肝细胞癌管理的临床实践指南:系统性审查
Ishith Seth1,2,3,4,5, Adrian Siu6,7,8, Lyndel Hewitt6,9,7
1Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW, 2500, Australia. ishithseth1@gmail.com.
这次审查发现,肝细胞癌 (HCC) 管理的国际临床实践指南是高质量和全面的. 它们强调风险因素评估,分期和多学科护理,为澳大利亚指南提供了坚实的基础.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 基于证据的医学 基于证据的医学
背景情况:
- 肝细胞癌 (HCC) 是全球癌症死亡的主要原因.
- 澳大利亚缺乏针对HCC的特定临床实践指南 (CPG),阻碍了有效的患者管理.
- 本审查评估了国际CPG,以在澳大利亚提供潜在的指导.
研究的目的:
- 系统地审查有关HCC管理准则的现有证据.
- 评估国际CPG的适用性,以告知澳大利亚医疗保健专业人员.
- 确定制定国家HCC指南的关键组成部分.
主要方法:
- 从2005年到2022年,对主要数据库 (MEDLINE,Embase,Cochrane,Google Scholar,PubMed) 进行系统搜索.
- 包括经过同行评审的文章,详细介绍基于证据的HCC管理计划或CPG.
- 使用研究和评估指南评估II (AGREE II) 工具评估所包含的CPG的质量评估.
主要成果:
- 包括21个国际CPG,所有推风险因素评估 (肝硬化,乙型肝炎/C型肝炎,肥胖,NAFLD).
- 67%的人支持BCLC分期系统; 86%的人建议采用多学科方法,每6个月对肝硬化患者进行一次超声波监测.
- AGREE II的平均得分为90%,表明高质量和强烈的建议跨领域.
结论:
- 国际CPG为HCC管理提供了一个全面的框架,重点关注风险因素,分期和多学科护理.
- 需要注意的是,在肝硬化患者中定期进行超声波监测的广泛建议.
- 了解这些准则可以帮助澳大利亚制定标准化,基于证据的全国HCC护理准则.
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