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Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Authors :
H. Takeda
Tomohiko Ukai
Masakazu Yamamoto
Makoto Ueno
Steven M. Strasberg
René Adam
Mariano E Giménez
Takuro Mizukami
Naohiro Okano
Palepu Jagannath
Ho-Seong Han
Katsunori Sakamoto
Masato Ozaka
Takayuki Ueno
Susumu Hijioka
Koji Asai
Yoo Seok Yoon
Keita Wada
Keiji Sano
Toru Beppu
Satoru Shikata
Takako Eguchi Nakajima
Tsutomu Tabata
Shingo Yamashita
Do Youn Oh
Yoichi Naito
Tadahiro Takada
Taizo Hibi
Junji Furuse
Masayuki Ohtsuka
Koichi Hayano
Tsann Long Hwang
Hee-Jung Wang
Masahiro Yoshida
Teijiro Hirashita
Nozomu Sakai
Shao Ciao Luo
Hisato Kawakami
Yukio Iwashita
Ryusei Matsuyama
Michael G. Sarr
Olivier Scatton
Yasuhisa Mori
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.

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