LAUSR

The Institute Salah Azaiez has been the Public AntiCancer Center in Tunisia since March 20, 1969. It has thus offered over 50 years of cancer care to our population. The center comprises 10 departments: Surgical Oncology, otorhinolaryngology, Medical Oncology, Radiation Oncology, Nuclear Medicine, Histology, Immunohistocytology, Diagnostic Radiology, Biology, and Epidemiology. Like every anticancer center, the decisionmaking process is made in a multidisciplinary meeting, known in our institution as a committee. One of those committees is dedicated to gynecologic malignancy. It is known as “Committee 06” and has been working since March 1969 (Figure 1) to help improve care. Since that date Committee 06 through its leading members has been a cornerstone in the field of gynecologic malignancies, with multiple roles in establishing and promoting standard of care. As part of its role promoting the best standard of care for Tunisian patients, Committee 06 members have produced the first countryspecific guidelines (Figure 2) for gynecologic cancers based on the international state of the art. As a team we have worked to adapt these international standards to our reality. This has helped in terms of recognizing and addressing our limitations and focusing on what we need to do to maintain our health system at a viable, highquality level. Since 2011 and the Arab Spring, approximately 4000 women per year have had surgery for various tumor types. Each year approximately 60 women had access to radical hysterectomies for cervical cancer. One hundred others had hysterectomies mainly for endometrial cancer and also earlystage cervical cancers. More than 60% of women diagnosed with ovarian cancer underwent optimal to complete cytoreductive surgery. Since 1969, a mean of 20 cases has been discussed per committee meeting. In addition to its role in decisionmaking, the committee through its members has worked to improve and homogenize women’s health care. Committee 06 members have been collecting and analyzing data from these patients, and comparing it to the existing international data. The aim has been to offer the best care possible for our patients. Despite being mostly retrospective, this data has been a vital tool in developing our standard of care. In 2018, Committee 06 started an early feasibility study to evaluate the safety and efficacy of dual tracer sentinel lymph nodes in stage I endometrial cancer. For Tunisan health care to keep pace with the standards of more developed countries in terms of endometrial Figure 1 The O6 Committee meeting.