| セッション情報 |
International Forum 2(Liver) 3.Practice Guideline
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| タイトル |
IF2-3-II (Keynote lecture) Evidence-based clinical practice guidelines for hepatocellular carcinoma in Japan: the J-HCC Guidelines
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| 演者 |
Norihiro Kokudo（Department of SurgeryHepato-Biliary-Pancreatic Surgery DivisionArtificial Organ and Transplantation DivisionUniversity of Tokyo^1） |
| 共同演者 |
Masatoshi Makuuchi（Japanese Red Cross Medical CenterTokyoJapan^2） |
| 抄録 |
The “Clinical practice guidelines for hepatocellular carcinoma （HCC）the first evidence-based guidelines for the treatment of HCC in Japan， were compiled by an expert panel supported by the Japanese Ministry of Health， Labour， and Welfare． English translation has been completed （http：//www.jsh.or.jp/） and its summary has just been published （Hetatol Res 38 ： 37-， 2008） ． This set of guidelines covers six research fields ： prevention， diagnosis ＆ surveillance， surgery， chemotherapy， transarterial chemoembolization， and percutaneous local ablation therapy． A systematic review of the English medical literature on HCC was performed， and a total of 7，192 publications were extracted， mainly from MEDLINE （1966-2002） ． Af- ter the second selection， 334 articles were adopted for the guidelines to form 58 pairs of research questions and recommendations． For the users’ convenience， practical algorithms for the surveillance and tireatment of HCC were also created which were based on evidence from the selected articles for the guidelines and modified according to the current status of medical practice in Japan， where liver resection for HCC is re- garded as safe with less than 1 % mortality ； cadaveric donors for liver transplantation are extremely diffi- cult to obtain ； many Japanese hepatologists personally perform ultrasonography， hepatic artery cathe- terization， or percutaneous local ablation therapies， and they are actively involved in the decision-making process for each HCC patient． The formation of the guidelines and the outline of their contents are de- scribed． In March 2006， approximately a year after publication of the J-HCC Guideline Book， a questionnaire sur- vey was conducted to investigate the level of awareness and influence of the guidelines among 2，279 mem- bers of the Liver Cancer Study Group of Japan． The J-HCC Guidelines were acknowledged by 71．9% of hepatologists， 75．6% of liver surgeons． After the introduction of the J-HCC Guidelines， only 19-21% of he- patologists or liver surgeons changed their practice pattern ； 50-52% did not change and were convinced that their choice of treatment was similar to the recommendations in the guidelines． The J-HCC Guide- lines have become well disseminated among both specialists and primary care physicians in Japan． As ex- pected， these guidelines have begun to be applied at every level of clinical decision-making for HCC． The first revision of the J-HCC Guidelines is now in process and it is scheduled to complete by March 2009． |
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