, radiation therapy, other local therapies, androgen deprivation therapy, chemotherapy, and immunotherapy. It also discusses risk stratification, imaging, and estimates of life expectancy. Recommendations are provided for the initial diagnosis, clinical assessment, and staging evaluation, as well as for treatment, which are based on both the level of risk, and specific disease present.
This is a clinical practice guideline for hepatobiliary cancers. The guideline examines the clinical management of patients with hepatocellular carcinoma (HCC), gallbladder cancer, as well as intrahepatic and extrahepatic cholangiocarcinoma. Risk factors, diagnosis, staging and prognosis, and treatment are discussed for the different conditions.
This is a clinical practice guideline for women with epithelial ovarian cancers, specifically focusing on patients with type-2 ovarian cancers. The guideline examines diagnostic imaging methods, used for both staging and evaluating potential recurrence. Imaging modalities discussed include x-ray, magnetic resonance imaging (MRI), fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and computed tomography (CT).
This is a clinical practice guideline for patients with primary bone cancers, including osteosarcoma, Ewing sarcoma and chondrosarcoma. The guideline examines diagnosis and treatment of these patients. Specific topics addressed include biopsy, chemotherapy, surgery, and management of lung metastases.
This is a clinical practice guideline for patients with thyroid tumours. Recommendations are provided pertaining to the optimal use of radiofrequency ablation (RFA) for benign thyroid nodules, recurrent thyroid cancers, follicular neoplasms, and primary thyroid cancer. The guideline also discusses appropriate laboratory and imaging evaluations, and more.
This is a clinical practice guideline for patients with colorectal cancer (CRC). The guideline provides recommendations for the management of emergencies including perforation and obstruction of the left or right colon. Ileostomy, colectomy, proctosigmoidectomy, and non-surgical procedures such as the use of self-expandable metallic stents (SEMSs), are discussed as potential management options.
This is a clinical practice guideline for patients with a malignant pleural effusion (MPE). The guideline provides recommendations for the management of these patients, and specifically discusses the use of thoracic ultrasound to guide pleural interventions, pleural drainage, large-volume thoracentesis and pleural manometry, among other topics. Recommendations for asymptomatic and symptomatic patients are addressed, as well as recommendations for patients with expandable lung.
This is a clinical practice guideline for patients with nonmelanoma skin cancer, precancerous lesions, or infectious and inflammatory dermatoses. The guideline examines the use of topical photodynamic therapy (PDT) in these patients. Photosensitizing agents, photodynamic diagnosis, light sources and dosimetry, protocols for delivery of photodynamic therapy, and adverse effects are also discussed.
This is a clinical practice guideline for patients with cutaneous melanoma. The guideline examines the immunotherapy options for the treatment of this patient population. Topics of interest include the different immunotherapy options for every stage of melanoma and special issues in tumour immunotherapy.
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline focuses on the clinical assessment and management of these patients. Outcomes of interest include improved care delivery and quality of life, enhanced treatment compliance, as well as minimized patient burden regarding dressings (i.e. cost, frequency/difficulty of dressing changes).
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline provides recommendations regarding interventions aimed at the promotion of skin health. Specific topics discussed include the promotion of skin hygiene, promotion of comfort, preventing infections, protection from trauma, and protection from the environment.
This is a clinical practice guideline for patients with T-cell lymphoma. The guideline examines the diagnostic workup, staging, treatment, follow-up, and supportive care for the most common subtypes of T-cell lymphoma. These subtypes include peripheral T-cell lymphomas (PTCLs), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), mycosis fungoides (MF) and Sezary syndrome (SS), primary cutaneous CD30+ T-cell lymphoproliferative disorders, T-cell large granular lymphocytic leukemia (TGLL), adult T-cell leukemia/lymphoma (ATLL), T-cell prolymphocytic leukemia (TPLL), and extranodal NK/T-cell lymphomas (ENKL), nasal type.
This is a clinical practice guideline for patients with polycythemia vera (PV). The guideline provides recommendations on diagnosis, risk stratification and management of PV. Specific topics discussed include the initial assessment, stage 1 investigations, considerations based on erythropoietin (EPO) levels, gene sequencing for congenital erythrocytosis, and cytoreductive therapy.
This is a clinical practice guideline for adult patients with esophageal cancer or cancer of the gastro-esophageal junction. The guideline provides recommendations on assessment, systemic therapy, surgical approaches, and post-curative therapy follow-up of these patients. The discussion of treatment is stratified by stage, performance status, and disease type. Chemotherapy regimens are also considered.
This is a clinical practice guideline for women with vulvar cancer, and particularly those with squamous cell carcinoma (SCC) of the vulva. The guideline examines diagnosis and workup, as well as primary treatment, adjuvant radiotherapy and chemotherapy, and surveillance of these patients. Treatment options are discussed for early-stage disease, locally advanced disease, and metastases beyond the pelvis.
This is a clinical practice guideline for patients with systemic mastocytosis (SM). The guideline provides recommendations on the diagnostic criteria for variants of SM, as well as for treatment and follow-up. Specific variants discussed include indolent SM, smoldering SM, aggressive SM, and SM with an associated hematological neoplasm.
This is a clinical practice guideline for patients with myeloproliferative neoplasms. The guideline specifically examines the diagnosis, risk-stratification, treatment, and supportive care for patients with polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF). Risk-stratified treatment algorithms are provided for each disorder.
This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS). The guideline discusses diagnostic classification, evaluation, prognostic stratification, therapeutic options, and recommended treatment approaches for MDS. There is a particular focus on supportive care, and the guideline also provides recommendations for the management of thrombocytopenia and iron overload, the treatment of related anemia, the use of low-intensity therapy (i.e. hypomethylating agents or biologic response modifiers and immunosuppressive therapy), and high-intensity therapy.
This is a clinical practice guideline for patients with Waldenström macroglobulinemia or lymphoplasmacytic lymphoma. The guideline examines the diagnosis, workup, primary treatment regimens, assessment of response to primary treatment, and follow-up after primary treatment. Regimens not toxic to stem cells and regimens with potential or unknown toxicity to stem cells are considered. Treatment of Immunoglobulin M (IgM) related peripheral neuropathy, maintenance therapy, and therapy for previously treated Waldenström macroglobulinemia are also discussed.
This is a clinical practice guideline for the management of rectal cancer. The guideline provides recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, and patient surveillance. Outcomes of interest include safety and efficacy of treatment, adverse outcomes, and overall survival.
This is a clinical practice guideline for patients with bladder cancer. Non-muscle-invasive urothelial bladder cancer, muscle-invasive urothelial bladder cancer, metastatic (Stage IVB) urothelial bladder cancer, non-urothelial carcinomas of the bladder, upper tract urothelial carcinoma (UTUC), urothelial carcinomas of the prostate, and primary carcinomas of the urethra are all specifically discussed. The guideline provides algorithms for diagnosis, staging, treatment, and follow-up.
This is a clinical practice guideline for men with localized prostate cancer. The guideline provides recommendations on the use of moderate hypofractionated and ultrahypofractionated external beam radiation therapy (EBRT), with particular reference to oncologic outcomes, toxicity, and quality of life.
This is a clinical practice guideline for patients with metastatic pancreatic cancer. The guideline examines the appropriate therapy for patients with metastatic pancreatic cancer who experience either disease progression or intolerable toxicity with prior regimens. Options for routine testing of patients who are considered to be candidates for checkpoint inhibitor therapy are discussed, as are programmed cell death-1 (PD-1) immune checkpoint inhibitor pembrolizumab as second-line therapy, and the use of fluorouracil with either nanoliposomal irinotecan, irinotecan, or oxaliplatin.
This is a clinical practice guideline for adult patients with active cancer. The guideline examines screening, assessment, and management strategies for cancer-related pain of any severity in these patients. Pharmacological management options discussed include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), adjuvant analgesics, opioid drugs, and management of cancer pain in patients with renal impairment. Non-pharmacological management options including radiotherapy, vertebroplasty and kyphoplasty, anesthetic interventions, surgical interventions, and complementary therapies are also discussed. The guideline also considers supportive care of these patients.
This is a clinical practice guideline for women with early-stage squamous cell vulvar cancer. The guideline examines sentinel lymph node biopsy (SLNB), including its safety and effectiveness in identifying women with node-negative, early-stage vulvar cancer. The appropriate procedures for SLNB in these patients are also discussed, such as selecting appropriate patients, determining the appropriate technique, and managing patients with positive sentinel lymph nodes.
This clinical practice guideline provides recommendations on the use of Mohs micrographic surgery (MMS) for adult patients diagnosed with skin cancer. MMS is compared to other surgical excision techniques, as well as other treatment modalities such as radiation. Guidance is provided on the indications and considerations for appropriate use of MMS, including disease stage, aesthetic outcomes, patient comorbidities, and patient preferences. Outcomes of interest include cure rate, recurrence rate, quality of life, and adverse events.
This is a clinical practice guideline for patients with mantle cell lymphoma (MCL), a type of B-cell non-Hodgkin lymphoma (NHL). The guideline examines the management of these patients, and includes recommendations on first-line treatment, assessment of treatment response, and second-line treatment (and beyond). Autologous stem cell transplantation (ASCT) for patients with MCL is also discussed.
This is a clinical practice guideline for adult men with a suspicion or recent diagnosis of localized prostate cancer. The guideline examines staging, treatment options, and follow-up for these patients. Management is discussed for low, intermediate, and high-risk disease. Treatment options considered include variations of radical prostatectomy, brachytherapy, external beam radiotherapy, cryosurgery, and active surveillance.
This is a clinical practice guideline for older patients with cancer. The guideline provides recommendations for comprehensive geriatric assessments, as well as treatment modalities such as surgery, radiation therapy (RT), chemotherapy, and targeted therapy. Disease-specific issues are also addressed for breast cancer, central nervous system cancers, gastrointestinal cancers, genitourinary cancers, gynecological cancers, head and neck cancers, lung cancers, melanoma, and hematologic malignancies.
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines the clinical presentation, workup, primary treatment, and pathologic diagnoses of these patients. Separate recommendations are provided for different stages of pure seminomas and nonseminomas, and the guideline also discusses second-line and subsequent therapies for metastatic GCTs.
This is a clinical practice guideline for patients with non-small cell lung cancer. The guideline examines the risk factors, classification factors, diagnostic evaluation, pathologic evaluation, staging, predictive and prognostic biomarkers, treatment, and surveillance of lung cancer. Treatment approaches considered include surgery, radiation therapy, and combined modality therapy. The discussion on initial therapy is stratified by disease stage.
This is a clinical practice guideline for patients with chronic myeloid leukemia (CML). The guideline discusses diagnosis and workup, staging, and management options for these patients, and includes specific considerations for children with CML. The guideline separates treatment options based on characteristics such as genetic profile, and phase (i.e. chronic phase, accelerated phase, and blast phase). Topics discussed include toxicities and response milestones for different treatment options.
This is a clinical practice guideline for children with solid or hematological malignancies. The guideline provides recommendations for the use of anthracycline chemotherapy in these patients, while specifically focusing on the timing of therapy (i.e. prolonged infusion
duration versus shorter infusion duration). The primary outcomes of interest being compared between regimens are tumour response, quality of life, progression-free survival, overall survival, cardiotoxicity (i.e. clinical and subclinical heart failure, etc.) and adverse effects other than cardiac manifestations.
This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.
This is a clinical practice guideline for adults with solid tumours and non-myeloid malignancies who are receiving myelosuppressive chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) in these patients as a method for reducing the incidence of neutropenia. Topics of interest include the benefits and risks of MGFs, as well as their use in prophylactic, therapeutic, and post-transplant settings.
This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.
This is a clinical practice guideline for patients with prostate cancer. The guideline examines various treatment options including active surveillance, radical prostatectomy, radiation therapy, other local therapies, androgen deprivation therapy, chemotherapy, and immunotherapy. It also discusses risk stratification, imaging, and estimates of life expectancy. Recommendations are provided for the initial diagnosis, clinical assessment, and staging evaluation, as well as for treatment, which are based on both the level of risk, and specific disease present.
This is a clinical practice guideline for patients with pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.
This is a clinical practice guideline for patients with Merkel cell carcinoma. The guideline provides recommendations on diagnosis, workup, staging, radiation therapy, chemotherapy, follow-up, and recurrence. Specific recommendations are provided for the postoperative management of primary tumours, management of the draining nodal basin, and treatment of distant metastatic disease.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia, or small lymphocytic lymphoma. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Prognosis and treatment algorithms are presented based on patient characteristics such as age, and genetic profile.
This is a clinical practice guideline for patients with chronic myeloid leukemia (CML). The guideline discusses diagnosis and workup, staging, and management options for these patients, and includes specific considerations for children with CML. The guideline separates treatment options based on characteristics such as genetic profile, and phase (i.e. chronic phase, accelerated phase, and blast phase). Topics discussed include toxicities and response milestones for different treatment options.
This is a clinical practice guideline for patients with breast cancer. The guideline examines the staging, pathology assessment, and treatment approach for these patients. Pure non-invasive carcinomas (stage 0), stage 1, 2A, 2B or 3A (T3, N1, M0) invasive breast cancer, stage 3 invasive breast cancer, and stage 4 metastatic or recurrent breast cancer are discussed. Special situations including Paget's disease, phyllodes tumours of the breast, breast cancer during pregnancy, inflammatory breast cancer, and axillary breast cancer are also considered.
This is a clinical practice guideline for patients with bone cancer. The guideline focuses on chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and provides recommendations for treating giant cell tumour of the bone (GCTB). Workup, treatment, surveillance, and relapsed disease are discussed for each of the types of bone cancer mentioned. Staging, high-grade undifferentiated pleomorphic sarcoma of bone, and immunotherapy for bone cancer are also considered.
This is a clinical practice guideline for adult patients with cancer being treated with immune checkpoint inhibitor (ICPi) therapy. The guideline examines how to manage immune-related adverse events (irAEs) in these patients. Adverse events considered include skin, gastrointestinal, lung, endocrine, musculoskeletal, renal, nervous system, hematologic, cardiovascular, and ocular toxicities. Patient and clinician communication, health disparities, and multiple chronic conditions are also discussed.
This is a clinical practice guideline for men with metastatic non-castrate prostate cancer being considered for treatment with androgen-deprivation therapy (ADT). The guideline examines the addition of docetaxel or abiraterone to ADT, and the resulting effects on overall survival (OS), progression-free survival (PFS), failure-free survival (FFS), prostate-specific antigen (PSA) response, overall response rate, and quality of life (QOL).
This is a clinical practice guideline for patients with non-small cell lung cancer (NSCLC). The guideline examines the use of concurrent chemotherapy (CC) with palliative thoracic external beam radiation (EBRT). Patients with incurable stage 3 NSCLC and stage 4 NSCLC are considered. Outcomes of interest include overall survival, local and regional control, distant failure, toxicity, and quality of life.
This is a clinical practice guideline for women with potentially curable, non-operable, locally advanced cervical cancer. The guideline provides recommendations on treatment using brachytherapy (BT), and compares different forms of BT such as two-dimensional BT, computed tomography-guided BT, magnetic resonance (MR)-guided intracavitary BT, and MR-guided intracavitary/interstitial BT. Outcomes of interest include survival, local tumour control, and toxicity.
This is a clinical practice guideline for patients with aggressive pituitary tumours and carcinomas, which provides recommendations on diagnosis, treatment, and follow-up. Treatment options such as surgery, radiotherapy, and temozolomide are examined. Further guidance on dosing regimens, adverse effects, discontinuation, and combination chemotherapies is provided for temozolomide. Recurrence, non-responders, and systemic metastasis are also discussed.
This is a clinical practice guideline for patients with adrenocortical carcinoma (ACC). The guideline examines the diagnostic criteria and management options for ACC. Topics of interest include a discussion of the best prognostic markers for ACC, treatment options including mitotane treatment, and supportive therapies.
This is a clinical practice guideline for hepatocellular carcinoma (HCC) occurring in adult patients with cirrhosis. The guideline examines techniques for surveillance and screening, diagnostic evaluation methods, and the various therapeutic options for the treatment of HCC. Outcomes of interest include the sensitivity and specific of screening tests, as well as morbidity, recurrence, and survival.
This is a clinical practice guideline for adults with advanced-stage lung cancer. Recommendations are provided for the molecular analysis of lung cancers to guide treatment decisions with targeted inhibitors. The guideline examines the genes that should be tested for lung cancer patients, the methods that should be used to perform molecular testing, the appropriateness of molecular testing for lung cancers that do not have an adenocarcinoma component, the testing that is indicated for patients with targetable mutations who have relapsed on targeted therapy, and the role of testing for circulating cell-free DNA in lung cancer patients.
This is a clinical practice guideline for adults with suspected pancreatic cancer, or those with newly diagnosed or recurrent pancreatic ductal adenocarcinoma. The guideline provides recommendations for the monitoring of people with an inherited high risk of pancreatic cancer. Recommendations are also made for diagnosis, staging, psychological support, pain and nutrition management, as well as management for resectable, borderline resectable, and unresectable cancer.
This is a clinical practice guideline for adult patients with advanced cancer who are experiencing constipation due to diagnosis or treatment. The guideline discusses the assessment, diagnosis, and management of constipation in these patients. Specific recommendations are provided for managing constipation in older adults with cancer, opioid-induced constipation, and fecal impaction. Management options considered include prevention and self-care, laxatives, suppositories, and enemas.
This is a clinical practice guideline for adults with cancer who are at risk for, or have been diagnosed with, delirium. The guideline provides recommendations regarding delirium prevention, diagnosis, screening, treatment and experiential impact. Pharmacological and non-pharmacological interventions are discussed. Guidance is also provided on education and support for the healthcare team and family members.
This is a clinical practice guideline for children with suspected or confirmed transient leukemia of Down syndrome (TL-DS). The guideline examines the clinical features and diagnosis of TL-DS, outcomes, risk factors for early death, and treatment of TL-DS, as well as monitoring for resolution of TL-DS and development of myeloid leukemia of Down syndrome (MI-DS). Fetal TL-DS, silent TL-DS and screening for mutations in the hematopoietic transcription factor gene GATA1 are also discussed.
This is a clinical practice guideline on the use of the 9-valent human papillomavirus (HPV) vaccine. The guideline examines the effect and safety of the 9-valent HPV vaccines, the recommended age for a 3-dose schedule, the vaccine's efficacy among middle-aged women, and the efficacy of a 2-dose schedule.
This is a clinical practice guideline for adult cancer survivors and those living with advanced disease. The guideline examines the screening, diagnosis and management of cancer-related pain in these patients. Specific topics addressed include the frequency of pain screening, support for patient self-management, as well as patient-specific, multimodal treatment plans.
This is a clinical practice guideline for the diagnosis and treatment of patients with pancreatic cystic neoplasms (PCN). The use of blood and cystic biomarkers, as well as imaging modalities such as magnetic resonance imaging / cholangiopancreatography (MRI/MRCP), computed tomography (CT), and endoscopy guided ultrasound (EUS) are all discussed as potential diagnostic approaches. Management options are presented based on tumour-specific features such as size, as well as general clinical features like the presence of jaundice.
This is a clinical practice guideline for adult and adolescent cancer patients who are experiencing cancer-related pain. The guideline examines various pharmacological and radiotherapeutic management options. Topics of interest include initiation of pain relief, maintenance of pain relief with opioids, cessation of opioids, and the use of radiotherapy.
This is a clinical practice guideline for the management of adult patients with primary cutaneous B-cell and T-cell lymphomas. This guideline does not include patients presenting with or found to have skin involvement as part of a systemic lymphoma. Treatment recommendations are organized by clinicopathological subtypes of lymphomas and are further stratified based on the stage of the disease. Economic and practical considerations of also discussed.
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline focuses on the management of long term effects, and provides recommendations on 1 month post-treatment and late reactions to promote cleanliness, treat the wound, prevent infections, protect from trauma and the environment, promote skin health and maintain skin flexibility.
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines the clinical presentation, workup, primary treatment, and pathologic diagnoses of these patients. Separate recommendations are provided for different stages of pure seminomas and nonseminomas, and the guideline also discusses second-line and subsequent therapies for metastatic GCTs.
This is a clinical practice guideline for patients with any type of cancer who are experiencing or are at high risk for experiencing nausea and/or vomiting due to treatment. The guideline examines treatment options for nausea and/or vomiting induced by radiation therapy (RT), chemotherapy, targeted therapy, and immunotherapy. In addition to antiemetic treatment options, the guideline discusses the emetogenic potentials of different anticancer therapies.
