Masato Nagino1, Satoshi Hirano2, Hideyuki Yoshitomi3, Taku Aoki4, Katsuhiko Uesaka5, Michiaki Unno6, Tomoki Ebata7, Masaru Konishi8, Keiji Sano9, Kazuaki Shimada10, Hiroaki Shimizu11, Ryota Higuchi12, Toshifumi Wakai13, Hiroyuki Isayama14, Takuji Okusaka15, Toshio Tsuyuguchi16, Yoshiki Hirooka17, Junji Furuse18, Hiroyuki Maguchi19, Kojiro Suzuki20, Hideya Yamazaki21, Hiroshi Kijima22, Akio Yanagisawa23, Masahiro Yoshida24, Yukihiro Yokoyama7, Takashi Mizuno7, Itaru Endo25. 1. Aichi Cancer Center, Nagoya, Japan. 2. Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan. 3. Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Japan. 4. Second Department of Surgery, Dokkyo Medical University, Mibu, Japan. 5. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan. 6. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 7. Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 8. Department of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 9. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. 10. Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan. 11. Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan. 12. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 13. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 14. Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan. 15. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan. 16. Department of Gastroenterology, Chiba Prefectural Sawara Hospital, Sawara, Japan. 17. Department of Gastroenterology and Gastroenterological Oncology, Fujita Health University, Toyoake, Japan. 18. Department of Medical Oncology, Faculty of Medicine, Kyorin University, Mitaka, Japan. 19. Education and Research Center, Teine-Keijinkai Hospital, Sapporo, Japan. 20. Department of Radiology, Aichi Medical University, Nagakute, Japan. 21. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. 22. Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. 23. Department of Pathology, Japanese Red Cross Kyoto Diichi Hospital, Kyoto, Japan. 24. Department of Hepato-Biliary-Pancreatic & Gastrointestinal Surgery, International University of Health and Welfare, Ichikawa, Japan. 25. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Abstract
BACKGROUND: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. METHODS: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. CONCLUSIONS: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.
BACKGROUND: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. METHODS: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. CONCLUSIONS: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.
Authors: Alessandro Rizzo; Angela Dalia Ricci; Antonio Cusmai; Silvana Acquafredda; Giuseppe De Palma; Giovanni Brandi; Gennaro Palmiotti Journal: Curr Oncol Date: 2022-01-27 Impact factor: 3.677