Back to Search
Start Over
Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021
- Source :
- Journal of Hepato-Biliary-Pancreatic Sciences. 28:1-25
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background Hepatectomy is standard treatment for colorectal liver metastases; however, it is unclear whether liver metastases from other primary cancers should be resected or not. The Japanese Society of Hepato-Biliary-Pancreatic Surgery therefore created clinical practice guidelines for the management of metastatic liver tumors. Methods Eight primary diseases were selected based on the number of hepatectomies performed for each malignancy per year. Clinical questions were structured in the population, intervention, comparison, and outcomes (PICO) format. Systematic reviews were performed, and the strength of recommendations and the level of quality of evidence for each clinical question were discussed and determined. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations. Results The eight primary sites were grouped into five categories based on suggested indications for hepatectomy and consensus of the guidelines committee. Fourteen clinical questions were devised, covering five topics: (1) diagnosis, (2) operative treatment, (3) ablation therapy, (4) the eight primary diseases, and (5) systemic therapies. The grade of recommendation was strong for one clinical question and weak for the other 13 clinical questions. The quality of the evidence was moderate for two questions, low for 10, and very low for two. A flowchart was made to summarize the outcomes of the guidelines for the indications of hepatectomy and systemic therapy. Conclusions These guidelines were developed to provide useful information based on evidence in the published literature for the clinical management of liver metastases, and they could be helpful for conducting future clinical trials to provide higher-quality evidence.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Population
030230 surgery
Malignancy
Systemic therapy
03 medical and health sciences
0302 clinical medicine
medicine
Hepatectomy
Humans
education
Grading (tumors)
education.field_of_study
Hepatology
business.industry
General surgery
Standard treatment
Liver Neoplasms
medicine.disease
Clinical trial
Systematic review
030220 oncology & carcinogenesis
Surgery
business
Subjects
Details
- ISSN :
- 18686982 and 18686974
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Hepato-Biliary-Pancreatic Sciences
- Accession number :
- edsair.doi.dedup.....94fc2d48b623e40c340c594271d02dae
- Full Text :
- https://doi.org/10.1002/jhbp.868