A clinical practice guideline on the diagnosis, work-up, and treatment of patients who have been diagnosed with or are suspected of having primary cutaneous B-cell lymphomas (PCBCLs). The guideline focuses on the three main types of PCBCLs: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle-center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, leg type). Recommendations for treatment are provided based on lymphoma type and whether treatment is for initial, relapsed, or refractory disease.
This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.
This is a clinical practice guideline for malignant pleural mesothelioma (MPM). The guideline examines the clinical management options for these patients, which include surgery, radiation therapy (RT), and chemotherapy. The potential for multimodal therapy is also addressed.
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline specifically examines the initial evaluation, staging, diagnosis, clinical management options, and follow-up of patients with clear cell carcinoma and non-clear cell carcinoma. Pharmacologic agents discussed include pazopanib, sunitinib, and nivolumab.
This is a clinical practice guideline for patients with gastric cancer. The guideline examines the pathology, initial workup, staging, treatment, follow-up, and supportive care of these patients. Treatment options discussed include lymph node dissection, laparoscopic resection, endoscopy, radiation therapy, combined modality therapy, chemotherapy (preoperative, perioperative, and postoperative), and targeted therapies.
This is a clinical practice guideline for adults with esophageal or esophagogastric junction cancer. The guideline examines the initial workup, histological staging, primary treatment, and follow-up of both squamous cell carcinoma and adenocarcinoma. Treatment modalities discussed include surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies.
This is a clinical practice guideline for the management of rectal cancer. The guideline provides recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, and patient surveillance. Outcomes of interest include safety and efficacy of treatment, adverse outcomes, and overall survival.
This is a clinical practice guideline for patients with acute myeloid leukemia (AML), including those with acute promyelocytic leukemia (APL). The guideline examines the initial evaluation of AML, risk stratifications based on cytogenetics and molecular markers, management options, as well as supportive care. Management strategies are separated based on whether patients are above or below sixty years of age.
This is a clinical practice guideline for patients with breast cancer. The guideline examines common approaches for the treatment of breast cancer with adjuvant systemic therapy. A specific topic discussed is the use of adjuvant therapy for HER2 positive breast cancer, with recommendations for both oncologists and pathologists.
This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC). The guideline examines the goals of therapy, and provides recommendations for the treatment of patients with different stages of HCC, from very early stages to terminal stage. Outcomes of interest include rendering the patient free of disease, preventing recurrence, and improving quality of life.
This is a clinical practice guideline for adults with benign brain tumors. The guideline examines the appropriateness of stereotactic radiosurgery for treating these patients, as well as the appropriate dose for stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). Recommendations are provided for benign brain tumors that can be treated with stereotactic radiotherapy, including vestibular schwannoma, pituitary adenomas, meningiomas, and other indications such as craniopharyngiomas and hemangioblastomas.
This is a clinical practice guideline discussing influenza immunization for adult and pediatric cancer patients. The guideline provides guidance on the timing of influenza immunization in relation to severity of immunosuppression and chemotherapy schedules, number of administrations, types of influenza vaccines, and contraindications and precautions for immunization. Recommendations for the immunization of family members and hospital or clinic staff are also provided.
This is a clinical practice guideline for women with vulvar cancer, and particularly those with squamous cell carcinoma (SCC) of the vulva. The guideline examines diagnosis and workup, as well as primary treatment, adjuvant radiotherapy and chemotherapy, and surveillance of these patients. Treatment options are discussed for early-stage disease, locally advanced disease, and metastases beyond the pelvis.
This is a clinical practice guideline for the prevention of acute chemotherapy-induced nausea and vomiting (CINV) in pediatric cancer patients. The guideline provides recommendations on the use of pharmacological treatments for CINV, such as aprepitant and palonosetron. Outcomes of interest include CINV control rate and adverse events.
This is a clinical guideline for the treatment of primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL). The guideline provides recommendations regarding chemotherapy and radiation therapy and the optimal regimens, radiation dose and schedule. Outcomes of interest include overall survival, measure of disease control (response rates and progression-free survival), and frequency of adverse events.
This is a clinical practice guideline for adults diagnosed non-metastatic cutaneous melanoma, located on the trunk, extremities, or head and neck. The guideline examines optimal excision margins and the use of sentinel lymph node biopsy (SLNB) in these patients. The recommendations are organized by location of melanoma on the body, and consider the thickness/depth of the melanoma. Outcomes of interest include recurrence rate, survival rate, morbidity, and rate of sentinel lymph node positivity.
This clinical practice guideline is an endorsement of the American Society for Radiation Oncology's 2017 guideline titled Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma: Executive Summary of an Astro Evidence-Based Clinical Practice Guideline. The guideline examines the use of radiation therapy (RT) for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). The guideline discusses the indications for RT as both a primary method of treatment, and as post-operative adjuvant therapy. Appropriate dose, fractionation, and volume regimens for RT with and without systemic therapy are also discussed, in addition to an examination of induction chemotherapy in patients with OPSCC.
This is a clinical practice guideline for the management of localized prostate cancer. The guideline provides a clinical framework stratified by cancer severity to guide the care plan and reviews management options including active surveillance, observation/watchful waiting, prostatectomy, radiotherapy, cryosurgery, high intensity focused ultrasound (HIFU), and focal therapy. Shared decision making is highlighted, and guidance is provided on outcome expectations and management.
This is a clinical practice guideline for the management of patients with clinically localized small renal masses (SRM). The guideline examines management options for small renal masses, which includes biopsies, active surveillance for patients with significant comorbidities and limited life expectancy, partial nephrectomy (PN), percutaneous thermal ablation, radical nephrectomy, and referral to a nephrologist. Outcomes of interest include recurrence-free survival, disease-specific survival, and overall survival.
This is a provisional clinical opinion (PCO) for chemotherapy-naive men with castration-resistant prostate cancer (CRPC). This PCO examines second-line hormonal therapy and provides recommendations on staging, treatment, follow-up, and palliative care for men with CRPC. Outcomes of interest include overall survival, adverse events, quality of life, and treatment efficacy (defined as response in prostate-specific antigen values).
This is a clinical practice guideline for adult and pediatric patients who receive antineoplastic agents or radiation therapy for cancer. The guideline examines important developments in antiemetic management options for patients undergoing the above treatments. Comparisons are made between antiemetic management options on the basis of potential benefits, potential harms, and quality of evidence. Outcomes of interest include new evidence regarding antiemetic efficacy and new antiemetic management options.
This is a clinical practice guideline for the diagnosis, treatment and follow-up of adult patients with anaplastic gliomas. The guideline provides a diagnostic algorithm for anaplastic gliomas that considers isocitrate dehydrogenase 1/2 (IDH1/IDH2) missense mutations and 1p/19q co-deletions. Topics of discussion include radiology, histology and molecular biology, prognostic factors, surgery, radiotherapy, options for first-line systemic treatment, support treatment (e.g., corticoids and anticonvulsants), and follow-up.
This is a clinical practice guideline for adult cancer patients. The guideline provides recommendations for the diagnosis and treatment of non-infectious and infectious gastrointestinal complications often experienced by these patients. Specific conditions examined include paraneoplastic diarrhea, therapy-associated diarrhea, neutropenic enterocolitis, Clostridium difficile infection, other bacterial infections causing diarrhea (e.g. non-typhoidal Salmonella, Shigella, Yersinia, and Campylobacter spp.), viral infections, and parasitic infections.
This is a clinical practice guideline for patients with metastatic prostate cancer (mPCa). The guideline examines the management of patients with castration-naïve mPCa and those with metastatic castration-resistant prostate cancer (mCRPC). The use of predictive markers in mCRPC, sequencing treatment in mCRPC, managing men with oligometastases, as well as the staging and monitoring of mCRPC treatment, are also discussed.
This is a clinical practice guideline on enhanced recovery after colon and rectal cancer surgery. Recommendations address the appropriate preoperative, perioperative and postoperative interventions that contribute to improved patient recovery. Outcomes of interest include freedom from nausea, freedom from pain at rest, early return of bowel function, improved wound healing, and early hospital discharge.
This is a clinical practice guideline for adult patients with cancer. The guideline examines comprehensive oncology nutrition practice for the care of this patient population. Topics of interest include validated tools for malnutrition screening and nutrition assessment, evaluation of nutritional status as key component in patient care process, and dietary supplements.
This is a clinical practice guideline for patients with central nervous system (CNS) diffuse large B-cell lymphoma who have or at risk of developing leptomeningeal and/or brain parenchyma lymphoma relapse. The guideline examines the treatment of central nervous system involvement of lymphoma using whole-brain radiotherapy, systemic chemotherapy, intensification chemotherapy and autologous hematopoietic stem cell transplantation, and intrathecal therapy. Risk factors, diagnostic screening, and CNS prophylaxis are also discussed.
This is a clinical practice guideline for men and women with inherited polyposis syndromes. The guideline examines the identification and management of familial adenomatosis polyposis (FAP), attenuated FAP, MutY homologue-associated polyposis (MAP), and polyposis without an identified genotype. Extraintestinal manifestations included in the adenomatous polyposis syndromes are also discussed.
This is a clinical practice guideline for fever of unknown origin (FUO) in adult neutropenic patients. The guideline updates recommendations for diagnosis and empirical therapy of these patients in light of the challenges of antimicrobial stewardship. Specific recommendations are provided for taking down patient history and performing a physical examination, ordering chest radiograph, and taking nasal/pharyngeal (MRSA) or rectal (VRE) swabs.
This is a clinical practice guideline for patients with cutaneous squamous cell carcinoma (cSCC). The guideline provides recommendations for the evaluation and management of patients with cSCC. Topics of interest include biopsy techniques and histopathologic assessment, tumour staging, surgical and non-surgical management, follow-up and prevention of recurrence, and management of advanced disease.
This is a clinical practice guideline for the management of febrile neutropenia in children, including those with cancer, and/or those who are undergoing hematopoietic stem cell transplantation (HSCT). The guideline examines the signs and symptoms of febrile neutropenia, as well as the evaluation of affected patients. Antibiotic selection and dose are recommended based on factors related to patient's condition, including stability on presentation, presence of penicillin allergy, and current treatment. Continued management of inpatients and management based on culture results are also discussed.
This is a clinical practice guideline for patients who are receiving systemic anticancer therapy. The guideline examines the management of infusion reactions (IRs), which can be either allergic reactions to foreign proteins, or non-immune-mediated reactions. Specific topics discussed include risk assessment, diagnosis, management, how to document an IR, drugs which may frequently cause IRs, and cases of rechallenge.
This is a clinical practice guideline for the diagnosis and treatment of patients with testicular cancer. The guideline examines the pathology of the illness, staging and classification systems, diagnostic evaluation, prognosis, disease management, and follow-up. Topics of interest include diagnostic tools, treatment with chemotherapy, and discussion of quality of life and long-term toxicities after curative treatment.
This is a clinical practice guideline for the management of muscle-invasive and metastatic bladder cancer. The guideline provides recommendations on prevention, staging, imaging, diagnosis, treatment, and follow-up. Treatment options such as neoadjuvant chemotherapy, radiotherapy, and radical surgery are discussed. Other topics of interest include risk factors, comorbidities, quality of life, and pelvic organ preservation techniques.
This is a clinical practice guideline discussing the treatment and prophylaxis of venous thromboembolism (VTE) in patients receiving treatment for solid (i.e. non-hematologic) tumours. The guideline examines the pharmacologic therapy and dosing options for both inpatients and ambulatory patients with established VTE or who are at risk for VTE (i.e. prophylaxis). The guideline also discusses common complications associated with antithrombotic therapy, as well as the follow-up of patients during its administration.
This is a clinical practice guideline on pneumococcal immunization for adult and pediatric cancer patients with solid tumours or hematologic cancers. The guideline provides recommendations on the type of vaccine and timing of immunization in relation to the type of treatment, therapy cycle, and severity of immunosuppression. Guidance is also provided on restrictions for immunization.
This is a clinical practice guideline for adult patients with desmoid tumours. The guideline provides recommendations for diagnosis, staging procedures, treatment, and follow-up. Treatment options including active surveillance, surgery, radiation therapy, and chemotherapy are examined. Topics of interest include desmoid tumours occurring during pregnancy, pain management, and rehabilitation.
This is a clinical practice guideline for the prevention and treatment of cancer-related infections in neutropenic and immunocompromised non-neutropenic patients with cancer. This guidelines aims to provide an overview of the risk categorization and recommended strategies for prevention of infections in high-risk patient populations, as well as monitoring in patients with signs and/or symptoms of infections. Outcomes of interest include a finding that advances in treatment further emphasize the need for multidisciplinary care.
This is a clinical practice guideline for patients with renal cancer, and is especially relevant to those with comorbid chronic kidney disease. The guideline examines the treatment of chemotherapy-induced renal injury in these patients. Specific topics discussed include the assessment of renal function during chemotherapy, the appropriateness of biomarker-based assessments for the diagnosis of chemotherapy-induced renal injury, and whether or not chemotherapy doses should be reduced in patients with decreased renal function.
This is a clinical practice guideline for children and adults with ependymal tumours. The guideline provides recommendations for the diagnosis, staging, treatment and follow-up of these patients. Radiological, histological, and molecular components of diagnostic assessment are discussed, and treatment approaches involving surgery and radiation therapy are examined.
This is a clinical practice guideline for the management of rectal cancer in adult patients. The guideline discusses the indications for neoadjuvant therapy, the quality criteria for surgical resection, the management of postoperative disordered function, the role of local excision in early rectal cancer, the role of conservative strategies after neoadjuvant treatment, the management of synchronous liver metastases, as well as the indications for adjuvant therapy.
This is a clinical practice guideline for patients with uterine corpus cancer. These guideline discusses screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. Other topics of interest include lymphadenectomy, fertility-sparing treatment, chemotherapy, and hormonal therapy.
This is a clinical practice guideline for the management of patients with advanced breast cancer (ABC), including those with locally advanced breast cancer (LABC) and metastatic breast cancer (MBC). The guideline provides recommendations for the management of these patients, and specifically discusses the use of chemotherapy, management of bone metastases, management of cancer related fatigue, as well as supportive and palliative care.
This is a clinical practice guideline for adult patients who have undergone cancer treatment, and are at risk for developing secondary upper quadrant lymphedema (SUQL). The guideline provides recommendations for the diagnosis of SUQL, using methods such as clinical examination and patient-reported symptom assessments, bioimpedance analysis, circumferential measurement, water displacement, and imaging techniques such as magnetic resonance imaging (MRI), and computed tomography (CT). The primary outcomes of interest are decreases in both morbidity as well as activity and participation restrictions, and an increase in overall quality of life (QOL).
This is a clinical practice guideline on the appropriate use of immunotherapy for the treatment of patients with bladder cancer, specifically non-muscle invasive bladder cancer, muscle invasive bladder cancer, and advanced bladder cancer. The guideline addresses issues related to the definition of risk categories, patient selection, toxicity management, clinical endpoints, as well as the combination and sequencing of therapies. The guideline also highlights areas for future direction and development to advance the use of immunotherapy in bladder cancer treatment.
This is a clinical practice guideline on the use of accelerated partial-breast irradiation (APBI) as adjuvant radiation after breast-conserving surgery for patients with ductal carcinoma in situ and early-stage invasive breast cancer. The guideline provides recommendations regarding appropriate patient selection and techniques to deliver APBI. Patient selection criteria include age, tumour size, histology, estrogen receptor response, surgical margins, lymphovascular space invasion and nodal status. Efficacy and toxicity are considered with respect to recommendations for the appropriate and safe utilization of APBI.
This is a clinical practice guideline for patients with colorectal cancer. The guideline examines tumour budding as a prognostic factor in these patients. The definition of tumour budding, clinical scenarios and tumour budding, H&E and immunohistochemistry for the tumour budding score, intratumoural and peritumoural budding, field number and size for the tumour budding score, cut-offs and continuous scale for the tumour budding score, and reporting tumour budding are all discussed.
This is an update to the American Society for Radiation Oncology's evidence-based consensus statement on accelerated partial breast irradiation (APBI). The focus of the update centers on the selection criteria for APBI and intraoperative radiation therapy (IORT) for partial breast irradiation outside of a clinical trial.
This is a clinical practice guideline for squamous cell skin cancer. Basal cell and squamous cell skin cancers, collectively known as non-melanoma skin cancers (NMSCs), are the most common cancer in the United States. The guideline provides recommendations related to clinical presentation and workup, local treatment, recurrence and metastasis, and follow-up. The guideline also provides a discussion about risk stratification and common risk factors including age, degree of differentiation, and site of prior radiotherapy.
This is a clinical practice guideline for patients with breast cancer. The guideline examines the use of integrative therapies for specific clinical indications during and after breast cancer treatment. The integrative therapies discussed in the guideline address anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance.
This is a clinical practice guideline for patients with multiple myeloma (MM). The guideline provides recommendations for the prevention and management of organ health-related toxicities, and gives best practice recommendations for optimal nursing care of this patient population. Specific outcomes examined include myeloma-induced renal impairment, gastrointestinal symptoms, and peripheral neuropathy.
This is a clinical practice guideline for adults who have been diagnosed with or are suspected of having basal cell carcinoma (BCC). The main focus of the guideline is on the most common approaches for the treatment of primary BCC, but it also includes recommendations on the treatment of recurrent tumours, appropriate biopsy techniques, staging, follow-up, and prevention of BCC.
This is a clinical practice guideline for the prevention and management of constipation in pediatric cancer patients. Pharmacological and non-pharmacological treatment options (including dosing recommendations) are discussed. The management of refractory opioid-induced constipation is also examined.
This is a clinical practice guideline for patients with leptomeningeal metastases from solid tumours. The guideline discusses the diagnosis, treatment, and follow-up of these patients, and a treatment algorithm is presented based on life expectancy. Treatment options examined include systemic pharmacotherapy, intra-cerebrospinal fluid pharmacotherapy, focal radiotherapy (RT), and whole brain radiotherapy (WBRT).
This is a clinical practice guideline for the management of urothelial carcinoma of the upper urinary tract (UTUC). The guideline provides recommendations on diagnosis, staging, treatment, and follow-up. Prognostic factors, predictors of survival and recurrence, as well as risk stratification are also discussed. Outcomes of interest include diagnostic accuracy, overall survival, recurrence rates, and adverse effects.
This is a clinical practice guideline for adult patients with soft-tissue sarcoma who are being considered for chemotherapy. The guideline provides recommendations for staging procedures and classifications, as well as treatment options based on staging results and other risk factors. Treatment options including surgery, systemic therapy, radiation therapy, and chemotherapy are discussed. Outcomes of interest include adverse events, performance status, progression-free survival, and overall survival.
This is a clinical practice guideline for adult patients with head and neck cancer. The guideline examines oral and dental care assessment and management of patients before, during, and after cancer treatment. Topics addressed include pain, xerostomia, speech and swallowing disorders, oral hygiene, and functional capacity. The primary outcome of interest is quality of life.
This is a clinical practice guideline for the assessment of patients who are at high risk for colorectal cancer due to genetic or familial factors. The guideline provides recommendations for the management of patients with high-risk syndromes, including Lynch syndrome, familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome (PJS), Juvenile Polyposis Syndrome (JPS), Serrated Polyposis Syndrome (SPS), and other high-risk syndromes associated with colorectal cancer risk.
This is a clinical practice guideline for adult patients with early stage colon cancer. The guideline discusses diagnostic work-up, staging, and treatment options. Recommendations for adjuvant chemotherapy are presented, based on cancer stage.
This is a clinical practice guideline for the prevention and treatment of cancer-related infections. The guideline examines external risk factors for infection, major host factors that predispose patients to infectious diseases, prevention of infectious complications (including the use of antimicrobial prophylaxis and preemptive therapy), management of neutropenic fever, and management of site-specific infections such as pneumonia, abdominal infections, and catheter-associated infections.
This is a clinical practice guideline for patients with Waldenström's macroglobulinemia or lymphoplasmacytic lymphoma. The guideline examines the diagnosis, workup, primary treatment regimens, assessment of response to primary treatment, and follow-up after primary treatment. Regimens not toxic to stem cells and regimens with potential or unknown toxicity to stem cells are considered. Treatment of Immunoglobulin M (IgM) related peripheral neuropathy, maintenance therapy, and therapy for previously treated Waldenstrom's macroglobulinemia are also discussed.
This is a clinical practice guideline for patients with hairy cell leukemia. The guideline provides recommendations regarding diagnosis, initial treatment, response assessment and additional therapy, second-line therapy for relapsed/refractory or progressive disease, and supportive care. The impact of infections, such as hepatitis B (HBV) is also discussed.
