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Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022
In-Ho Kim1, Seung Joo Kang2, Wonyoung Choi3
1Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract:
Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area. Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version. Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.
Insights
The 5th edition of Korean Practice Guidelines for Gastric Cancer offers updated evidence-based recommendations for optimal patient care. This comprehensive update focuses on systemic treatments and incorporates recent research for gastric cancer management.
Area of Science:
- Oncology
- Clinical Practice Guidelines
- Evidence-Based Medicine
Background:
- Gastric cancer is a prevalent malignancy globally and in Korea.
- Regular updates to the Korean Practice Guidelines for Gastric Cancer ensure current clinical practice.
- The 4th edition (2022) involved multidisciplinary expert collaboration.
Purpose of the Study:
- To present the 5th edition of the Korean Practice Guidelines for Gastric Cancer.
- To incorporate significant advancements in systemic treatment and recent research findings.
- To provide clinicians with evidence-based recommendations for optimal gastric cancer patient care.
Main Methods:
- Development of 6 updated or proposed key questions (KQs).
- Systematic review of literature from MEDLINE, Embase, Cochrane Library, and KoreaMed.
- Recommendations categorized using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Main Results:
- 7 statements developed, revised, or discussed based on systematic reviews.
- Major updates focus on recent changes in systemic cancer treatments.
- Minor modifications in other sections reflect new research.
Conclusions:
- The guideline provides updated, multidisciplinary, and evidence-based recommendations.
- It supports clinicians in delivering optimal care for gastric cancer patients.
- The structure remains consistent with the 2022 version, enhancing usability.
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