ヤマシタ　シンゴ   YAMASHITA Shingo   山下　信吾    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国外
巻・号・頁	28(1),pp.1-25
著者・共著者	Yamamoto Masakazu, Yoshida Masahiro, Furuse Junji, Sano Keiji, Ohtsuka Masayuki, Yamashita Shingo, Beppu Toru, Iwashita Yukio, Wada Keita, Nakajima Takako Eguchi, Sakamoto Katsunori, Hayano Koichi, Mori Yasuhisa, Asai Koji, Matsuyama Ryusei, Hirashita Teijiro, Hibi Taizo, Sakai Nozomu, Tabata Tsutomu, Kawakami Hisato, Takeda Hiroyuki, Mizukami Takuro, Ozaka Masato, Ueno Makoto, Naito Yoichi, Okano Naohiro, Ueno Takayuki, Hijioka Susumu, Shikata Satoru, Ukai Tomohiko, Strasberg Steven, Sarr Michael G, Jagannath Palepu, Hwang Tsann-Long, Han Ho-Seong, Yoon Yoo-Seok, Wang Hee Jung, Luo Shao-Ciao, Adam René, Gimenez Mariano, Scatton Olivier, Oh Do-Youn, Takada Tadahiro
発行年月	2021/01
概要	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.
DOI	10.1002/jhbp.868
PMID	33200538