This guideline provides recommendations on use of vertebroplasty or kyphoplasty as treatment options for cancer patients with vertebral compression fractures. The guideline outlines clinical criteria for when vertebroplasty, kyphoplasty, or focal tumour ablation (FTA) assisted vertebroplasty/kyphoplasty should be performed, and provides recommendations on selecting the most appropriate procedure. The role of radiation treatment, absolute contraindications, and service provider requirements are also discussed.
This clinical practice guideline is an endorsement of the American Thyroid Association's 2015 guideline titled Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The guideline provides recommendations on management of patients thyroid nodules and differentiated thyroid cancers. Topics include evaluation of thyroid nodules to determine the presence of malignancy, and management of differentiated thyroid cancer including surgery, radioactive iodine (RAI) therapy, hormonal therapy, external beam radiation therapy (EBRT), and systemic treatment.
This is a clinical practice guideline for adult males with potentially curable prostate cancer. The guideline examines surgical procedures and outcomes for radical prostatectomy (RP), while specifically addressing the extent of resection, acceptable positive margins, nerve-sparing techniques, pelvic lymph node dissection (PLND), and the recommended procedures for handling and processing RP specimens. Incontinence, erectile dysfunction, rectal injury, and blood transfusion are discussed as surgical complications that need to be limited.
This is a clinical practice guideline for patients with locally advanced invasive breast cancer who are being treated with, or considered for, neoadjuvant systemic therapy. The guideline examines imaging methods used to monitor responses to neoadjuvant systemic therapy, from pre-treatment to post-treatment. Digital mammography, digital breast tomosynthesis, ultrasound (US), and magnetic resonance imaging (MRI) are discussed as the key imaging modalities used.
This is a clinical practice guideline that examines the use of radiation therapy (RT) for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). The guideline discusses the indications for RT as both a primary method of treatment, and as post-operative adjuvant therapy. Appropriate dose, fractionation, and volume regimens for RT with and without systemic therapy are also discussed, in addition to an examination of induction chemotherapy in patients with OPSCC.
This is a clinical practice guideline for women with recurrent epithelial ovarian cancer (EOC), including fallopian tube and primary peritoneal cancers. The guideline examines the most up-to-date systemic therapy treatment recommendations for recurrent EOC in order to promote evidence-based practice in Ontario. Outcomes of interest include improvements in progression-free survival and symptom control.
This is a clinical practice guideline for patients with actinic keratosis (AK). The guideline provides recommendations on treatment options such as topical therapies, cryosurgery, surgery, systemic therapy, photodynamic therapy, laser therapy, and combination treatment. Diagnosis and follow-up are also discussed.
This is a clinical practice guideline for adult patients with solid tumour malignancies. The guideline provides recommendations for administering influenza vaccines to these patients. The timing of vaccination, and for whom vaccination is appropriate, are both discussed.
This is a consensus statement providing recommendations to assist health care providers with the appropriate management of patients with biallelic mismatch repair deficiency (BMMRD) syndrome, also called constitutional mismatch repair deficiency syndrome. The guideline outlines what is known about BMMRD, the unique genetic and clinical aspects of the disease, and reviews the current management approaches taken.
This is a clinical practice guideline for patients with head and neck cancer. The guideline examines the optimal perioperative care for patients undergoing head and neck cancer surgery with free flap reconstruction. Specific topics discussed include preadmission education, perioperative nutritional care, preoperative nutritional status, nutritional formulae, prophylaxis against thromboembolism, and antibiotic prophylaxis.
This is a clinical practice guideline for patients with thyroid cancer. The guideline examines the diagnosis, treatment, management, and follow-up of these patients. Topics of interest include a shift towards a standardized ultrasound/cytologic concordance system to guide investigation and management of thyroid nodules, acceptance of thyroid lobectomy as an option for many low risk thyroid cancers, acceptance of either no or lower dose radio-iodine treatment for many low risk thyroid cancers, and dynamic risk stratified follow-up for thyroid cancer.
This is a clinical practice guideline for adults with cancer-related fatigue. The guideline examines the appropriate screening, assessment, and management of these patients. Interventions discussed include pharmacological management, physical activity, functional and occupational therapy interventions, psychosocial and educational interventions, complementary therapies, nutrition, and management of anemia. Recommendations are provided based on the severity of fatigue.
This is a clinical practice guideline for adults and children who are taking anti-resorptive or anti-angiogenic medications. The guideline, aimed at dental care practitioners, provides recommendations for reducing the risk of medication-related osteonecrosis of the jaw (MRONJ) in these patients. Risk factors for MRONJ are discussed, and recommendations are provided for assessing and classifying patients' risk.
This is a clinical practice guideline for patients with vulvar and vaginal cancer, including those with epithelial tumours of the vulva or vagina, as well as those with primary vulvar Paget's disease or malignant melanomas of the vulva or vagina. The guideline provides recommendations for the treatment of these patients, and examines specific topics such as primary treatment, management of inguinal lymph nodes, treatment of distant metastases, and treatment of recurrent tumours.
This is a clinical practice guideline for adults with colorectal cancer (CRC). The guideline discusses the treatment of these patients, and provides specific recommendations on endoscopic treatment, treatment of stage 0 to stage 4 CRC, treatment of metastases of the liver and lung, treatment of recurrent CRC, and surveillance after surgery. Adjuvant chemotherapy and radiotherapy are also examined, as are approaches to palliative care.
This is a clinical practice guideline for patients with localized high-risk upper tract urothelial carcinoma (UTUC). The guideline examines the treatment of these patients using surgery, neoadjuvant and adjuvant chemotherapy, and adjuvant radiotherapy. Surgical techniques discussed include radical nephroureterectomy, regional lymph node dissection, renal-sparing surgery, and salvage surgery after renal-sparing approaches. The management of the distal ureter during nephroureterectomy and prevention of bladder cancer recurrence following nephroureterectomy are also discussed.
This is a clinical practice guideline for patients with cervical cancer. The guideline discusses the diagnosis, treatment, and surveillance of patients with primary cervical cancer, and also provides recommendations regarding the treatment of recurrent cervical cancer. Specific diagnostic techniques examined include computed tomography (CT) and positron emission tomography (PET) scans, while treatment modalities examined include laparoscopic and robotic radical hysterectomy, nerve sparing radical hysterectomy, intensity-modulated radiation therapy (IMRT), and more.
This is a clinical practice guideline for patients with Waldenström macroglobulinemia (WM). The guideline examines the diagnosis and treatment of these patients. Common presentations, diagnostic criteria, prognostic markers, as well as diagnostic workup using protein studies and bone marrow biopsy are considered. Therapeutic regiments are discussed for front-line therapy of WM and treatment of relapsed WM, as well as important management aspects unique to WM.
This is a clinical practice guideline for patients with epithelial ovarian-type cancers (e.g. ovary, fallopian tube or peritoneal origin) and borderline tumours. This guideline addresses epithelial cancers of varying histological subtypes. The guideline covers the full continuum of care including screening and prevention, diagnosis, treatment options such as surgery, systemic therapy and chemotherapy, follow-up, as well as management of recurrent disease. The guideline also highlights the support needs for women with ovarian cancer.
This is a clinical practice guideline for patients with hematologic malignancies and/or patients who underwent hematologic stem cell transplantation (HSCT). who are at risk for hepatitis B virus (HBV) infection reactivation. The guideline provides recommendations on HBV screening, monitoring, prophylaxis, treatment and vaccination in these patients. The primary outcome of interest is the prevention of hepatic failure and death caused by HBV reactivation.
This is a clinical practice guideline for the management of adult patients with adenocarcinoma of the pancreas. The guideline provides recommendations on diagnostic work-up, staging, and treatment options based on stage of cancer. Specific topics discussed include management recommendations for unresectable adenocarcinoma, and toxicity-associated dose modification. Outcomes of interest include adverse events, overall survival, and quality of life.
This is a clinical practice guideline for adults and children with cancer-induced anemia (CIA). The guideline discusses the etiology of CIA, and examines the screening, evaluation, and treatment methods for reducing CIA in affected patients. Red blood cell transfusion, erythropoietic therapy, and iron monitoring and supplementation are discussed as treatment options.
This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.
This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.
This is a clinical practice guideline for patients with AIDS-related Kaposi sarcoma. The guideline examines diagnosis, staging, treatment, and follow-up, while also providing recommendations on HIV screening and HIV therapy during cancer treatment. Antiretroviral therapy (ART), topical therapies, intralesional chemotherapy, local incisions, radiation therapy, and systemic therapy are all discussed as treatment options.
This is a clinical practice guideline for adults with melanoma. The guideline examines the use of sentinel lymph node (SLN) biopsy as a method for identifying nodal metastases, and provides recommendations on which patients should receive SLN biopsy based on the size and morphology of their melanoma. The guideline also discusses the appropriateness of completion lymph node dissection (CLND) as a method of treatment.
This is a clinical practice guideline for adults with Stage I to IV gastric cancer (specifically gastric adenocarcinoma) who are being considered for surgery. The guideline examines the optimal techniques to adequately stage gastric cancer, and the optimal techniques of gastric cancer surgery with curative intent. The guideline also considers indications for surgery for Stage IV gastric cancer in asymptomatic and symptomatic patients, and the relationship between surgical volumes and outcomes.
This is a clinical practice guideline for adult patients with clinical or pathological stage III non-small cell lung cancer (NSCLC). The guideline provides recommendations for the treatment of NSCLC by comparing treatment options such as chemotherapy, radiotherapy, and surgery. Outcomes of interest include adverse effects, overall survival, progression-free survival, quality of life, and local control.
This clinical practice guideline is an endorsement of the American Society for Radiation Oncology's 2017 guideline titled Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer. The endorsement examined new evidence and modified the guideline recommendations on the use of SBRT. Shared decision-making and implementation are discussed. Outcomes of interest include survival, quality of life, toxicity, pain and other adverse events.
This is a clinical practice guideline for the use of stereotactic body radiation therapy (SBRT) for patients with early-stage non-small cell lung cancer (NSCLC). The guideline examines the evidence for SBRT for early-stage NSCLC and offers guidance towards its use in challenging clinical scenarios. Outcomes of interest include survival, quality of life, toxicity, pain, and other adverse events.
This is a clinical practice guideline for patients with localized renal masses that are suspicious for renal cell carcinoma. The guideline discusses the evaluation, diagnosis, staging, and management of these renal masses. The management options discussed include partial nephrectomy, radical nephrectomy, thermal ablation, and active surveillance.
This is a clinical practice guideline discussing adjuvant therapy for adult patients with non-small cell lung cancer (NSCLC). The guideline specifically examines the appropriateness of adjuvant systemic therapy versus adjuvant radiation therapy in adults with completely resected stage I-IIIA NSCLC. Recommendations are made based on disease stage, as well as other factors such as tumour size, genetics, and histology.
This is a clinical practice guideline for patients with newly diagnosed prostate cancer who require or choose active treatment, and are not receiving active surveillance by choice or lack of suitability. The guideline examines the efficacy of brachytherapy, as compared to and combined with external beam radiation therapy (EBRT) and radical prostatectomy (RP). The guideline also considers which isotopes should be used for low-dose rate (LDR) brachytherapy to maximize clinical outcomes.
This is a clinical practice guideline for patients with early or locally advanced (nonmetastatic) breast cancer. The guideline examines the use of bisphosphonates and other bone-modifying agents as adjuvant therapy in patients with breast cancer. Outcomes of interest include recurrence and survival, with focus on the dependency of effectiveness on age or menopausal status.
This is a clinical practice guideline for oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. The guideline examines the core communication skills and tasks that apply across the continuum of cancer care. Topics include the discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating family involvement in care, and clinician training in communication skills.
This is a clinical practice guideline for merkel cell carcinoma. Merkel cell carcinoma is a rare, aggressive cutaneous tumor that combines the local recurrence rates of infiltrative non-melanoma skin cancer along with the regional and distant metastatic rates of thick melanoma. This guideline provides recommendations for diagnosis and workup, staging, treatment, follow-up and recurrence. Treatment recommendations include surgery, sentinel lymph node biopsy, radiation therapy, and chemotherapy as possible options.
This is a clinical practice guideline for women who have both completed childbearing and are undergoing a gynecologic procedure (e.g., hysterectomy) with the intention of leaving the ovaries in situ. The guideline provides recommendations on the use of opportunistic salpingectomy in these patients, for the prevention of high grade serous cancers (HGSC) of the ovary, fallopian tube, and peritoneum. Other risk factors for developing HGSC are also discussed, including the use of oral contraceptives, the use of talcum powder, and the role played by diet and obesity.
This is a clinical practice guideline for patients with ovarian cancer, including epithelial ovarian, fallopian tube, and peritoneal cancers. The guideline examines the use of specialized multidisciplinary decision making, as well as the diagnosis, preoperative workup, and surgical management of these patients. Information to aid in discussions with patients and caregivers is also provided.
This is a clinical practice guideline for adult patients with head and neck cancers. Specifically, the guideline focuses on the diagnosis and treatment of oral cancer (tongue cancer), maxillary sinus cancer, nasopharyngeal cancer, oropharyngeal cancer, hypopharyngeal cancer, and laryngeal cancer. Recommendations are provided for each specific cancer type, with treatment options including radiotherapy, chemotherapy, and surgery.
This is a clinical practice guideline for patients with squamous cell carcinoma of the vulva. The guideline examines diagnosis and referral, preoperative investigations, surgical management (i.e. local treatment, groin treatment and reconstructive surgery), sentinel lymph node procedures, radiation therapy, chemoradiation, systemic treatment, treatment of recurrent disease (i.e. vulvar recurrence, groin recurrence and distant metastases), and follow-up, in addition to providing information for discussions with patients and caregivers.
This is a clinical practice guideline for patients with hematologic malignancies or recipients of hematopoietic stem cell transplantation. The guideline examines diagnostic strategies as well as prophylactic, pre-emptive or targeted therapy for various types of infections in these patients. Invasive candidiasis or aspergillosis infections, and mucormycosis are discussed. Both first-line treatment and salvage and maintenance therapy are addressed.
This is a clinical practice guideline on the perioperative care of patients undergoing surgery for adrenocortical carcinoma (ACC). Topics covered in the guideline include the optimal preoperative investigations, surgical approach, quality criteria of the operative note and pathological report, follow-up after surgery, surgical management of metastatic and/or recurrent ACC, and debulking or palliative surgery. The guideline also emphasizes the need for inclusion in collaborative and/or prospective databases to advance research and evidence on the topic.
This is a clinical practice guideline for adult patients with lung cancer who have been treated with surgery or systemic anti-cancer treatment such as chemotherapy or (external-beam) radiotherapy. The guideline provides recommendations for the symptomatic management of persistent, bothersome cough among theses patients. Multiple options for reducing cough are discussed, based on the etiology of the cough and the patient's response to various treatments.
This is a clinical practice guideline for women with uterine cancer. The guideline provides recommendations for the screening and prevention of uterine cancer in the general population and in high risk groups, as well as for the pathological work-up, management, and follow-up of patients with uterine cancer. Specific conditions discussed include endometrioid endometrial cancer, as well as non-endometrioid cancers such as uterine serous carcinoma, uterine clear cell carcinoma, and uterine carcinosarcoma.
This is a clinical practice guideline for patients with lung cancer. The guideline examines techniques used in high-precision thoracic radiotherapy for treating these patients. Topics of interest include fractionation for stereotactic body radiotherapy (SBRT), reproducibility of patient positioning and tumour position, computed tomography (CT) scanning, and treatment planning.
This a clinical practice guideline on the use of radiosurgery for the treatment of patients with central nervous system (CNS) metastatic tumours. Treatment efficacy, safety, toxicity are specifically discussed. The guideline also considers the benefits and disadvantages of performing two treatment modalities involving radiosurgery, as well as the role adjuvant radiosurgery.
This is a clinical practice guideline for patients with Waldenström macroglobulinemia (WM). The guideline discusses a risk-adapted approach to the management of WM, using a grading system. Topics of interest include diagnosis, risk stratification and response assessment, initial therapy, as well as subsequent therapy.
This is a clinical practice guideline for patients with cutaneous melanoma. The guideline examines the care of these patients throughout the cancer care continuum, including prevention and surveillance, diagnosis and prognosis, surgical management and staging, further investigations and non-surgical staging, adjuvant treatment of stage 2 and 3 melanoma, follow up of patients with stage 1, 2 and 3 melanoma, and management of advanced (unresectable stage 4 or 5) melanoma.
This is a clinical practice guideline for patients diagnosed with colon cancer. The guideline examines the evaluation, staging, and treatment of these patients. Surgical treatment of the primary tumour is discussed, as well as treatment of tumour-related emergencies, management of stage 4 disease, management of locoregional recurrence, documentation, and adjuvant therapy.
This is a clinical practice guideline for patients with Lynch syndrome (LS). The guideline examines screening, prevention, and treatment of cancer in these patients. Specifically, screening tests for endometrial, ovarian, gastric, small intestinal, pancreatic, breast, and prostate cancers, as well as cancers of the urinary tract, are discussed. Prophylactic hysterectomy and oophorectomy, tumour testing, germline testing, and LS management are also examined.
This is a clinical practice guideline for adult patients with renal cell carcinoma (RCC). The guideline examines the staging, diagnosis, prognosis, treatment, and follow-up of these patients. Management recommendations are provided for treating localized RCC, locally advanced RCC, advanced/metastatic RCC, and recurrent RCC. The epidemiology, etiology, and pathology of RCC are also discussed.
This is a clinical practice guideline for the management of non-muscle-invasive bladder cancer. Recommendations are provided for diagnosis, staging, treatment, and follow-up. The guideline also discusses how to predict the short-term and long-term risks of disease recurrence and progression, as well as the stratification of patients into risk groups. Treatment options are presented based on these risk groups. Management of side effects is also discussed.
This clinical practice guideline is part three of a series focusing on the management of pancreatic cancer (PC). The guideline focuses on the neoadjuvant and induction therapies for PC and locally advanced pancreatic cancer (LAPC). Comparisons are made between the clinical effectiveness of neoadjuvant treatment with chemotherapy, radiotherapy or both.
This recommendations report provides guidance on the investigation and management of suspected or proven pelvic and extra-pelvic gynecologic sarcomas. Recommendations are made on the use of pathology during investigation, while recommendations pertaining to treatment focus on surgery and adjuvant therapy. The guidance document also provides recommendations on a number of quality assurance measures to assess gynecologic sarcoma services.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline titled American Society of Clinical Oncology Clinical Practice Guideline Update: Recommendations on the Role of Bone-modifying Agents in Metastatic Breast Cancer. The guideline examines the role of bone-modifying agents (BMAs) in the treatment of patients with metastatic breast cancer, while specifically focusing on the intervals between doses of zoledronic acid, and the use of BMA's to control pain secondary to bone metastases. In addition to zolendronic acid, BMA's compared include denosumab, and pamidronate.
This is a clinical practice guideline for the screening and treatment of thyroid cancer in asymptomatic adults. The guideline examines the accuracy of screening for thyroid cancer, and the harms of screening and/or treating thyroid cancer, such as overdiagnosis. Outcomes of interest include thyroid-specific morbidity and mortality, general mortality, and quality of life.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline titled Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. The update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumour? Outcomes of interest include treatment efficacy, and improved survival.
This is a clinical practice guideline for patients with stage IV non-small-cell lung cancer (NSCLC). The guideline provides recommendations on systemic therapy options for NSCLC such as standard chemotherapy, immune checkpoint therapy, antibody therapy and other drug classes and treatment settings. Outcomes of interest include therapeutic efficacy, adverse effects, overall survival and quality of life. The guideline also discusses health disparities and multiple chronic conditions and provides recommendations on managing these barriers.
This is a clinical practice guideline for the management of non-metastatic muscle-invasive urothelial bladder cancer in adults. The guideline examines the initial evaluation, treatment, follow-up, and survivorship of affected patients, and discusses approaches to counseling and the role of patient preferences throughout. Specific treatment options considered include neoadjuvant and adjuvant chemotherapy, radical cystectomy, pelvic lymphadenectomy, and bladder preserving approaches such as maximal transurethral resection of bladder tumours, partial cystectomy, primary radiation therapy, and multi-modal bladder preserving therapy.
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline examines the clinical management of RCC, including diagnosis, treatment, and follow up. The primary outcomes of interest are survival, recurrence, and quality of life.
