scholarly journals Synopsis of a clinical practice guideline for pancreatic ductal adenocarcinoma with peritoneal dissemination in Japan; Japan Peritoneal Malignancy Study Group.

2021 ◽  
Author(s):  
Sohei Satoi ◽  
Naminatsu Takahara ◽  
Tsutomu Fujii ◽  
Hiroyuki Isayama ◽  
Suguru Yamada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Peritoneal Dissemination ◽  
Ductal Adenocarcinoma ◽  
Study Group ◽  
Peritoneal Malignancy

scholarly journals Clinical practice guideline for the treatment of malignant ascites: section summary in Clinical Practice Guideline for peritoneal dissemination (2021)

2021 ◽  
Author(s):  
Keisuke Matsusaki ◽  
Kuniaki Aridome ◽  
Shigenobu Emoto ◽  
Hiroaki Kajiyama ◽  
Nobumasa Takagaki ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Peritoneal Dissemination ◽  
Symptom Relief ◽  
Malignant Ascites ◽  
Future Perspective ◽  
Poor Performance Status ◽  
Dismal Prognosis ◽  
Clinical Questions

AbstractPatients with peritoneal dissemination (PD) caused by abdominal malignancies are often associated with massive ascites, which shows extremely dismal prognosis because of the discontinuation of systemic chemotherapy mostly due to poor performance status. Many treatment methods, such as simple drainage, peritoneovenous shunting (PVS) and cell-free and concentrated reinfusion therapy (CART), have been used for symptom relief. However, the clinical efficacies of these methods have not been fully investigated yet. Recently, we developed the Clinical Practice Guideline for PD caused by various malignancies according to "Minds Clinical Practice Guideline Development Guide 2017". In this guideline, we systematically reviewed information on clinical diagnosis and treatments for PD using PubMed databases (2000 – 2020), and clarified the degree of recommendation for clinical questions (CQ). The evidence level was divided into groups by study design and quality. The literature level and a body of evidence were evaluated in reference to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Based on the results of systematic review, the strength of the recommendations was evaluated at a consensus meeting of the Guideline Committee. This is the English synopsis of the part of treatment of malignant ascites in Clinical Practice Guideline for PD, 2021 in Japanese. The guidelines summarize the general aspect of the treatment of malignant ascites and statements with recommendation strengths, evidence levels, agreement rates and future perspective for four raised clinical questions.

Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

2017 ◽  
Vol 35 (20) ◽  
pp. 2324-2328 ◽  
Author(s):  
Alok A. Khorana ◽  
Pamela B. Mangu ◽  
Jordan Berlin ◽  
Anitra Engebretson ◽  
Theodore S. Hong ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Practice ◽  
Clinical Oncology ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Complete Recovery ◽  
Phase Iii ◽  
Ductal Adenocarcinoma ◽  
Open Label ◽  
American Society

Purpose To update the Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline published on May 31, 2016. The October 2016 update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumor? Methods The recently published results of a randomized phase III study prompted an update of this guideline. The high quality of the reported evidence and the potential for its clinical impact prompted the Expert Panel to revise one of the guideline recommendations. Results The ESPAC-4 study, a multicenter, international, open-label randomized controlled phase III trial of adjuvant combination chemotherapy compared gemcitabine and capecitabine with gemcitabine monotherapy in 730 evaluable patients with resected pancreatic ductal adenocarcinoma. Median overall survival was improved in the doublet arm to 28.0 months (95% CI, 23.5 to 31.5 months) versus 25.5 months (95% CI, 22.7 to 27.9 months) for gemcitabine alone (hazard ratio, 0.82; 95% CI, 0.68 to 0.98; P = .032). Grade 3 and 4 adverse events were similar in both arms, although higher rates of hand-foot syndrome and diarrhea occurred in patients randomly assigned to the doublet arm. Recommendations All patients with resected pancreatic cancer who did not receive preoperative therapy should be offered 6 months of adjuvant chemotherapy in the absence of medical or surgical contraindications. The doublet regimen of gemcitabine and capecitabine is preferred in the absence of concerns for toxicity or tolerance; alternatively, monotherapy with gemcitabine or fluorouracil plus folinic acid can be offered. Adjuvant treatment should be initiated within 8 weeks of surgical resection, assuming complete recovery. The remaining recommendations from the original 2016 ASCO guideline are unchanged.

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