Article type
Abstract
Background: Hepatocellular carcinoma (HCC), commonly treated in early stages with radiofrequency ablation (RFA) or surgical resection, has varied treatment guidelines. This study aims to evaluate the methodological quality and evidence strength of these guidelines, focusing on RFA and surgical resection.
Method: Following PRISMA 2020 statements, 2017–2022 guidelines and consensus documents from major liver societies in Asia Pacific and Europe were reviewed. The AGREE-II framework assessed the quality, and a thorough analysis of the references supporting each guideline's recommendation was performed. The study is registered with PROSPERO (CRD42022342266).
Results: Sixteen guidelines and consensus documents were analyzed. All showed high quality, with the 2021 ASCO Guidelines receiving the top AGREE-II score. A notable gap identified was low stakeholder involvement in guideline development. Among these, 20 recommendations were identified, comparing RFA and surgical resection, with varying levels of evidence favoring each approach.
Conclusion: The study reveals inconsistencies in guidelines for early-stage HCC treatment and emphasizes the need for extensive randomized controlled trials to optimize strategies. It also underlines the importance of stakeholder participation in the development of guidelines to enhance their robustness and patient-centeredness, aiming to provide comprehensive and inclusive recommendations for early-stage HCC treatment.
Method: Following PRISMA 2020 statements, 2017–2022 guidelines and consensus documents from major liver societies in Asia Pacific and Europe were reviewed. The AGREE-II framework assessed the quality, and a thorough analysis of the references supporting each guideline's recommendation was performed. The study is registered with PROSPERO (CRD42022342266).
Results: Sixteen guidelines and consensus documents were analyzed. All showed high quality, with the 2021 ASCO Guidelines receiving the top AGREE-II score. A notable gap identified was low stakeholder involvement in guideline development. Among these, 20 recommendations were identified, comparing RFA and surgical resection, with varying levels of evidence favoring each approach.
Conclusion: The study reveals inconsistencies in guidelines for early-stage HCC treatment and emphasizes the need for extensive randomized controlled trials to optimize strategies. It also underlines the importance of stakeholder participation in the development of guidelines to enhance their robustness and patient-centeredness, aiming to provide comprehensive and inclusive recommendations for early-stage HCC treatment.