This is a clinical practice guideline for adult patients with four or fewer brain metastases. The guideline examines the important prognostic factors for assessing and managing these patients, the role of surgery and radiotherapy in the management of oligometastatic disease, and the appropriate follow-up and surveillance strategy. Treatments considered include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), both alone and in conjunction.
This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.
This is a clinical practice guideline for patients with myeloproliferative neoplasms. The guideline specifically examines the diagnosis, risk-stratification, treatment, and supportive care for patients with polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF). Risk-stratified treatment algorithms are provided for each disorder.
This is a clinical practice guideline for patients with colorectal cancer, breast cancer, or cancers of the aerodigestive tract, who are being considered for treatment with fluoropyrimidines (5-fluorouracil and capecitabine). The guideline provides recommendations for the interpretation of clinical dihydropyrimidine dehydrogenase (DPYD) genotype tests so that the results can be used to guide fluoropyrimidine dosage. The primary outcome of interest is reduced toxicity among individuals with subnormal DPYD metabolism.
This is a clinical practice guideline for adults and children with hematologic malignancies, solid tumours, or hypoproliferative thrombocytopenia. The guideline examines when and how clinicians should use platelet transfusion to prevent or manage bleeding in these patients. Recommendations are made on topics such as the preparation of platelet products, the prevention of Rhesus (Rh) alloimmunization, and platelet transfusion thresholds for patients with different conditions.
This is a clinical practice guideline for the empirical management of fever and neutropenia (FN) in children with cancer, and those who have received hematopoietic stem-cell transplantation (HSCT). The guideline examines initial presentation, ongoing management, and empirical antifungal therapy. Topics of interest include risk stratification to define patients with high-risk invasive fungal disease (IFD), recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and empirical antifungal therapy in IFD low-risk patients with prolonged FN.
This is a clinical practice guideline for adult female patients diagnosed with advanced stage or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas) or uterine papillary serous carcinoma. The guideline examines chemotherapeutic and hormonal therapy options for patients with these cancers. Outcomes of interest include improved response rates and survival.
This is a clinical practice guideline for the management of venous thromboembolism (VTE) and cardiovascular disease (CVD) in patients with multiple myeloma. The guideline provides recommendations on assessment, diagnosis, prevention, treatment, and follow-up for VTE and CVD. Risk factors and risk stratification for VTE and CVD are discussed. The guideline also highlights multiple myeloma treatments with side-effects related to VTE and CVD.
This is a clinical practice guideline for patients who have been diagnosed with breast cancer. The guideline examines breast reconstruction, specifically reconstruction with deep inferior epigastric perforator (DIEP) flap and pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, to treat breast defects in these patients, which may be a result of mastectomy. Outcomes of interest include clinical complications and patient satisfaction.
This is a clinical practice guideline for patients with colorectal polyps. The guideline examines the use of polypectomy and endoscopic mucosal resection (EMR) in colonoscopy and for colorectal cancer (CRC) prevention. Polyp classification, polypectomy for polyps smaller than 20mm, EMR for polyps 20mm or larger, technical considerations, adverse events, and histopathology are discussed.
This is a clinical practice guideline for children with cancer who are receiving chemotherapy and/or radiation therapy. Recommendations are provided for the prevention of mucositis through oral care management, and various treatment options are considered for the management of mucositis in affected patients. The guideline also lists the risk factors for mucositis, and provides an oral assessment tool.
This is a clinical practice guideline for pediatric cancer patients who are receiving chemotherapy. Guidance is provided for the diagnosis and treatment of chemotherapy-induced diarrhea in these patients. Risk factors, grading of diarrhea, dietary modifications during diarrhea, and anti-diarrheal agents are also discussed.
This is a clinical practice guideline for adult patients with prostate cancer. The guideline examines the screening, diagnosis, staging, treatment, and follow-up of these patients. Treatment options considered include deferred treatment, radical prostatectomy, definitive radiotherapy, and hormonal therapy. Management of metastatic prostate cancer, prostate cancer in older men, prostate-specific antigen-only recurrence after treatment, and castration-resistant prostate cancer are also discussed, as well as the epidemiology and etiology of prostate cancer, and quality of life outcomes.
This is a clinical practice guideline for patients with primary urethral carcinoma (UC). The guideline provides recommendations on the diagnosis and treatment of UC. Staging and classification systems for UC are also discussed. Outcomes of interest include detection rate, overall survival, complications, and toxicity.
A clinical practice guideline on the diagnosis, staging, treatment and management of adult patients who are suspected of having, or have been diagnosed with, chronic myelogenous leukemia (CML). Treatment options examined include the use of tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib, dasatinib, bosutinib, and ponatinib, as well as allogeneic stem cell transplant (SCT) and Interferon-a (IFNa). Special consideration is paid to the use of TKIs in the treatment of elderly patients with CML.
This is a clinical practice guideline for adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.
This is a clinical practice guideline for adults with low-grade gliomas (LGG), including oligodendrogliomas and astrocytomas. The guideline provides recommendations for the diagnosis, management and follow-up of these patients. Radiological evaluation, surgical options, and the use and timing of complementary treatment (i.e. adjuvant chemotherapy and radiation therapy) after surgery are specifically discussed.
This is a clinical practice guideline for patients with brain metastases from solid tumours. The guideline examines the diagnosis of these patients using neuroimaging and neuropathology, as well as various treatment options including surgery, stereotactic radiosurgery/stereotactic fractionated radiotherapy, whole-brain radiotherapy, chemotherapy, and targeted therapy. Staging, prognostic factors, and supportive care for these patients are also addressed.
This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). The guideline examines the use of allogeneic hematopoietic stem cell transplantation (HSCT) as a curative treatment option. Topics of interest include factors of relevance for selection of the source of hematopoietic cells, timing of transplantation, factors relevant for selecting the intensity of preparatory regimens, and post-transplantation strategies.
This is a clinical practice guideline for the management of stage I to III melanoma in adult patients. The guideline discusses classification, resection margins, sentinel node biopsy, adjuvant treatments, initial work-up, follow-up, and the role of molecular biology tests. The guideline also compares the recommendations provided by other European guidelines and addresses any disparities in recommendations.
This is a clinical practice guideline for patients with hepatitis C virus (HCV) infection who are candidates for liver transplantation (LT). Specifically, the guideline provides recommendations on the treatment of patients with compensated cirrhosis and hepatocellular carcinoma (HCC), the treatment of patients with decompensated cirrhosis with or without HCC, the management of HCV in the context of an anti-HCV-positive donor, the treatment of post-transplant severe cholestatic hepatitis, the treatment of recurrent HCV infection, the treatment of recurrent HCV cirrhosis, and the treatment of HCV pre- and post-LT in human immunodeficiency virus (HIV)-HCV co-infected patients. Outcomes of interest differ between specific patient populations, and include wait-list mortality, post-LT survival, HCV recurrence post-LT, and the development of extrahepatic complications.
This is a clinical practice guideline for patients who have received initial treatment for chordomas, who are at risk for loco-regional recurrence. The guideline provides recommendations for pre-treatment assessment, resection of recurrent or progressive disease, radiotherapy of recurrence, other local therapies, follow-up, as well as for palliative, supportive and end-of-life care. Outcomes of interest include quality of life, recurrence-free survival, and overall survival.
This consensus guideline provides recommendations on safe handling of oral anti-cancer drugs (OACDs) in community pharmacies across the medication lifecycle, from manufacturer packaging to waste management and incident reporting. Specifically, the guideline addresses packaging, labeling, receiving and unpacking, storage, drug preparation and handling, verification and dispensing, transportation, personal protective equipment (PPE), disposal, waste management and cleaning, and incident reporting. Recommendations for training and education are also discussed, along with staffing considerations.
This is a clinical practice guideline for adults with non-resected limited stage and extensive stage small cell lung cancer who can safely receive definitive radiation. The guideline examines thoracic radiotherapy and first-line chemotherapy as treatment options for these patients. The recommendations are tailored to patients' stage of cancer, and consider optimal timing of each treatment option, whether treatment should be sequential or concurrent, and appropriate dose or treatment regimen.
This clinical practice guideline provides recommendations for breast reconstruction in women following mastectomy for the prevention or treatment of breast cancer. The guideline discusses patient education, eligibility for reconstruction, timing of reconstruction, factors that enhance recovery from reconstruction, post-reconstruction surveillance, and measuring outcomes of construction. The benefits and risks of implant-based, autologous flap, and combination reconstruction procedures are examined. The guideline also discusses the extent to appropriately perform mastectomy.
This is a clinical practice guideline for adults with inoperable locally advanced or metastatic renal cell cancer. The guideline provides recommendations on optimal targeted therapies and compares different drug treatments and combinations of treatments. Outcomes of interest include overall quality of life, overall survival, toxicity, fatigue, and other adverse events.
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline titled Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women with Early-stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline. The update discusses the use of MammaPrint to guide decisions on the use of adjuvant systemic therapy by examining both the publication of the phase III randomized MINDACT (Microarray in Node-Negative and 1 to 3 Positive Lymph Node Disease May Avoid Chemotherapy) study and other published literature on the MammaPrint assay for evidence of clinical utility. The guideline examines the contexts in which the MammaPrint assay will be beneficial for improving treatment decisions.
This clinical practice guideline focuses on molecular biomarker testing for patients with early and advanced colorectal cancer. The recommendations are intended to help establish standard molecular biomarker testing, guide decisions on whether or not to use epidermal growth factor receptor (EGFR)-targeted therapy, and to ensure that the most effective and advance personalized care is delivered to patients.
A clinical practice guideline for the treatment of small cell and non-small cell lung cancer. The guideline examines treatment options for multiple stages of these two cancer modalities, including surgical and non-surgical procedures. Palliative, supportive, and psychological care for lung cancer patients are also discussed. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of April 23, 2018.
This is a clinical practice guideline for basal cell skin cancer. The guideline considers clinical presentation and workup, local treatment, recurrence and metastasis, and follow-up. The guideline also includes a discussion about risk stratification and explores different risk factors for basal cell skin cancer including location and size, age, and site of prior radiotherapy.
This is a clinical practice guideline for women with breast cancer who have chosen or been recommended for therapeutic mastectomy, and women who are at high risk for breast cancer who have chosen or been recommended prophylactic mastectomy. The guideline considers the suitability of patients for immediate or delayed breast cancer reconstruction surgery, appropriate timing of treatment, and optimal surgical techniques. Techniques examined include skin-sparing mastectomy (SSM), nipple-sparing mastectomy (NSM) and areola-sparing mastectomy, as well as autologous tissue and implant-based reconstruction.
This is a clinical practice guideline for women presenting with suspicious adnexal masses, either symptomatic or asymptomatic. The guideline examines the optimal strategies for preoperative identification of adnexal masses that are suspicious for ovarian cancer, and the most appropriate surgical procedures for those identified.
This is a clinical practice guideline for adult patients with cutaneous melanoma of the trunk or extremities. The guideline examines the optimal surgical management of patients with positive sentinel lymph nodes (SLNs) and biopsy-proven clinically palpable or biopsy-proven radiologically detected lymph nodes from cutaneous melanoma originating in the trunk or extremities. Outcomes of interest include local and regional recurrence, distant recurrence, overall survival (OS), and disease-free survival (DFS).
This is a clinical practice guideline for stem cell transplantation (SCT) in the treatment of acute lymphoblastic leukemia. The guideline establishes indications for allogeneic stem cell transplantation (allo-SCT) in the management of acute lymphoblastic leukemia (ALL) in adults. It identifies the role of reduced-intensity conditioning (RIC) regimens for SCT in the management of ALL adult patients, and the role of tyrosine-kinase inhibitors (TKIs) for patients undergoing allo-SCT for Philadelphia chromosome-positive ALL (Ph+ ALL). The guideline also discusses the role of alternative donor transplantation (haploidentical, cord blood) in the management of adult patients with ALL who lack a suitable donor. Outcomes of interest are relapse, disease-free survival, relapse-free survival, progression-free survival, and overall survival.
This is a clinical practice guideline for patients with gastroesophageal adenocarcinoma. The guideline provides recommendations for the assessment of HER2 (or erb-b2 receptor tyrosine kinase (ERBB2)) mutations, while addressing which patients and tumour specimens are appropriate. Outcomes of interest include increased accuracy of HER2 testing, and increased utility for clinician decision-making.
A clinical practice guideline for the management of adult onset sarcoma. The guideline examines the diagnosis, staging, treatment, and follow-up options for sarcoma. Imaging modalities for the purpose of diagnosis and staging are compared, while the importance of multidisciplinary care and the effects of delayed referrals to specialists are discussed. In addition, pre-operative and post-operative radiotherapy are compared, and the guideline also examines adjuvant and systemic chemotherapy, as well as surgical procedures. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of April 23, 2018.
This is a clinical practice guideline for patients with suspected or incidentally diagnosed adnexal masses. The guideline discusses the use of ultrasonography and serum marker testing during initial evaluation, which findings indicate malignant versus benign masses, and the appropriate situations for surgery versus observation. Specific recommendations are also provided for adolescents and pregnant women.
This is a clinical practice guideline for the management of venous thromboembolism (VTE) in patients with cancer. The guideline examines the use of direct oral anticoagulants (DOACs) for the treatment of VTE. Topics of interest include initial treatment of VTE, maintenance, long-term treatment, and recurrence.
This is a clinical practice guideline on the use of immunotherapy for the treatment of patients with metastatic renal cell carcinoma (mRCC). Specifically, the guideline addresses the role of high-dose interleukin-2 (HD IL-2) therapy, the selection of patients for IL-2-based regimens and the criteria for those choices, the current role of interferon and its use in conjunction with bevacizumab, the identification of biomarkers of response to immunotherapy, the sequencing of immunotherapy with the anti-vascular endothelial growth factors agents, the management of patients with central nervous system metastases, and the potential role and sequencing of new immunotherapy agents including the programmed death 1 / programmed death ligand 1 (PD-1/PD-L1) pathway inhibitors.
This is a clinical practice guideline for patients with hematological malignancies including allogeneic hematopoietic stem-cell transplantation (allo-HSCT) recipients. The guideline provides recommendations for the management of central nervous system infections in these patients. Specific topics addressed include epidemiology and causative agents, pathogenesis, prophylaxis, diagnosis, antimicrobial treatment, and adjunctive treatment.
This is a clinical practice guideline for women with a history of breast cancer. The guideline examines the management of menopausal symptoms in these patients. Non-pharmacological, pharmacological, and hormonal therapies are considered for vasomotor symptoms, sleep disturbance, vulvovaginal symptoms, and sexual function. Depression and anxiety, mood and emotional well-being, mental health, global quality of life, and breast cancer recurrence are also discussed.
This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.
This guideline covers diagnosing and managing non-Hodgkin's lymphoma in people aged 16 years and over. It aims to improve care for people with non-Hodgkin's lymphoma by promoting the best tests for diagnosis and staging and the most effective treatments for 6 of the subtypes: follicular lymphoma, MALT lymphoma, mantle cell lymphoma, diffuse large B-cell lymphoma, Burkitt lymphoma, and peripheral T-cell lymphoma. Tests and treatments covered include excision biopsy, radiotherapy, immunochemotherapy and stem cell transplantation.
This clinical practice guideline provides recommendations for the diagnosis, treatment, and follow-up of epithelial ovarian cancer. This guideline covers: carcinoma of the ovary, fallopian tube and primary peritoneal carcinoma; epithelial carcinoma, e.g. serious, mucinous, clear cell or endometrioid histology; borderline and invasive disease, diagnosis and first-line treatment; and follow-up after treatment. Recommendations consider patient values and preferences when treated for ovarian cancer.
This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.
A clinical practice guideline for patients with gastrointestinal stromal tumours. The guideline examines appropriate imaging modalities, and treatment for newly diagnosed and metastatic tumours. Outcomes of interest include disease progression and recommended imaging.
This clinical practice guideline discusses specific issues related to the management of cancer in adults aged 65 years or older. Topics include screening and comprehensive geriatric assessment (CGA), assessing risks and benefits of treatment, preventing or decreasing complications from therapy, and managing disease-specific issues. Recommendations are also provided for management of patients deemed to be at high risk for toxicity from standard treatment.
This is a clinical practice guideline for the use of myeloid growth factors in adult patients with solid tumours and non-myeloid malignancies. Benefits and risks are reviewed, the role of biosimilars is discussed, and recommendations are provided for prophylactic and therapeutic uses of both granulocyte and granulocyte-macrophage colony stimulating factors (CSFs). Recommendations are also given regarding the use of CSFs in the hematopoietic cell transplant setting. Outcomes of interest include efficacy of CSFs, mortality, length of hospitalization, toxicity, and adverse effects.
This is a clinical practice guideline for Non-Hodgkin's Lymphomas (NHL). The guideline focuses on recommendations for diagnostic workup, treatment, and surveillance strategies for the most common subtypes of NHL, in addition to a general discussion on the classification systems used in NHL and supportive care considerations. The most common NHL subtypes that are covered in the guideline are: Mature B-cell lymphomas, Mature T-cell and NK-cell lymphomas, Post Transplant Lymphoproliferative Disorders (PTLD), and Castleman's Disease.
This is a clinical practice guideline for multiple myeloma. The guideline addresses diagnosis, treatment, and follow-up care. It offers specific recommendations for primary therapy, surveillance and follow-up tests for solitary plasmacytoma, smoldering (asymptomatic) myeloma, active (symptomatic) multiple myeloma, as well as for transplant and non-transplant candidates.
This clinical practice guideline reviews workup and treatment of bone cancer, with specific recommendations provided for chondrosarcoma, chordoma, Ewing's sarcoma family of tumors, and osteosarcoma. Surveillance and relapse is also reviewed. An overview of systemic therapy agents is provided, and principles of radiation therapy are discussed.
This clinical practice guideline provides recommendations for the diagnosis and treatment of acute myeloid leukemia (AML). Induction therapy and post-remission (consolidation) therapy are reviewed with recommendations stratified by risk and age. Specific recommendations are provided for the management of acute promyelocytic leukemia (APL). The guideline also discusses therapy for relapse, evaluation and treatment of CNS leukemia, and supportive care.
This is a clinical practice guideline for adult patients with non-small cell lung cancer. The guideline provides updated recommendations around prevention and screening, evaluation and staging, treatment, and follow up care. Areas of focus are discussed with recognition that much progress has been made in regards to screening, minimally invasive techniques for diagnosis and treatment, advances in radiation therapy (RT) including stereotactic ablative radiotherapy (SABR), and targeted therapies.
This clinical practice guideline reviews diagnostic assessment and management of prostate cancer. The guideline discusses risk stratification, molecular testing, and imaging for clinical assessment and staging workup. Management options reviewed include observation, active surveillance, radical prostatectomy, radiation therapy, androgen deprivation therapy, chemotherapy, and immunotherapy, with treatment recommendations stratified by risk. Outcomes of interest include survival and adverse effects of treatment.
A clinical practice guideline for patients with primary cutaneous melanoma. The guideline examines diagnosis, treatment, and follow-up including preventive excision and body mapping. Outcomes of interest include melanoma-specific survival and morbidity.
This clinical practice guideline provides recommendations on the diagnosis and treatment of locally advanced and borderline resectable pancreatic cancer. Radiotherapy alone is compared to chemoradiation for treatment of locally advanced disease, and preoperative therapy for borderline resectable disease is discussed. The guideline reviews neoadjuvant systemic therapy followed by local treatment and provides recommendations on chemotherapy regimes. Outcomes of interest include progression-free survival, median survival, 1-year survival, and local control.
This clinical practice guideline provides recommendations on the investigation, treatment, and follow-up care of patients aged 16 years and older with cancer of the upper aerodigestive tract. HPV-related disease and less common upper aerodigestive tract cancers including carcinoma of the nasopharynx or paranasal sinuses, unknown primary of presumed upper aerodigestive tract origin, and mucosal melanoma, are also reviewed. Additionally, recommendations are provided on optimizing rehabilitation and function. Outcomes of interest include prevalence, predictive value, sensitivity, specificity, local control, survival (overall, progression-free), treatment-related morbidity and mortality, and resource use, among others.
This is a clinical practice guideline for women with early-stage invasive breast cancer. The guideline provides recommendations on use of breast tumour biomarker assay results to inform decisions on adjuvant therapy. Several markers are reviewed including 21 gene recurrence score (Oncotype DX), 12 gene risk score (EndoPredict), 70 gene assay (MammaPrint), 50 gene subtype predictor (PAM50 Risk of Recurrence), Breast Cancer Index (BCI), 5 protein panel risk specification (Mammostrat), immunohistochemistry 4 (IHC-4), urokinase plasminogen activator and plasminogen activator inhibitor type 1 (uPA and PAI-1), circulating tumour cells (CTCs), tumour-infiltrating lymphocytes (TILs), and protein encoded by the MKI67 gene. Additionally, the guideline provides recommendations on the use of specific biomarkers to guide choice of specific drugs and regimes. Outcomes of interest include overall survival and disease-free or recurrence-free survival.
This is a clinical practice guideline for the diagnosis, treatment and follow-up of patients with gastrointestinal stromal tumours (GISTs). The guideline discusses the diagnosis of GISTs using radiology, histology and molecular biology, while also providing recommendations for the treatment of both localized and advanced disease. Surgery, adjuvant and neoadjuvant treatment options are specifically examined.
This is a clinical practice guideline for patients with hematological disorders who are at risk for Pneumocystis jirovecii pneumonia (PCP). The guideline focuses on the prevention of PCP, and specifically examines PCP diagnosis, prophylaxis and treatment. Differences in clinical presentations between hematology patients and other immunocompromised populations, especially HIV-infected patients, are discussed.
This is a clinical practice guideline for adults with diffuse gliomas. Diagnosis, as well as treatment methods including chemotherapy, radiation therapy, and surgical procedures are discussed. The guideline provides general recommendations, as well as specific recommendations for low grade gliomas (WHO grade II), anaplastic gliomas (WHO grade III), and glioblastoma (WHO grade IV).
This clinical practice guideline discusses the evaluation and treatment of patients with suspected solid pancreatic neoplasia. The guideline reviews presentation and clinical evaluation of pancreatic neoplasia, and provides an overview of radiologic and endoscopic modalities for adenocarcinoma of the pancreas, neuroendocrine tumours (NETS) of the pancreas, solid pseudopapillary tumours (SPTs), metastatic disease, and lymphoma. Screening for pancreatic cancer is also discussed. Outcomes of interest include sensitivity and specificity, as well as adverse events.
This is a clinical practice guideline for patients with non-muscle invasive bladder cancer. Recommendations are provided on diagnostic procedure, risk stratification, variant histologies, urine markers, and treatment options including TURBT/Repeat resection, intravesical therapy, BCG/maintenance, and chemotherapy BCG combinations. BCG relapse and salvage regimens are reviewed as is the role of cystectomy and cystoscopy. Additionally, recommendations are provided for risk adjusted surveillance and follow-up strategies.
A clinical practice guideline for the prevention of chemotherapy and radiotherapy-induced nausea and vomiting in advanced cancer patients. The guideline examines the emetogenic potential of antineoplastic agents and recommended pharmacological treatments. Outcomes of interest include antiemetic prophylaxis, efficacy, and optimal dosing.
This is a clinical practice guideline for recurrent Hodgkin lymphoma. The guideline provides recommendations for the treatment of patients with early relapsed or progressive disease. Areas of focus include: stem cell transplantation, the role of radiation therapy, and chemotherapy.
A clinical practice guideline for patients with prostate cancer. The guideline examines permanent source brachytherapy in low and high risk patients combined with external-beam radiation therapy and/or androgen deprivation therapy. Outcomes of interest include quality of life, quality of life, complication rates, and biochemical outcomes.
This is a clinical practice guideline for soft tissue sarcoma. The guideline examines diagnosis, treatment and follow up. Various stages are addressed, as well as a various treatment options and disease progression. Guidance is presented for specific issues (e.g., gastrointestinal stromal tumors).
This is a clinical practice guideline for chronic lymphocytic leukemia/ small lymphocytic lymphoma. This guideline provides recommendations relating to diagnosis, prognostic factors, workup, staging, and response criteria. It also provides recommendations as they pertain to treatment options, which include discussions about first-line therapy, relapsed or refractory therapy, as well as assessment of functional status and comorbidity.
This is a clinical practice guideline for patients (children/adolescents and adults) who are experiencing cancer-related fatigue. The guideline discusses evaluation and intervention for patients on active treatment, post-treatment, and at end of life. Education and counselling, nonpharmacologic interventions, and pharmacologic interventions are all discussed along with general strategies for management of fatigue.
This clinical practice guideline provides recommendations on assessment and management of cancer pain in adult patients, including pain in adult cancer survivors. Pathophysiologic classification of cancer pain syndromes is reviewed, and recommendations are provided for pain assessment, management/intervention, and reassessment. Both pharmacologic and non-pharmacologic interventions are discussed.
This is a clinical practice guideline for gastric cancer. The guideline provides an evidence- and consensus-based treatment approach for the management of patients with gastric cancer. Topic areas discussed within the guideline include: staging, principles of pathology, surgery, endoscopic therapies, radiation therapy, combined modality therapy, chemotherapy, and follow-up.
This is a clinical practice guideline for patients with colon cancer. The guideline reviews risk assessment, TNM staging, and pathology, and provides recommendations on the clinical presentation and treatment of nonmetastatic disease as well as recommendations on management of metastatic disease. Treatment for locally recurrent disease and survivorship are also discussed, as is the role of vitamin D in colorectal cancer.
This is a clinical practice guideline for the management of chronic pain in survivors of adult cancers. Whereas other guidelines have largely focused on relieving acute pain or pain associated with advanced disease, this guideline focuses on the care required when pain persists months or years after the completed cancer treatment. Areas addressed in the guideline include: screening and comprehensive assessment; treatment and care options; nonpharmacologic interventions; pharmacologic interventions; as well as risk assessment, mitigation, and universal precautions with opioid use.
This is a clinical practice guideline for patients with resectable pancreatic cancer. The guideline reviews biomarkers, specifically carbohydrate antigen 19-9 (CA19-9), and SMAD4 (DPC4), as well as other prognostic factors such as resection margin status and lymph node involvement. Adjuvant therapy, neoadjuvant therapy, and radiotherapy are discussed as treatment options, taking patient risk factors for local recurrence into consideration.
A clinical practice guideline for adult patients with recurrent endometrial cancer. The guideline examines management, including re-staging workups, and treatment through salvage radiotherapy and surgical intervention. Outcomes of interest include improved local control and 5-year survival rates through external beam radiation and brachytherapy.
A clinical practice guideline for adults with locally advanced, high-risk prostate cancer. The guideline examines aggressive approaches to prostate cancer treatment, focusing on intensive local therapy through external beam radiation. Outcomes of interest include improved local control resulting in improved outcomes via combination therapy.
A clinical practice guideline for patients with favorable-prognosis stage I and II Hodgkin lymphoma. The guideline examines the use of combined modalities therapy to treat Hodgkin lymphoma, including a focus on optimization of duration and volume. Outcomes of interest include improved tumour control rate and reduced number of cycles in appropriate cases.
This is a clinical practice guideline for patients undergoing major head and neck cancer surgery with free flap reconstruction. The guideline provides recommendations for the optimal perioperative care of these patients, focusing on topics such as preadmission education, preoperative nutritional status, perioperative nutritional care, prophylaxis against thromboembolism, antibiotic prophylaxis, postoperative nausea and vomiting prophylaxis, standard anesthetic protocol, pain management, postoperative wound care, postoperative pulmonary physical therapy, and more.
This is a considerations document for personalizing busulfan-based conditioning. The document examines a list of the most frequently asked questions (FAQs) regarding personalized busulfan dosing, and provides recommendations addressing topics of practical relevance to clinicians involved with hematopoietic cell transplantation.
This is a clinical practice guideline for patients with chronic lymphocytic leukemia (CLL). The guideline examines the role of allogeneic hematopoietic cell transplantation (allo-HCT) for patients with CLL in an era of highly active targeted therapies. The recommendations emerge from comparing allo-HCT against novel therapies for treatment of CLL, at various disease stages.
This is a clinical practice guideline for adults with low-grade gliomas (LGGs). The guideline examines the diagnosis, prognosis, and treatment of these patients. Treatment modalities discussed include surgery, radiation therapy, and chemotherapy.
This is a clinical practice guideline for adults diagnosed with incurable gastroenteropancreatic neuroendocrine tumours. The guideline examines treatment options for pancreatic neuroendocrine tumours and non-pancreatic neuroendocrine tumours, including chemotherapy, targeted therapy, somatostatin analogues and interferon, and combination therapy. Outcomes of interest include progression-free and overall survival, adverse events, and quality of life.
This is a clinical practice guideline for women diagnosed with invasive early-stage breast cancer. The guideline discusses the use of different multigene profiling assays for determining risk profiles (high-risk vs low-risk) in patients with estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative tumours. The validity and clinical utility of different assays are examined, including Oncotype DX, Prosigna, MammaPrint, EndoPredict, and EPclin. In addition, assays are specifically compared to Oncotype DX, the only assay that was publicly funded and part of standard practice in Ontario at the time of publication.
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines appropriate management and follow-up strategies for different stages of the two main histological types of testicular GCTs: seminomas and nonseminomas. Outcomes of interest include recurrence and overall survival.
This is a clinical practice guideline for the treatment of adult patients with metastatic colorectal cancer. The guideline examines different management options, including treatment via clinical trials, treatment chemotherapy, palliative chemotherapy, EGFR inhibitors, and regorafenib (as a fourth-line therapy). The guideline also discusses the need to test for Ras mutations before treatment. Outcomes of interest include treatment efficacy and improved survival outcomes.
This is a clinical practice guideline for patients with neoplasms causing biliary obstruction. The guideline examines the management of malignant biliary obstructions, including diagnostic work-up and treatment options. Recommendations are provided based on factors such as the resectability and location of the obstruction. Outcomes of interest include improved quality of life (QOL) and prolonged survival.
This is a clinical practice guideline for patients who have undergone allogenic hematopoietic stem cell transplantation (HSCT). The guideline examines the prevention, diagnosis and management of post-lymphoproliferative disorders caused by Epstein-Barr virus (EBV) infections in these patients. Outcomes of interest include the sensitivity and specificity of tests that detect EBV-related post-transplant lymphoproliferative disorders, and the reduction of morbidity and mortality in patients undergoing HSCT.
This is a clinical practice guideline for the management of malignant melanoma. Topics of interest include acceptable time intervals from referral to surgical management, which patients should be candidates for sentinel lymph node biopsy, and acceptable surgical margins.
This is a clinical practice guideline for patients with soft-tissue sarcoma (STS). The guideline examines the therapeutic decision-making processes used for the management of STS in order to improve patient care. Recommendations are provided for staging, diagnosis, and treatment.
This is a clinical practice guideline for patients with meningiomas. Recommendations are provided regarding diagnosis, including radiological methods used, collection and storage of tissue, and histological verification. Different treatment and follow-up recommendations are also discussed, based on which World Health Organization (WHO) grade the meningioma is classified as (i.e. WHO grades I-III).
This is a clinical practice guideline for the management of viral hepatitis in patients with hematological malignancy and in patients undergoing haemopoietic stem cell transplantation. The guideline examines the screening, vaccination, and treatment options for these conditions. Primary outcomes of interest include the prevention of viral reactivation, and increasing overall survival.
This is a clinical practice guideline for adult patients with recurrent retroperitoneal sarcoma (RPS). The guideline examines pretreatment assessment, patient selection for resection of recurrence, preoperative therapy, resection, postoperative systemic therapy, and other locoregional therapies. Pretreatment assessment options discussed include imaging, pathology, patient evaluation, and review of previous treatment. Treatment for patients who are not eligible for curative resection is also addressed.
This is a clinical practice guideline for cancer patients with community-acquired respiratory virus (CRV) infections. The guideline examines the diagnosis of CRV infections using virology and radiology techniques, as well as the management of CRV infection with infection control and supportive measures. Causal treatment is also discussed for influenza, respiratory syncytial virus (RSV), parainfluenza (PIV), adenovirus, human metapneumovirus (hMPV), rhinovirus, coronavirus, and others.
This is a clinical practice guideline for patients with myeloproliferative neoplasms (MPN). The guideline examines the diagnosis, management, and prevention of severe bleeding complications in patients diagnosed with classic Philadelphia chromosome negative (Ph-negative) MPN. Bleeding due to alterations of primary hemostasis, secondary hemostasis, and vascular alterations are discussed. Management of elective surgery in MPN patients is also examined.
This is a clinical practice guideline for the prevention and treatment of cancer-associated venous thromboembolism (VTE). The guideline provides recommendations for the appropriate workup to search for occult malignancy in patients with idiopathic VTE, the identification of high-risk cancer patients for primary thromboprophylaxis, the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, the appropriate duration of anticoagulation and the appropriate treatment strategy in patients with recurrent VTE on anticoagulation.
This is a clinical practice guideline for the treatment of advanced non-small cell lung cancer (NSCLC). The guideline examines the efficacy of different therapies including chemotherapy and immune checkpoint inhibitors. Outcomes of interest include overall survival, progression-free survival, quality of life, toxicity, and response rate.
This clinical practice guideline is an endorsement of the American Society for Radiation Oncology's 2016 guideline on radiation therapy (RT) for glioblastoma not originating from the brainstem. This guideline provides recommendations on whether and how RT should be applied, and examines dose-fractionation, target volume design, and the effects of concurrent and adjuvant systemic therapies. Outcomes included overall and progression-free survival, recurrence rates, toxicity, and quality of life (QOL).
This is a clinical practice guideline for patients with glioblastoma. The guideline examines radiation therapy as treatment for these patients, and the ways in which systemic therapies modify its effects. The guideline also reviews ideal dose-fractionation, target volume design, and reirradiation for recurrent glioblastoma. Tumour-specific and patient-specific factors are considered in the recommendations.
A clinical practice guideline for patients with lymphoma, including small lymphocytic leukemia (SLL)/chronic lymphocytic leukemia (CLL), Waldenstroms, marginal zone lymphoma, and cutaneous lymphoma. The guideline examine the use of PET/CT, primarily for staging and response assessment. Outcomes of interest include survival, quality of life, and appropriate use.
This clinical practice guideline provides recommendations on influenza vaccinations for children and adults with solid tumours or hematologic malignancies. Recommendations are provided for vaccine type (live versus inactivated) and administration in relation to the therapy cycle, and are stratified by patient age (adult versus pediatric). Topics of discussion include the effects of age, duration, and type of systemic therapy in regards to response of patients to the influenza vaccine, as well as contraindications and precautions for immunization.
This is a clinical practice guideline for the screening, diagnosis, staging, and treatment of neuroendocrine tumors. This guideline provides recommendations on issues including: multiple endocrine neoplasia, surveillance of resected neuroendocrine tumors of the gastrointestinal tract, lung, and thymus, and genetic counseling/testing in pheochromocytomas/paragangliomas. Most of the guideline sections pertain to well-differentiated, low- to intermediate-grade tumors, although poorly differentiated/high-grade/large or small cell carcinomas are also addressed.
This is a clinical practice guideline for the diagnosis and management of systemic light chain amyloidosis. Primary systemic light chain amyloidosis is typically characterized by decreased numbers of monoclonal plasma cells in the bone marrow compared to multiple myeloma, however, the protein produced by these plasma cells has an affinity for visceral organs (such as kidney, heart, liver, and spleen), and this protein causes related end-organ dysfunction. Recommendations include a discussion of the management options such as transplant and chemotherapy.
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline provides recommendations for the initial evaluation and staging, treatment, and follow-up for adults with various stages of kidney cancer. Topic areas discussed in the guideline include: imaging, surgery, lymph node dissection, targeted therapy, and supportive care.
This clinical practice guideline discusses evaluation, treatment (primary and secondary) options, and follow-up care for patients with bladder cancer. Specific workup and treatment recommendations are provided for non-muscle invasive disease, muscle invasive disease, upper genitourinary tract (GU) tumours, urothelial carcinomas of the prostate, and primary carcinoma of the urethra. Non-urothelial carcinomas of the bladder are also discussed.
This is a clinical practice guideline for the treatment of patients with metastatic pancreatic cancer. This clinical practice guideline addresses six overarching clinical questions: After a histopathologic confirmation of pancreatic adenocarcinoma diagnosis, what initial assessment is recommended before initiating any therapy for metastatic pancreatic cancer? What is the appropriate first-line treatment of patients with metastatic pancreatic cancer? What is the appropriate therapy for patients with metastatic pancreatic cancer who experience either disease progression or intolerable toxicity with prior regimens for metastatic pancreatic cancer? When should the concept of palliative care be introduced? For patients with metastatic pancreatic cancer, what are the recommended strategies for relief of pain and symptoms? What is the recommended frequency of follow-up care/surveillance for patients with metastatic pancreatic cancer?
This is a clinical practice guideline for small cell lung cancer and lung neuroendocrine tumours. Diagnosis, staging, prognostic factors, treatment and surveillance are reviewed. Treatment options include chemotherapy, with special topics of discussion including elderly patients and second- and third-line therapies, radiotherapy (thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy), and surgery. Outcomes of interest include survival (disease free, overall, progression-free), response rates, and treatment toxicity.
This is a clinical practice guideline for patients with colon cancer or adenocarcinomas of the small bowel and appendix. The guideline reviews staging, pathology, clinical presentation and treatment of nonmetastatic disease, management of metastatic disease, post-treatment surveillance, and survivorship. The role of vitamin D in colorectal cancer is also discussed.
This clinical practice guideline reviews workup, staging, and treatment for both noninvasive and invasive breast cancer. Special considerations include phyllodes tumor, Paget's disease, breast cancer during pregnancy, and inflammatory breast cancer. Treatment recommendations for invasive cancer are stratified by tumor receptor status and stage. Fertility and birth control is also discussed.
The guideline provides recommendations for management and treatment of patients 18 years of age and older who have malignant superior vena cava obstruction (SVCO) or airway obstruction, compression, or invasion, or those experiencing hemoptysis. The course of management is dependent on symptoms, primary histology, urgency of histology, previous treatment, and access to resources. External beam radiotherapy (EBRT), endobronchial brachytherapy, chemotherapy, radiotherapy, bronchoscopic debulking, surgical resection, photodynamic therapy, and Neodymium-doped yttrium aluminum garnet (Nd:YAG) are discussed as treatment options. For superior vena cava obstruction, external beam radiation EBRT, RT dose fractionation, SVC stent insertion, steroids, and palliative intent chemotherapy are discussed.
A clinical practice guideline for patients with locally advanced breast cancer. The guideline examines appropriate screening to determine extent and node involvement, and treatment through systemic therapies and radiotherapies. Outcomes of interest include improved breast conservation in select populations and improved outcomes through trimodal therapy.
A clinical practice guideline for patients with newly diagnosed stage III or IV Hodgkin lymphoma. The guideline examines diagnosis, primarily through biopsy, and treatment options focusing primarily on chemotherapy. Outcomes of interest include increased toxicity using both mechlorethamine, vincristine, procarbazine, and prednisone and doxorubicin, bleomycin, and vinblastine hybrid treatment.
A clinical practice guideline for patients with localized prostate cancer undergoing external beam radiation. The guideline examines treatment planning and delivery, with specific intervention details for multiple clinical variants. Outcomes of interest include improved clinical outcomes and reduced GI toxicity.
This is a clinical practice guideline for teleoncology models of care. Teleoncology seeks to offer solutions to some of the access issues faced by patients and health professionals from regional, rural and remote communities around the world. The focus of the guideline is shaped by a number of clinical questions that include: what teleoncology models of care are available to health services in Australia and overseas; what models of care for teleoncology are available to nursing services; what models of care for teleoncology are available to allied health services; is teleoncology as effective as standard oncology care for the screening of cancer; is teleoncology as effective as standard oncology care for the diagnosis of cancer; is teleoncology as effective as standard oncology care for the treatment of cancer; and is teleoncology as effective as standard oncology care for the palliative care of cancer patients.
This is a clinical practice guideline for patients with rectal cancer. The guideline provides recommendations on use of MRI for staging, optimal surgical techniques for patients with T1-T2 anal cancer with comparisons made between local resection or transanal endoscopic microsurgical resection and radical resection, and the use of adjuvant chemotherapy for patients who have received neoadjuvant radiotherapy (RT). Outcomes of interest include survival (overall, disease free, metastasis-free, local recurrence free), and quality of life.
This is a clinical practice guideline for women who are at risk of developing cervical cancer. The guideline examines the optimal methods for cervical cancer screening and the management of women with abnormal screening results. Primary screening, exiting screening, triage and post-triage time periods, and the treatment of women with precursor lesions are all discussed. Different recommendations are provided based on economic resource level (i.e., basic, limited, enhanced or maximal).
This is a clinical practice guideline for adult patients with pancreatic neoplasms. The guideline provides recommendations for the use of laparoscopic pancreatic surgery (LAPS) in these patients, with a specific focus on laparoscopic distal pancreatectomy, laparoscopic pancreatoduodenectomy, laparoscopic pancreatic enucleation, and laparoscopic central pancreatectomy. Other topics discussed include laparoscopic compared to robotic pancreatic surgery, and the use of intraoperative laparoscopic ultrasound as compared to pre-operative imaging.
This is a clinical practice guideline on the indications and methods for prophylaxis against Pneumocystis jirovecii pneumonia (PCP) in pediatric oncology patients undergoing treatment for solid malignancies. Recommendations are provided for the following patient populations: those receiving corticosteroids, temozolamide, or radiotherapy in combination with corticosteroids and/or chemotherapy, or rituximab in combination with other cancer treatments (e.g. chemotherapy, radiotherapy, corticosteroids), as well as those with underlying lung pathology or previous PCP.
This is a clinical practice guideline for patients with prostate cancer. The guideline provides recommendations on the use of immunotherapy for the treatment of these patients, with recommendations separated based on the stage of disease (i.e. whether metastatic or non-metastatic, castration-sensitive or castration-resistant). Specific topics discussed include issues related to patient selection, monitoring of patients during and after treatment, and sequence/combination with other anti-cancer treatments.
This is a clinical practice guideline for patients with hematologic malignancies. The guideline specifically examines immunotherapy for the treatment of multiple myeloma, lymphoma, and acute leukemia. Topics of interest include patient selection, toxicity management, clinical endpoints, and the sequencing or combination of therapies.
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline discusses diagnosis, treatment, and follow-up, and provides specific recommendations on topics such as the primary treatment of RCC without metastases, systemic treatment for metastatic RCC, neoadjuvant/adjuvant therapy, as well as the resection and radiotherapy of metastases.
This is a clinical practice guideline for non-HIV-infected hematology patients. The guideline examines the treatment of Pneumocystis jirovecii pneumonia (PCP) in these patients. First-line treatment including selection of drugs and route of administration is discussed, as well as assessment of treatment response, second-line treatment, drug-related side-effects and drug-drug interactions, treatment duration, intensive care, glucocorticosteroids as adjuvant therapy, and secondary anti-PCP prophylaxis. The symptoms of PCP in hematology patients, criteria for initiation of PCP treatment, and grading of PCP severity and prognostic factors are also addressed.
This is a clinical practice guideline for patients with locally advanced nonmetastatic (stages III-IVB) squamous cell carcinoma of the head and neck (LASCCHN). The guideline examines the use of systemically administered drugs in combination or in sequence with radiation (RT), surgery, or both. Outcomes of interest include tumour response rate, survival rate, and organ preservation.
This is a clinical practice guideline for men with prostate cancer who are receiving androgen deprivation therapy (ADT). The guideline examines the effectiveness of therapies that target bone, which can mitigate the effects of ADT on bone health. Outcomes of interest include fracture, bone mineral density (BMD), osteoporosis, skeletal-related events (SREs), bone metastasis, pain, patient-reported quality of life (QOL), and overall survival.
This is a clinical practice guideline for women diagnosed with invasive cervical cancer. The guideline examines the most effective antitumour and palliative care interventions for clinicians and planners. Treatment options that are discussed include cone biopsy, extrafascial hysterectomy, modified radical or radical hysterectomy, and combinations of surgery, chemotherapy, and radiation therapy.
This is a clinical practice guideline for the staging and treatment of colorectal cancer. The guideline focuses on surgical and pathological considerations for the resection of colorectal cancer and provides recommendations on the technique and extent of resection, as well as the reporting of resection results. Outcomes of interest include overall survival, disease-free survival, recurrence rates, and margin status.
A clinical practice guideline for patients with chronic lymphocytic leukemia (CLL), monoclonal B cell lymphocytosis (MBL) and small lymphocytic lymphoma (SLL). The guideline examines clinical assessment, staging, and treatment including supportive therapy and potential complications. Outcomes of interest include long-term remission, increases in secondary malignancies, and disease progression.
This is a clinical practice guidelines on the use of psoralen-ultraviolet A (PUVA) photochemotherapy as a therapeutic modality for conditions including cutaneous T-cell lymphoma (CTCL). Topics of discussion that are specific to CTCL include a comparison between PUVA and other types of phototherapy such as narrowband ultraviolet B (TL-01) for treatment of patch-stage CTCL, as well as use of PUVA in early stage CTCL of the MF type. Adverse reactions are reviewed along with risk reduction measures and methods to manage treatment side-effects. Outcomes of interest for PUVA treatment of CTCL include response rates, remission duration, and survival.
This guideline aims to described the role of esophageal stents in patients with malignant or benign esophageal disease and makes recommendations on circumstances that warrant their use. Questions addressed in this guideline include: what are the results for palliative stent placement compared to other treatment modalities; what are the short-term and long-term adverse events of stent placement; and can stents be used to treat benign esophageal leaks and perforations.
The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. The guideline provides recommendations for management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment.
A clinical practice guideline for patients with early stage endometrial cancer. The guideline examined adjuvant therapy, including brachytherapy, radiation, chemotherapy, as well as observation in patients with low-grade/low-risk endometrial adenocarcinoma. Outcomes of interest include recurrence, local control, and overall survival.
This is a clinical practice guideline for antiemesis. The guideline examines emesis, types of nausea/vomiting (e.g., chemotherapy induced), antiemetic therapies, and treatment issues associated with antiemetic therapies.
This is a clinical practice guideline for patients with squamous cell carcinoma (SCC) of the penis. The guideline reviews risk factors and clinical presentation, and provides recommendations for clinical staging, management of primary legions, management of regional lymph nodes, surveillance, and management of metastatic disease. Surgery, radiotherapy, and chemotherapy are reviewed as treatment options.
This is a clinical practice guideline for patients with epithelial ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Less common histopathologies including ovarian low malignant potential (LMP) tumor, malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumors [MMMTs] of the ovary), and malignant sex cord-stromal tumors, are also discussed. The guideline provides recommendations on diagnosis, treatment, follow-up, and relapse. Primary treatment options for ovarian cancer include surgery (risk-reducing or cytoreductive), chemotherapy (neoadjuvant and adjuvant), incomplete surgery and/or staging, anti-angiogenesis agents, and radiation therapy. The number of chemotherapy cycles and agents are reviewed, along with drug reactions.
This is a clinical practice guideline for myelodysplastic syndromes (MDS). The guideline provides an update to recommendations on standard approaches to the diagnosis and treatment of MDS in both children and adults. The guideline discusses evaluation and prognostic stratification, Topics of interest include prognostic stratification, evaluation of related anemia and treatment of symptomatic anemia, and supportive care. Molecular abnormalities in MDS and comorbidity indices are also discussed.
This is a clinical practice guideline for patients with anal carcinoma. Risk factors are discussed and recommendations are provided on risk reduction including HIV immunization, work up, management, and follow-up care. Treatment options are reviewed, with specific recommendations provided for primary treatment of: non-metastatic anal carcinoma, anal canal cancer, and anal margin cancer, as well as treatment for metastatic cancer and for locally progressive or recurrent anal carcinoma. Special considerations are made regarding treatment of anal cancer in patients with HIV/AIDS.
This clinical practice guideline provides evidence-based recommendations to oncologists and others for treatment of patients with locally advanced, unresectable pancreatic cancer (LAPC). The guideline addresses a number of key clinical questions including: what initial assessment is recommended before initiating therapy for LAPC; what is the appropriate initial treatment approach for people diagnosed with LAPC; and for people with LAPC, what are the recommended strategies for relief of pain and symptom burden.
This guideline applies to patients with ductal carcinoma in situ (DCIS) treated with whole-breast radiation therapy (WBRT). The primary question addressed in this guideline is "what margin width minimizes the risk of ipsi-lateral breast tumor recurrence (IBTR) in patients with DCIS receiving breast-conserving surgery?" The guideline developed from a consensus panel is intended to assist treating physicians and patients in the clinical decision-making process based on the best available evidence.
These clinical practice guidelines for survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment to aid health care professionals who work with survivors of adult-onset cancer in the post-treatment period, including those in specialty cancer survivor clinics and primary care practices. The guidelines focus on the vast and persistent impact both the diagnosis and treatment of cancer can have on the adult survivor’s health, physical and mental states, health behaviors, professional and personal identity, sexuality, and financial standing.
This is a clinical practice guideline for patients with cervical cancer including squamous cell carcinoma, adenosquamous carcinoma, and adenocarcinoma of the cervix. The guideline discusses diagnosis and workup, principles of staging and surgery, primary treatment, adjuvant treatment, surveillance, and therapy for relapse. Special topics of consideration include incidental cervical cancer, radiation therapy, and cervical cancer and pregnancy.
This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing. Provincial resources are provided.
A clinical practice guideline for patients with bone metastases and spinal compression as common causes of cancer-related pain. The guideline examines radiotherapy and prophylactic steroids to reduce pain and pain flares. Outcomes of interest include improved neurological outcomes, survival, and reduced functional interference.
This is a clinical practice guideline for patients with, or suspected of having, upper urinary tract urothelial carcinomas (UTUCs). The guideline reviews diagnostic assessment, staging, treatment, and follow-up. Treatment recommendations are provided based on whether the disease is localized or advanced and include radical nephroureterectomy, conservative surgery, adjuvant topical agents, chemotherapy, and radiotherapy. Outcomes of interest include risk factors, sensitivity and specificity of diagnostic tests, survival (recurrence-free, disease-free, and overall), disease progression, morbidity, and mortality.
This guideline reviews clinical presentation and patient evaluation, prognostic factors, principles of management, and treatment outcomes for patients with nasal cavity and paranasal sinus cancers. Surgery, radiotherapy, and chemotherapy are discussed as treatment options. Special topics of interest include the management of cervical lymph nodes and the management of unusual pathologies of nasal cavity cancers, namely esthesioneuroblastoma and sinonasal undifferentiated carcinoma.
A guideline for the management of fluorouracil for treating solid tumours. The guideline examines the safe management of fluorouracil in medication pumps, and recommendations for treating and monitoring patients who have overdosed. Important aspects include specific dosing regimens, fluid administration calculations, and outpatient management.
This is a clinical practice guideline for adults and children who are receiving hematopoietic stem cell transplantation (HSCT) or are undergoing treatment for hematological malignancies. The guideline provides recommendations for the diagnosis, prevention, and management of common respiratory viral infections in these patients. Diseases discussed include influenza, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), human parainfluenza virus (HPIV), and human rhinovirus (HRV).
This is a clinical practice guideline for the screening and treatment of precancerous lesions for cervical cancer prevention. The guideline focuses specifically on the screening for cervical intraepithelial neoplasia 2 & 3 and the treatment of those lesions to prevent cervical cancer in women who tested positive after screening. In formulating the recommendations, the guideline authors specifically took into account resource implications in the Saudi context.
This clinical practice guideline is for patients undergoing major abdominal surgery, including patients with cancer. The guideline provides recommendations for preoperative care before procedures such as colorectal surgery, gastrectomy, gastric bypass, hysterectomy, prostatectomy, and cystectomy, as well as other oncological, gynecological, and urological surgeries. Outcomes of interest include the prevention of surgical complications and reductions in hospital stays.
This is a clinical practice guideline for children aged 1 month to 18 years who are receiving chemotherapy. The guideline examines the management of chemotherapy-induced nausea and vomiting (CINV), including the treatment of breakthrough CINV and the prevention of refractory CINV. The primary outcome of interest is a decrease in the incidence of CINV.
This is a clinical practice guideline for patients with stage 1-3 cutaneous melanoma who have received curative resection. The guideline examines the appropriateness of adjuvant radiation therapy (RT) for these patients, narrowing the focus on those patients with primary melanoma, in-transit primary melanoma, recurrent melanoma, and those at high risk for regional recurrence of melanoma. The guideline also considers whether equivalent disease control is provided with a standard fractionation schedule and a hypofractionated schedule. Outcomes of interest include control rate, survival rate and adverse event rates.
A clinical practice guideline for the use of palliative radiation therapy (RT) in adults with bone metastases. The guideline discusses the appropriateness of different fractionation schemes depending on clinical context, and examines the risks of experiencing long-term side-effects associated with single fractionation. The efficacy of advanced RT techniques for initial treatment and retreatment is also discussed, and the guideline examines the potential impacts that surgery, radionuclides, bisphosphonates, and kyphoplasty/vertebroplasty have on the appropriateness of palliative RT. Outcomes of interest include reductions in pain, spinal cord compression, hypercalcemia, and pathologic fracture.
This clinical practice guideline examines adjuvant systemic therapy for early stage breast cancer. The guideline provides a systematic method for treatment decision-making for patients with lymph node negative breast cancer and lymph node positive breast cancer, based on level of risk and hormone receptor status. The guideline further explores chemotherapy options for these patients and considers the influence of menopausal status on treatment decisions.
This is a clinical practice guideline for the identification, prevention, and treatment of reversible elements of malnutrition in adult cancer patients. The specific objectives of this guideline are to improve early detection and treatment of malnutrition and metabolic derangements in cancer patients and cancer survivors; to provide guidance to health care workers and patients on the most appropriate and effective management of nutritional and metabolic problems in cancer patients; and, by this, to lower the incidence and impact of malnutrition and metabolic derangements in cancer patients and survivors. Topics considered include: effects of nutritional intervention during cytostatic and targeted therapies on treatment tolerance, response to treatment and overall survival, as well as effect of artificial nutrition on treatment tolerance, treatment completion, relapse rate and overall survival.
This is a clinical practice guideline for the diagnosis and management of melanoma. The purpose of these guidelines is to achieve early diagnosis whenever possible, make doctors and patients aware of the most effective treatment options, and minimize the financial burden on the health system by documenting investigations and therapies that are inappropriate. Topics discussed include: features of melanoma, biopsy, sentinel node biopsy, and excision margins.
This is a clinical practice guideline for the management of diffuse large B-cell lymphoma. Recommendations include consideration of: prognostic factors, early stage disease, advanced stage disease, relapsed/refractory disease in the transplant-eligible patient, HIV-associated DLBCL, management of the elderly, frail or unfit patient with DLBCL, and follow-up.
A clinical practice guideline for adult and pediatric patients with cancer, including hematological cancers and solid tumours. The guideline examines pneumococcal immunization in order to prevent secondary infections. Outcomes of interest include reduced pneumonial mortality and improved immunization scheduling.
This is a clinical practice guideline addressing lymphoma in the adult population. The guideline focuses on diagnosis and pathology, staging, and treatment of Non-Hodgkin Lymphomas, Hodgkin Lymphoma, HDCT and hematopoietic stem cell transplantation for lymphoma. Supportive and follow-up care is also addressed. The guideline updates the 2015 guideline of the same title.
A clinical practice guideline for the diagnosis and treatment of acute lymphoblastic leukemia in adult and pediatric patients. The guideline examines diagnostic methods, treatment by age group, and special considerations including allogeneic stem cell transplantation and the role of cranial radiation. Outcomes of interest include probability of survival and incidence of hematological relapse.
A clinical practice guideline for patients with suspected uterine neoplasms. The guideline examines surveillance, diagnostic assessment, and treatment focusing primarily on surgical interventions and systemic therapy. Outcomes of interest include long-term survival and reproductive sparing.
This is a clinical practice guideline for the evaluation, treatment, and management of thymomas and thymic carcinomas. The guideline considers surgical resection, systemic therapies, and radiation therapies for both mediastinal and thymic masses.
This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are also discussed.
This is a clinical practice guideline for smoking cessation in patients with cancer. The guideline emphasizes the importance of smoking cessation in all patients with cancer and seeks to establish evidence-based, standard of care recommendations tailored to the unique needs and concerns of patients with cancer. Treatment plans are provided that include recommendations that evaluate the merits of pharmacotherapy, behaviour therapy, and follow-up. The guideline developers acknowledge that smoking and nicotine addiction is a chronic relapsing disorder and as a result, the guideline also provides recommendations around retreatment and the management of relapse.
This is a clinical practice guideline for adult patients with cancer-induced anemia, with an emphasis on patients with anemia who are receiving concomitant chemotherapy. The guideline reviews etiology and provides recommendations on screening, follow-up risk assessment, and management. Red blood cell transfusion, erythropoietic therapy (ESA), and iron monitoring and supplementation are reviewed as treatment options.
This is a clinical practice guideline for the diagnosis, staging, and treatment of thyroid carcinoma. Recommendations are stratified by histologic type, namely papillary, follicular, Hürthle cell, medullary, and anaplastic. Primary treatment options and assessment and management after initial treatment is reviewed. Recurrent or persistent disease is also discussed.
This clinical practice guideline reviews diagnosis and management of adenocarcinomas of the exocrine pancreas. Risk factors and genetic predisposition are discussed, and the guideline provides recommendations on screening, diagnosis and staging, and treatment options including systemic therapy, chemoradiation, and surgical management. Palliative and supportive care are also reviewed. Topics of interest include an overview of biomarkers, and suggestions for management of premalignant tumours of the pancreas.
This clinical practice guideline provides recommendations for evaluation, workup, management, and follow-up of 2 pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Diagnostic tests are recommended based on disease location and patient gender. Treatment options for disseminated or localized disease for adenocarcinoma and site-specific SCC are also discussed.
This is a clinical practice guideline for Hodgkin lymphoma. The guideline discusses the clinical management of patients with classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), focusing exclusively on patients from post adolescence through the seventh decade of life who do not have serious intercurrent disease. Areas considered and discussed within the guideline include: staging and prognosis, the role of PET scans, treatment, principles of radiation therapy, and follow-up after completion of treatment.
This clinical practice guideline provides recommendations on esophageal and esophagogastric junction (EGJ) cancers, including: a review of hereditary cancer predisposition syndromes associated with increased risk for esophageal and EGJ cancers, staging and pathology, imaging, and treatment including surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies. Surveillance, management of metastatic, or recurrent cancer, and best supportive care are also discussed. Special topics of interest include treatment and surveillance options for patients with Barrett's esophagus, and suggested strategies to help alleviate the current problems associated with leucovorin shortage.
This is a clinical practice guideline for patients aged 15 or older with acute lymphoblastic leukemia (ALL). The guideline reviews diagnosis, workup and risk stratification, treatment and consolidation therapy stratified by age and Philadelphia chromosome presence/absence, surveillance, treatment for relapse/refractory disease, and supportive care. The guideline discusses typical immunophenotyping panels for all major subtypes, and minimal residual disease assessment. Evaluation and treatment of extra medullary involvement is also reviewed.
This is a clinical practice guideline for women with newly diagnosed or suspected stage IIIC or IV epithelial ovarian cancer, fallopian tub cancer, or primary peritoneal cancer. More specifically, the guideline provides guidance to clinicians and patients regarding the use of neoadjuvant chemotherapy (NACT) and interval cytoreduction. The guideline addresses a number of clinical questions including: what clinical evaluations should be performed in all women with suspected or newly diagnosed stage IIIC or IV epithelial ovarian cancer; what is the preferred chemotherapy regimen for women with stage IIIC or IV epithelial ovarian cancer who will receive NACT; and what are the treatment options for patients with progressive disease on NACT.
This is a clinical practice guideline provides evidence-based recommendations to oncologists and others on potentially curative therapy for patients with localized pancreatic cancer. Key recommendations are guided by questions including: what initial assessment is recommended before initiating any therapy for potentially curable pancreatic cancer; what is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone a resection of their primary tumor; and when should palliative care services be initiated for people with pancreatic cancer that is potentially curable by surgery.
The American Society of Clinical Oncology (ASCO) guideline for the use of postmastectomy radiotherapy (PMRT) was published in 2001. This update of that guideline, completed in collaboration with the American Society for Radiation Oncology (ASTRO) and the Society of Surgical Oncology (SSO), focuses on key areas of ongoing controversy, including the use of PMRT for patients with one to three positive lymph nodes, use of PMRT for patients undergoing neoadjuvant systemic therapy (NAST), and selected technical aspects of PMRT, particularly the extent of regional nodal irradiation (RNI). The question of whether PMRT is indicated in women with T1-2 tumours and a positive sentinel node biopsy (SNB) who do not undergo completion axillary lymph node dissection (ALND) is also discussed.
This a clinical practice guideline for women with hormone receptor (HR) -positive metastatic breast cancer (MBC). The guideline provides treatment recommendations for HR-positive MBC patients who are being considered for endocrine therapy. Recommendations are based on the answers to a number of different of questions including: Is there an optimal first-line endocrine therapy regimen for hormone receptor (HR) –positive metastatic breast cancer (MBC); is there an optimal second- or later-line endocrine therapy for HR-positive MBC; and how does adjuvant treatment affect recommendations for treatment in the metastatic or advanced setting.
This clinical practice guideline provides recommendations on colorectal screening for patients with high-risk syndromes of inherited colon cancer. Recommendations are provided for management of Lynch syndrome, FAP, MAP, Peutz-Jeghers syndrome, juvenile polyposis syndrome (JPS), SPS, and other high-risk syndromes associated with CRC risk (Li-Fraumeni syndrome [LFS] and Cowden syndrome/PTEN hamartoma tumor syndrome [PHTS]). Topics of discussion include risk assessment and genetic counselling, diagnosis, and preventative treatment options.
This is a clinical practice guideline for women who are at increased risk of developing breast cancer. The guideline provides an overview on risk assessment, risk-reduction interventions including lifestyle interventions, risk-reduction surgery, and risk-reduction agents (tamoxifen, raloxifene, aromatase inhibitors). Recommendations are also provided for managing side effects of risk-reduction agents and monitoring for complications. Risk-reduction counselling is also discussed.
This is a clinical practice guideline for patients over 18 years of age with esophageal cancer, including both squamous cell and adenocarcinoma. The guideline provides recommendations on diagnostic work-up, staging, treatment options for potentially curable cancer stratified by stage, and management options for incurable cancer. Esophagectomy, endoscopic therapy, primary chemoradiotherapy, radiotherapy, pre-operative chemoradiotherapy followed by esophagectomy and pre-operative chemotherapy are discussed, as well as supportive care. Outcomes of interest include survival (overall, progression-free, 5-year), morbidity, toxicity, and rate of sudden death.
This is a clinical practice guideline for adult patients with potentially curable, early stage (Stage I or II) NSCLC (without nodal involvement or metastases), and who are deemed medically inoperable or refuse surgery. The guideline provides discusses the use of stereotactic body radiation therapy (SBRT)/stereotactic ablative radiation therapy with curative intent and provides recommendations on fractionation schemes. Outcomes of interest include tumour control and survival as well as toxicity.
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline reviews the use of pre- and post-operative therapy including chemotherapy and radiotherapy as treatment options. Outcomes of interest include survival (overall, cause-specific), quality of life, acute and late toxicities, and postoperative morbidity (within 30 days of surgery).
This guideline is for adult patients over 16 years of age with suspected, newly diagnosed, or relapsed myeloma. The guideline provides recommendations on laboratory and imaging investigations, management of newly diagnosed myeloma, managing acute renal disease caused by myeloma, preventing and managing complications, disease monitoring, and managing relapsed myeloma. Recommendations are also provided on service organization. Outcomes of interest include time to biochemical and/or clinical progression, overall survival, adverse events, quality of life and resource use.
This is a clinical practice guideline for male patients diagnosed with or suspected of having prostate cancer. The guideline reviews classification and staging, diagnostic evaluation, disease management, and follow-up care. Side effects of local treatment and health-related quality of life in prostate cancer survivors are also discussed. Outcomes of interest include overall survival, cancer-specific survival, development of metastatic disease, sensitivity and specificity of diagnostic procedures, and side effects of treatment.
This is a clinical practice guideline for adult patients with acute myeloid leukemia (AML), excluding acute promyelocytic leukemia, who are deemed suitable for intensive treatment. The guideline includes consideration of the most effective systemic post-remission treatment - consolidation and/or maintenance - for adults with previously untreated AML. The guideline also considers which patient characteristics are most important when making treatment decisions.
A clinical practice guideline for adult, adolescent, and child patients with nodular lymphocyte predominant Hodgkin lymphoma. The guideline examines investigation and management for multiple treatment stages, including disease transformations and fertility preservation options. Outcomes of interest include improved outcomes through combination chemotherapy, and improved end of treatment scans.
This is a clinical practice guideline for adult patients with thyroid nodules and differentiated thyroid cancer (DTC). The guideline provides recommendations on initial management of thyroid cancer including screening, staging, risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine, as well as long-term management including surveillance techniques, management of recurrent and metastatic disease, and consideration for clinical trials and targeted therapy. The evaluation and diagnostic approach for thyroid nodules is also discussed, including a review of indications for fine-needle aspiration biopsy and interpretation of results, as well as use of molecular markers and management of benign thyroid nodules. Outcomes of interest include survival, recurrence, sensitivity and specificity.
This is a clinical practice guideline for premenopausal women with Stage I to III hormone receptor-positive breast cancer. The guideline reviews the use of ovarian suppression in addition to standard adjuvant or standard therapy, with recommendations stratified by risk. Outcomes of interest included survival (overall, disease free), freedom from breast cancer at 5 years, freedom from distant recurrence at 5 years, adverse events, quality of life, patient-reported outcomes, and cognitive impairment.
This is a clinical practice guideline for patients with a variety of cancers, including lung, liver, and kidney tumours, with a specific focus on patients with hepatocellular carcinoma (HCC) or liver metastases. The guideline examines the effectiveness of thermal ablation, which encompasses radiofrequency ablation (RFA) and microwave ablation, as well as transcatheter arterial chemoembolization (TACE), alone or in combination with other strategies. The guideline outlines patient clinical criteria, criteria for service providers, and system-level criteria.
This is a clinical practice guideline for women with vulvar carcinoma. The guideline examines the appropriate use of adjuvant therapy in these patients, following primary surgical treatment. Adjuvant radiation, including dose, fields, and technique, as well as adjuvant chemotherapy, were discussed as potential treatment options. In addition, the guideline examines the appropriateness of different imaging techniques, such as magnetic resonance imaging (MRI), fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and computed tomography (CT), for the staging of vulvar carcinoma.
A clinical practice guideline for adult patients with potentially curable esophageal carcinoma. The guideline examines diagnosis with FDG-PET/CT, staging, and treatment options including chemoradiotherapy and brachytherapy. Outcomes of interest include staging accuracy and treatment response.
This is a clinical practice guideline for the evaluation, diagnosis and management of a suspicious lateral neck mass in adults. Use of history and physical exam, X-ray, CT scan, and fine needle aspiration biopsy (FNAB) are discussed along with urgency of referral depending on results. Additionally, the guideline addresses the diagnosis or suspicion of lymphoma, as well as appropriate use of open biopsy.
This is a clinical practice guideline for the use of GI endoscopy in the evaluation and treatment of pancreatic neoplasms. Diagnosis by endoscopic ultrasound (EUS) is discussed, as is use of EUS-guided-fine needle aspiration (FNA) to determine cytology, chemistries and tumour markers such as CEA, as well as cyst fluid DNA and molecular analysis. Other topics of discussion include emerging techniques for cyst evaluation, adverse events fro EUS, diagnosis by ERCP (Endoscopic Retrograde Cholangio-Pancreatography), and endoscopic treatment of cystic lesions.
A clinical practice guideline for patients for have undergone surgery for breast cancer, or have metastatic breast cancer. The guideline examines the utility of radiotherapy in breast-conserving surgery, post-mastectomy, and metastasis. Outcomes of interest include recurrence, death risk, and overall survival.
A clinical practice guideline for adult patients with newly diagnosed WHO grade 2 astrocytoma, oligo-astroctyoma, or oligodendroglioma. The guideline examines the role of immunotherapy and tumour vaccines. nutrition, and alternative therapies for treatment. Outcomes of interest include adverse outcomes and self-reported use, however evidence is limited.
This is a clinical practice guideline for the management of renal cell carcinoma. The guideline examines the diagnosis, staging, treatment, and follow-up of renal cell carcinoma, with treatment recommendations stratified by disease stage. Therapeutic strategies are also discussed. Outcomes of interest include overall survival, cancer-specific survival, recurrence-free survival, and quality of life.
This clinical practice guideline provides recommendations for urothelial carcinomas of the upper urinary tract. The guideline covers epidemiology, etiology, and pathology, staging, diagnosis, prognosis, disease management, and follow-up. Issues addressed in the guideline include: risk factors, symptoms, imaging, preoperative factors, predictive tools, and management for both localized and advanced disease.
This is a clinical practice guideline for non-muscle-invasive bladder cancer (Ta, T1 and CIS). The guideline covers staging and classification systems, diagnosis, disease recurrence, management, and follow-up. Issues addressed include: imaging, chemotherapy, and biopsy.
This is a clinical practice guideline for immunocompetent adults with primary CNS lymphoma. The guideline provides consensus considerations and recommendations for diagnosis, assessment, staging, and treatment of primary CNS lymphoma. Specifically, the guideline addresses aspects of care related to surgery, systemic and intrathecal chemotherapy, intensive chemotherapy with autologous stem-cell transplantation, radiotherapy, intraocular manifestations, and management of elderly patients.
An organizational guideline for the provisions of gynecologic oncology services by multidisciplinary professionals. The guideline examines the efficacy of specialist treatment, resource allocation, and the organization of work and services. Important aspects include the role of gynecologic oncologist, annual surgical case volumes, and minimum treatment standards.
A clinical practice guideline for the management of complications in patients with multiple myeloma. The guideline examines treatment and supportive care for common complications, including pain management, anemia, renal impairment, peripheral neuropathy, infections, and venous thromboembolisms. Outcomes of interest include renal failure, fracture, and reduced impairment.
This clinical practice guideline provides recommendations on the diagnosis of Lynch syndrome in patients without a personal history of colorectal or another cancer but with a family history suggestive of Lynch syndrome, as well as for patients with colorectal cancer with IHC absent for MLH1. Management of the risk of colorectal cancer for patients with Lynch syndrome is also discussed with a review of surveillance colonoscopy and recommendations on the use of aspirin as a preventative measure for cancer. Outcomes of interest include sensitivity, specificity, false-positive and false-negative rates of diagnostic tests, as well as psychological distress/quality of life, colorectal cancer incidence, staging, and mortality, Lynch-syndrome associated cancer incidence and mortality, surgical complications from colonoscopy, and costs.
This is a clinical practice guideline for patients with resectable oropharyngeal (OP) carcinomas. The guideline reviews optimal radiation therapy treatment intensification, optimal concurrent chemotherapy including use of altered fractionation, the role of cetuximab, induction chemotherapy, organ-preserving surgery, and nonsurgical deintensification therapy. Special topics of consideration include the therapeutic implications of OP carcinomas in Human Papillomavirus–Positive (HPV) patients.
This is a clinical practice guideline for the diagnosis, staging, and treatment of oropharyngeal cancer. The guidelines provide recommendations on staging for primary tumour, regional lymph nodes, and distant metastases; management of invasive carcinoma of oropharynx, locally advanced resectable disease; post-operative adjuvant therapy options, post chemoradiation or post radiation evaluation; salvage therapy; radiation therapy; concurrent chemotherapy; and management of residual disease, loco-regional recurrent or distant metastases.
This is a clinical practice guideline for the assessment and management of patients with nasopharyngeal carcinoma. The guideline explores the etiology of nasopharyngeal carcinoma as well as the pathologic classification and staging. Recommendations are provided for assessment and include discussions of imaging and specimen collection. Additionally, the guideline explores appropriate management options and provides guidance on how to proceed in cases of suspected recurrent disease.
This is a clinical practice guideline for the treatment of patients with laryngeal cancer. The guideline provides different treatment options by the following laryngeal divisions: glottic, supraglottic, and subglottic. The role of surgery, radiotherapy and chemotherapy are explored in this guideline.
A clinical practice guideline for the diagnosis, treatment, and follow-up of oropharyngeal, hypopharyngeal and laryngeal cancers. The guideline examines preferred locoregional staging methods and treatment options including an emphasis on interprofessional care. Outcomes of interest include limited evidence for the benefits of surgical treatment in some cases and some evidence that primary chemotherapy may provide some benefit over radiotherapy.
These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with differentiated thyroid cancer (DTC) are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided.
This clinical practice guideline provides an update to a key recommendation for the use of antiemetics for patients receiving cancer therapy. More specifically, the update focuses on recommendations regarding the use of netupitant and palonosetron (NEPA), a drug used for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of chemotherapy. Areas addressed in the guideline include: dosing information for NEPA and other antiemetics summarized in a table, as well as cost consideration for the use of NEPA.
A clinical practice guideline for the management of female patients with cervical cancer. The guideline examines diagnosis, staging, treatment including surgery and adjuvant therapy, and follow up. Outcomes of interest include fertility preservations and improved quality of life through hormonal replacement therapy during follow up.
This clinical practice guideline provides recommendations on the use of colony-stimulating factors (CSFs) in adults or children with a solid tumour or lymphoma who are being treated with chemotherapy. The guideline reviews indications for use of CSFs as primary or secondary prophylaxis, as well as initiation, duration, dosing, and administration. Other topics covered include the use of CSFs to increase chemotherapy dose density, and the role of CSFs as: adjuncts to progenitor-cell transplantation; in the setting of acute leukemia or myelodysplastic syndromes; and in the treatment of radiation injury. Outcomes of interest include neutropenia- and infection-related outcomes, survival (progression-free and overall survival), and outcomes related to stem-cell mobilization or transplantation.
A clinical practice guideline for adult patients with renal cancer. The guideline examines treatment through surgery and ablative therapy, diagnosis, and follow-up. Outcomes of interest include improved prediction of cancer-specific survival through Karakiewicz nomograms and improved evidence for microwave ablation.
This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing.
This is a clinical practice guideline for patients (children/adolescents and adults) who are experiencing cancer-related fatigue. The guideline discusses evaluation and intervention for patients on active treatment, post-treatment, and at end of life. Education and counselling, nonpharmacologic interventions, and pharmacologic interventions are all discussed along with general strategies for management of fatigue.
This clinical practice guideline reviews diagnosis and management of adenocarcinomas of the exocrine pancreas. Risk factors and genetic predisposition are discussed, and the guideline provides recommendations on screening, diagnosis and staging, and treatment options including systemic therapy, chemoradiation, and surgical management. Palliative and supportive care are also reviewed. Topics of interest include an overview of biomarkers, and suggestions for management of premalignant tumours of the pancreas.
This clinical practice guideline provides recommendations for evaluation, workup, management, and follow-up of 2 pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Diagnostic tests are recommended based on disease location and patient gender. Treatment options for disseminated or localized disease for adenocarcinoma and site-specific SCC are also discussed.
This is a clinical practice guideline for multiple myeloma. The guideline addresses diagnosis, treatment, and follow-up for patients with multiple myeloma. It offers specific recommendations for primary therapy, surveillance and follow-up tests for solitary plasmacytoma, smoldering (asymptomatic) myeloma, active (symptomatic) multiple myeloma, as well as for transplant and non-transplant candidates.
This is a clinical practice guideline for patients with colon cancer or adenocarcinomas of the small bowel and appendix. The guideline reviews staging, pathology, clinical presentation and treatment of nonmetastatic disease, management of metastatic disease, post-treatment surveillance, and survivorship. The role of vitamin D in colorectal cancer is also discussed.
This is a clinical practice guideline for women with endometrial cancer, including uterine carcinosarcoma. The guideline provides recommendations on lynch syndrome screening, surgery, adjuvant treatment for completely surgically staged endometrioid carcinoma, and adjuvant treatment for surgically staged high risk histotypes including endometrial serous, clear cell, dedifferentiated/undifferentiated carcinomas and carcinosarcomas. The guideline also reviews therapy for relapsed patients, and follow-up and surveillance of women without evidence of disease after primary potentially curative treatment for any stage of endometrial cancer.
An organizational guideline for the processing and administration of chemotherapy to cancer patients. This guideline is an update to the 2013 guideline of the same title. The guideline examines the different stages and stakeholders in the chemotherapy treatment process, and the roles and responsibilities therein. Important aspects include accountability checks and staff safety procedures.
This clinical practice guideline is for patients diagnosed with or suspected of having melanoma. The guideline provides recommendations on diagnostic assessment, staging, and management. Follow-up care is also discussed, including topics such as management of suboptimal Vitamin D levels and concurrent drug therapies. Outcomes of interest include survival (overall, disease free, melanoma specific), and adverse events (acute toxicity, wound/sensory complications).
This clinical practice guideline provides recommendations on management of prostate cancer, including diagnosis and screening, management stratified by risk, and follow up care. Active surveillance, surgery (radical prostatectomy), external beam radiotherapy (EBRT), low dose rate (LDR) brachytherapy, cryosurgery, High Intensity Focused Ultrasound (HIFU), Androgen Deprivation Therapy (ADT), and systemic therapies are discussed as treatment options. Bone health is also reviewed. Outcomes of interest include survival and recurrence.
This is a guideline for management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem cell transplantation. The guideline reviews patient evaluation and provides recommendations on initial management, with considerations made to patient condition and whether or not they are already receiving empiric antibiotics. Recommendations are also provided for continued management of inpatients, management based on culture results, and management of fever in hematology/oncology patients who have completed therapy or are on therapy but are not neutropenic.
This is a clinical practice guideline fore patients who have been diagnosed with or are at risk of developing non-small cell lung cancer (NSCLC). The guideline provides recommendations on disease prevention and screening, including risk factors, the role of smoking cessation, and screening programs for early diagnosis. Recommendations regarding clinical presentation are also presented, with specific topics such as imaging studies, and surgical risk, including cardiological risk and the evaluation of respiratory function. The guideline also provides guidance on follow-up, when appropriate.
This is a clinical practice guideline for endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for early gastric cancer. The guideline provides recommendations for preoperative diagnosis, evaluation of curability, management of complications, long-term postoperative surveillance, and histological assessment. The management of perforation is also specifically discussed.
This is a clinical practice guideline for patients with differentiated thyroid cancer (DTC). The guideline examines the use of external-beam radiotherapy for locoregional control in patients with gross residual or unresectable disease, and as adjuvant therapy in select patients after complete resection of gross disease. Older patients with high likelihood of microscopic residual disease and low likelihood of responding to radioactive iodine (RAI) are explored in detail. Surgical and RAI considerations regarding locally invasive disease are also discussed.
This is a clinical practice guideline for patients with biliary tract cancers, including gallbladder cancer, intrahepatic and extrahepatic cholangiocarcinoma, and cancer of the duodenal papilla. The guideline examines the diagnosis, staging, and treatment of these patients. Tests discussed for the diagnosis and staging include endoscopic retrograde cholangiopancreatography (ERCP), upper GI endoscopy (UGIE), endoscopic ultrasound (EUS), cholangioscopy, and laparoscopy. Surgical options are stratified by disease type, and both adjuvant treatment and systemic treatment for metastatic cancer of the biliary tract are also discussed.
A clinical practice guideline for the treatment of actinic keratosis and cheilitis as precursors to invasive squamous cell carcinomas. The guideline examines treatment options including surgical and topical removal, and considers the use of combined modalities. There is also specific information for the monitoring and treatment of long-term immunosuppressed patients. Outcomes of interest include improved cosmetic results through the use of topical methods. This guideline is Chapter 3 of 5 of the Non-melanoma Skin Cancer in Canada guideline series.
This is an update to the 2013 clinical practice guideline for the management of multiple myeloma in adult patients. The guideline examines diagnosis and treatment for multiple myeloma, monoclonal gammopathy, smoldering myeloma, and amyloidosis, including prognostic criteria. Outcomes of interest include improved survival outcomes through triple drug based induction regimens and improved dose reduction options for elderly patients.
This is a clinical practice guideline addressing lymphoma in the adult population. The guideline focuses on the following areas: Diagnosis and Pathologic Classification, Staging, Treatment of Non-Hodgkin Lymphomas, Hodgkin Lymphoma, HDCT and hematopoietic stem cell transplantation for lymphoma, supportive care in the treatment of lymphoma, and follow-up care in the treatment of lymphoma. Additionally, it seeks to provide recommendations to the following questions: what are the diagnostic criteria for the most common lymphomas; what are the staging and re-staging procedures for Hodgkin and non-Hodgkin lymphomas; what are the recommended treatment and management options for Hodgkin and non-Hodgkin lymphomas; and what are the recommended follow-up procedures for patients with malignant Hodgkin and non-Hodgkin lymphoma.
A clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment, primarily though palliative chemotherapy regimens. Outcomes of interest include delayed disease progression through monoclonal antibodies and improved treatment planning through the identification of RAS testing.
This is a clinical practice guideline for female patients with metastatic breast cancer. The guideline examines whether biomarkers should be used to guide decisions on systemic therapy. Topics of interest include the clinical utility of sampling metastatic tumours to test for changes from the primary tumour with respect to endocrine receptor (ER/PR) or HER2 status, and whether additional clinical biomarkers beyond ER/PR/HER2 have shown clinical utility in initiating or directing clinical therapy, or guiding decisions on switching to a different regime or discontinuing treatment. Outcomes of interest include survival (overall, progression-free), quality of life, and cost effectiveness. The guideline examines whether changes to systemic therapy based on biomarker status improves health outcomes, quality of life and/or cost effectiveness. Specifically, the guideline reviews the testing of metastatic tumour for changes from primary tumour with respect to ER, PR, and HER2 status, whether there is evidence of additional tumour markers that have demonstrated clinical utility to initiate or direct selection of systemic therapy, or to switch or discontinue a specific drug regime.
This is a clinical practice guideline for patients with stage IV non-small-cell lung cancer. The guideline reviews systemic therapies as first-, second-, and third-line treatment options, with considerations made to patient performance status and tumour characteristics such as EGFR/ALK status. The guideline provides recommendations on therapy type and dosage as well as interval and duration. Topics of interest include treatment considerations for older adults (65 years or older) and a discussion on palliative care. Outcomes of interest include survival (overall, progression-free), and adverse events.
This is a guideline for the treatment and staging of small-cell lung cancer. The guideline examines treatment through chemotherapy, radiotherapy, and surgery with a focus on potential toxicity. Outcomes of interest include clarified duration of chemotherapy as a first-line treatment and increased use of PET scans for staging.
This clinical practice guideline discusses specific issues related to the management of cancer in adults aged 65 years or older. Topics include screening and comprehensive geriatric assessment (CGA), assessing risks and benefits of treatment, preventing or decreasing complications from therapy, and managing disease-specific issues. Recommendations are also provided for management of patients deemed to be at high risk for toxicity from standard treatment.
This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are also discussed.
This is a clinical practice guideline for adult patients with cancer-induced anemia, with an emphasis on patients with anemia who are receiving concomitant chemotherapy. The guideline reviews etiology and provides recommendations on screening, follow-up risk assessment, and management. Red blood cell transfusion, erythropoietic therapy (ESA), and iron monitoring and supplementation are reviewed as treatment options.
This is a clinical practice guideline for small cell lung cancer and lung neuroendocrine tumours. Diagnosis, staging, prognostic factors, treatment and surveillance are reviewed. Treatment options include chemotherapy, with special topics of discussion including elderly patients and second-line and third-line therapies, radiotherapy (thoracic radiotherapy, prophylactic cranial irradiation, and palliative radiotherapy), and surgery. Outcomes of interest include survival (disease free, overall, progression-free) and response rates, and treatment toxicity.
This is a clinical practice guideline for patients with epithelial ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Less common histopathologies including ovarian low malignant potential (LMP) tumour, malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumours [MMMTs] of the ovary), and malignant sex cord-stromal tumours, are also discussed. The guideline provides recommendations on diagnosis, treatment, follow-up, and relapse. Primary treatment options for ovarian cancer include surgery (risk-reducing or cytoreductive), chemotherapy (neoadjuvant and adjuvant), incomplete surgery and/or staging, anti-angiogenesis agents, and radiation therapy. The number of chemotherapy cycles and agents are reviewed, along with drug reactions.
This is a clinical practice guideline for dermatofibrosarcoma protuberans (DFSP). The NCCN Non-Melanoma Skin Cancer Panel has developed these guidelines outlining the treatment of DFSP to supplement their guidelines for basal cell and squamous cell skin cancers and merkel cell carcinoma. Topic areas discussed in this guideline as they relate to DFSP include: biopsy, surgery, chemotherapy, and radiotherapy.
This is a clinical practice guideline for Waldenström's Macroglobulinemia (WM) / Lymphoplasmacytic Lymphoma (LPL). The guideline provides recommendations for the diagnosis, work up, and treatment of WM / LPL. Topic areas discussed in the guideline include: primary treatment regimens (both regimens not toxic to stems cells as well as regimens with potential or unknown toxicity to stem cells), assessment of response to treatment, follow-up after primary treatment, treatment of IgM-related peripheral neuropathy, maintenance therapy, and management of patients who are intolerant to rituximab.
This is a clinical practice guideline for Hodgkin lymphoma. The guideline discusses the clinical management of patients with classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), focusing exclusively on patients from post adolescence through the seventh decade of life who do not have serious intercurrent disease. Areas considered and discussed within the guideline include: staging and prognosis, the role of PET scans, treatment, principles of radiation therapy, and follow-up after completion of treatment.
This is a clinical practice guideline for patients with colon cancer. The guideline reviews risk assessment, TNM staging, and pathology, and provides recommendations on the clinical presentation and treatment of nonmetastatic disease as well as recommendations on management of metastatic disease. Treatment for locally recurrent disease and survivorship are also discussed, as is the role of vitamin D in colorectal cancer.
This clinical practice guideline discusses evaluation, treatment (primary and secondary) options, and follow-up care for patients with bladder cancer. Specific workup and treatment recommendations are provided for non-muscle invasive disease, muscle invasive disease, upper genitourinary tract (GU) tumours, urothelial carcinomas of the prostate, primary carcinoma of the urethra. Non-urothelial carcinomas of the bladder are also discussed.
This clinical practice guideline provides recommendations for the diagnosis and treatment of acute myeloid leukemia (AML). Induction therapy and post-remission (consolidation) therapy are reviewed with recommendations stratified by risk and age. Specific recommendations are provided for the management of acute promyelocytic leukemia (APL). The guideline also discusses therapy for relapse, evaluation and treatment of CNS leukemia, and supportive care.
This is a clinical practice guideline for adults age 18 years and older who are suspected of having or are newly diagnosed with bladder cancer or cancer of the urethra, or diagnosed with recurring bladder cancer or cancer of the urethra. The guideline provides recommendations on diagnosis, staging, and management of muscle-invasive, non-muscle invasive, locally advanced, and metastatic bladder cancers. Management of treatment side effects and follow-up care is also discussed. Outcomes of interest include survival (overall, disease-free), disease-related morbidity and mortality, treatment-related morbidity and mortality, psychological well-being, quality of life, admissions to hospital after diagnosis, adverse events, and cost-effectiveness.
This is a clinical practice guideline for the investigation and management of pulmonary nodules. The guideline highlights new research evidence which has led to significant changes in recommendations for the management of pulmonary nodules. The guideline provides clarity in the use of imaging as well as clarity about the place of biopsy in the investigation and management of pulmonary nodules.
This is a clinical practice guideline for the management of patients with tumour lysis syndrome (TLS). The guideline provides recommendations for the management of TLS in both adults and children with haematological malignancies. Topics of interest include: the use of uricosuric drugs for the prevention and management of clinical TLS; management of hyperuricaemia; and the use of prophylaxis.
This is a clinical practice guideline for the prevention and management of venous thromboembolism (VTE) in patients with cancer. The guideline also provides guidance on an approach to screening for cancer in patients with unprovoked VTE in whom cancer was not initially suspected based on clinical grounds. The guideline probes the association between cancer and thrombosis, with areas of interest including the prevention of catheter-related thrombosis, treatment of symptomatic cancer-associated VTE, and screening for cancer in patients with apparently unprovoked VTE.
This is a clinical practice guideline for patients with early rectal cancer. The guideline provides recommendations on diagnosis, staging, and treatment. Local excision, rectal resection, and total mesorectal excision are discussed as surgical options, and laparoscopic and open approaches to abdominal surgery are compared. The use of neoadjuvant (chemo) radiation therapy is also discussed. Outcomes of interest include diagnostic accuracy, sensitivity, and specificity of diagnostic and staging procedures, local recurrence, survival (5-year, overall, disease free), distant metastases rate, morbidity, and quality of life.
This clinical practice guideline provides recommendations on the diagnosis and treatment of rectal cancer in adult patients. Imaging procedures for staging are discussed with comparisons made between ultrasound, MRI, and CT scan. Treatment options include neoadjuvant and adjuvant chemotherapy as well as rectal cancer surgery, specifically total mesorectal excision (TME). Surgical management of recurrent rectal adenocarcinoma is also discussed.
This is a clinical practice guideline on the management and admission to intensive care of critically ill adult patients with hematological malignancy. This guideline is intended to be of use to hematologists and intensivists practicing in the UK, and outlines some of the major considerations in the management of the critically ill patient with hematological malignancy.
A clinical practice guideline for the pathological diagnosis of breast cancer in adults. The guideline examines diagnostic procedures based on routine clinical practice and treatment modalities. Outcomes of interest include diagnostic accuracy, concordance rates, and margin negativity.
This is a clinical practice guideline for patients with, or suspected of having, primary urethral carcinoma. The guideline reviews diagnostic assessment, staging, and treatment. Treatment options include penile-preserving and urethral-sparing surgery, urethrectomy, radiotherapy, cisplatinum-based chemotherapy, chemoradiotherapy, transurethral resection (TUR), Bacille-Calmette-Guérin (BCG), and cystoprostatectomy with extended pelvic lymphadenectomy. Outcomes of interest include survival, sensitivity of diagnostic tests, local cure rate, local recurrence rate, and local tumour control rate.
This clinical practice guideline provides recommendations on use of systemic treatment in the care of advanced, stage IIIB/IV patients who have non-small cell lung cancer (NSCLC) that has not progressed (i.e., complete response, partial response or stable disease) following four to six cycles of platinum-based chemotherapy and who have maintained an Eastern Cooperative Oncology Group performance status of 0 to 2. The guideline discusses use of pemetrexed, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), and use of maintenance chemotherapies, namely docetaxel and gemcitabine. Overall survival and quality of life were critical outcomes for the development of recommendations within this guideline.
This clinical practice guideline provides recommendations on prevention, diagnosis, and treatment of hepatocellular carcinoma. Treatment options are discussed including surgical resection, transplantation, local ablation, transarterial chemoembolization, external-beam radiation therapy, systemic therapies, preemptive antiviral therapy, and drug treatment for cancer pain. Assessment of tumour response and post-treatment follow-up are also reviewed.
A clinical practice guideline for the use of plerixafor for autologous hematopoietic stem cell mobilization and transplantation in patients with hematologic cancers. The guideline examines administration with granulocyte-colony stimulating factor in patients who have or have not been mobilized before. Outcomes of interest include successful apheresis harvest, number of CD34+ cells collected, and survival rate.
A clinical practice guideline for the management of patients with non-small cell lung cancer. The guideline examines screening for at-risk populations, diagnostic work-up, treatment, and follow-up. Outcomes of interest include clarified current standard of care through lobectomy and mediastina lymph node dissection, with additional treatment selections based on patient population.
A clinical practice guideline for the surveillance of patients following treatment for uveal melanoma and the use of new and systemic treatments. The guideline examines the effectiveness of new surveillance technologies, staging, and treatment including special consideration for patients with hepatic recurrence. Outcomes of interest include local tumour control, preservation of eye function, and progression free survival.
A clinical practice guideline for patients with non-muscle invasive bladder cancer. The guideline examines management, emphasizing intravesical therapy and prognostic factors. Outcomes of interest include lower recurrence and longer disease-free intervals with transurethral resection of bladder tumours.
This clinical practice guideline is for the treatment of patients with stage II and III colon cancer who have undergone complete resection with curative intent. The guideline examines the impact of different adjuvant chemotherapy regimens. Outcomes of interest include overall survival, disease-free survival, adverse events, and quality of life.
This is a clinical practice guideline for women with the noninvasive breast cancer known as ductal carcinoma in situ (DCIS; intraductal carcinoma). The guideline examines the management options for DCIS, which commonly involves excision, radiotherapy, and hormonal therapy. Outcomes of interest include improvements in relapse-free survival and overall survival.
This is a clinical practice guideline for women with stage 1 and 2 breast cancer. The guideline discusses conservative surgery and radiation therapy, while specifically examining the National Institutes of Health (NIH) Consensus Conference statement, results of prospective randomized clinical trials, patient selection and evaluation, radiation therapy (RT) following conservative surgery, treatment techniques, the role of accelerated partial-breast irradiation (PBI), the integration of radiation and adjuvant systemic therapy, and follow-up care. The guideline discusses the appropriateness of different techniques for four unique clinical situations.
A clinical practice guideline for patients with any type of cancer. The guideline examines the benefits of smoking cessation, and education for quitting once a patient has been diagnosed with cancer. Outcomes of interest include quality of life and treatment-related toxicity.
This is a clinical practice guideline for patients with thyroid cancer. The guideline examines the post-surgical ablation of thyroid remnant with radioactive iodine (RAI) in these patients. Preparation for RAI ablation, diagnostic RAI scanning before ablation, post-operative serum thyroglobulin (Tg) levels and neck ultrasound (US), and post-therapy whole-body scan (WBS) after remnant ablation are discussed.
This is a clinical practice guideline for patients with epidermolysis bullosa. The guideline provides recommendations for the diagnosis, staging, and management of cutaneous squamous cell carcinoma (SCC) in these patients. Specific topics discussed include surveillance and diagnosis, tumour evaluation and staging, surgical treatment, nonsurgical treatment, the use of prosthetics, and end-of-life care.
This is a clinical practice guideline for patients with soft tissue sarcoma (STS). The guideline examines the diagnosis and treatment of these patients. Diagnostic techniques discussed include local staging, distant staging, biopsy, and pathology and molecular pathology. Treatment methods discussed include surgery, radiotherapy, adjuvant chemotherapy, neoadjuvant chemotherapy, isolated limb perfusion, as well as chemotherapy and targeted agents. Therapeutic considerations for specific STS subtypes are also examined.
This is a clinical practice guideline for children receiving chemotherapy or undergoing hematopoietic stem call transplantation (HSCT) for cancer. The guideline examines the effectiveness of prophylactic interventions for preventing or reducing the severity of oral and oropharyngeal mucositis in these patients. Interventions considered include cryotherapy, low-level light therapy and the use of keratinocyte growth factor (KGF).
This is a clinical practice guideline for patients with resectable gastric cancer. The guideline discusses treatment options such as chemotherapy, radiation therapy, and combined modality treatments such as definitive chemoradiotherapy, preoperative chemoradiotherapy, and postoperative chemoradiotherapy. The guideline also provides an overview of radiation therapy techniques.
This is a clinical practice guideline for cancer patients with non-spine bone metastases. The guideline examines treatment options for these patients, which include radiotherapy, systemic therapies, and surgical stabilization, and the appropriateness of different techniques is examined for different clinical situations. Outcomes of interest include reductions in pain, and improved palliative care.
This is a clinical practice guideline for the use of endoscopic approaches in the evaluation and treatment of ampullary adenomas. The guideline discusses evaluation of ampullary lesions before endoscopic therapy, the role of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) in assessment, and endoscopic resection. The role of EUS in management of duodenal adenomas is also examined. Adverse events and post-procedural care and surveillance are also addressed.
A clinical practice guideline for adult patients with newly diagnosed low grade gliomas. The guideline examines the role of chemotherapy as adjuvant therapy of choice in treatment, tumour markets to predict benefit, optimal treatment timing and chemotherapy agents, and additional adjuvant therapies. Outcomes of interest include overall survival and progression free survival.
This is a clinical practice guideline for adults with newly diagnosed diffuse low grade glioma (LGG). Recommendations are drawn from the following three questions: what is the optimal role of external beam radiotherapy in the management of adult patients with newly diagnosed low-grade glioma (LGG) in terms of improving outcome (i.e. survival, complications, seizure control or other reported outcomes of interest); which radiation strategies (dose, timing, fractionation, stereotactic radiation, brachytherapy, chemotherapy) improve outcomes compared to standard external beam radiation therapy in the initial management of low grade gliomas in adults; and Do specific factors (e.g. age, volume, extent of resection, genetic subtype) identify subgroups with better outcomes following radiation therapy than the general population of adults with newly diagnosed low-grade gliomas. In addition to providing recommendations in response to these questions, the guideline also provides a discussion about key issues for future investigation. These issues include the development of novel molecular or genetic markers in low-grade gliomas, and utilizing imaging alternatives to standard MRI to assess tumor response.
This is a clinical practice guideline for patients with diffuse low grade glioma (LGG). More specifically, these guideline recommendations apply to adults with imaging suggestive of a WHO grade 2 glioma (oligodendroglioma, astrocytoma, or oligo-astrocytoma). The central issue addressed in this guideline pertains to whether patients with imaging suggestive of LGG should undergo observation versus treatment involving a surgical procedure.
This is a clinical practice guideline on muscle-invasive and metastatic bladder cancer. This is an update to the European Association of Urology's 2000 guidelines on bladder cancer and provides recommendations related to staging, diagnostic evaluation, management, and follow-up. Issues addressed include: imaging, surgery, chemotherapy, radiotherapy, and recurrence.
A clinical practice guideline for laparoscopic liver resection. The guideline examines best practices for major and minor resections, including approaches, surgical safety, and potential adverse events. Outcomes of interest include operative mortality, postoperative complications, length of stay, and overall survival.
A clinical practice guideline for treatment of uterine cervical cancer. The guideline examines updated evidence on primary treatments, treatment for recurrent cancers, and additional presentations, focusing primarily of lymphadenectomy and hysterectomy. Outcomes of interest include recurrence and fertility preservation.
This is a clinical practice guideline for patients with upper tract urothelial carcinoma (UTUC). The guideline provides recommendations on diagnosis and treatment, with discussions on surgery, radiotherapy, chemotherapy and other anticancer drug therapies. Topics include surgical techniques, the use of neoadjuvant versus adjuvant chemotherapy, postoperative follow-up care, the use of ureteroscopic kidney-sparing surgery, instillation of BCG or other anticancer drugs into the upper urinary tract, treatment of metastatic or recurrent UTUC, and use of radiotherapy alone as treatment. Epidemiology is also discussed.
This is a clinical practice guideline for hematopoietic stem cell transplantation for multiple myeloma. In acknowledging the fact that therapeutic strategies for multiple myeloma have changed significantly over the past decade, the guideline developers provide recommendations on the role of hematopoietic stem cell transplantation (HCT), including how to incorporate HCT and when HCT is indicated.
This is a clinical practice guideline for adult patients with cancer who are receiving chemotherapy and experiencing fever, including patients with a solid tumour, lymphoma/myeloma/chronic lymphocytic leukemia, living at home, and/or with an unknown neutrophil count. This excludes hospital inpatients, patients in the emergency department, patients already diagnosed with febrile neutropenia, or with hematopoietic stem cell transplantation, acute leukemia, or myelodysplastic syndrome. The guideline provides recommendations on assessment of fever and provision of patient education. The guideline focuses on unfavourable outcomes including febrile neutropenia, infection, and death.
This is a clinical practice guideline for the treatment of unknown primary head and neck cancer. An unknown or 'occult' primary is one where a primary tumour cannot be identified after appropriate investigation, in a patient with no prior history of head and neck cancer. The guideline provides recommendations on the initial workup of all patients with a neck mass, as well as recommendations for staging, management, and cases of recurrent disease.
A clinical practice guideline for patients with solid and hematological malignancies undergoing antineoplastic treatment. The guideline examines risk-adapted approaches to viral infections, including reactivated viruses and seasonal viruses. Outcomes of interest include secondary complications, including bacterial pneumonia, and increased risk of contracting infections.
A clinical practice guideline for adult and pediatric patients with Hodgkin's lymphoma. The guideline examines the use of autologous stem cell transplant and allogeneic HCT and their appropriateness for patient populations depending on staging. Outcomes of interest include progression-free survival and the use of risk-adapted therapy to improve outcomes.
This is a clinical practice guideline for patients undergoing gynecologic/oncology surgery. The guideline examines supporting pre- and intra-operative management of surgery, including counselling, pre-operative bowel preparations, and the importance of minimally invasive surgery. Outcomes of interest include improving surgical outcomes with readmission optimization and reducing length of hospital stay. This guideline is part 1 of 2 in the Enhanced Recovery After Surgery (ERAS®) Society Recommendations guidelines.
This clinical practice guideline provides recommendations on management of early-stage Hodgkin lymphoma. Chemotherapy alone, radiation therapy alone, and chemoradiation therapy are all reviewed as potential treatment options and provides recommendations on strategy, optimum radiation doses and schedule, and chemotherapy regimes. Outcomes of interest include overall survival, other measures of disease control (e.g. event-free survival or failure-free survival), and long-term adverse events, among others.
This is a clinical practice guideline for patients with castration-resistant prostate cancer (CRPC). The guideline provides recommendations on different patient types, with consideration to whether patient is symptomatic/asymptomatic, if cancer is metastatic, poor vs good performance status, and whether or not patient has previously received docetaxel chemotherapy. Outcomes of interest include survival (overall survival, progression-free, metastasis-free) PSA PFS, PSA decline, measurable disease response, adverse events/side-effects of treatment, quality of life (QOL), skeletal-related events (SREs), pain-free survival, and pain response.
