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Clinical Practice Guidelines for Pancreatic Cancer 2016 From the Japan Pancreas Society: A Synopsis

Yamaguchi, Koji MD, PhD*; Okusaka, Takuji MD, PhD; Shimizu, Kyoko MD, PhD; Furuse, Junji MD, PhD§; Ito, Yoshinori MD; Hanada, Keiji MD, PhD; Shimosegawa, Tooru MD, PhD#; Okazaki, Kazuichi MD, PhD**

doi: 10.1097/MPA.0000000000000816
Original Articles
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Objectives Clinical Practice Guidelines for Pancreatic Cancer based on Evidence-Based Medicine 2006 were first published by the Japan Pancreas Society, and they were revised to Clinical Practice Guidelines for Pancreatic Cancer 2009 in July 2009 and were further revised to Clinical Practice Guidelines for Pancreatic Cancer 2013 in October 2013. These guidelines were established according to evidence-based medicine. In October 2016, the Clinical Practice Guidelines for Pancreatic Cancer were newly revised in Japanese.

Methods In the revised version, we introduced the concepts of GRADE - grading recommendations assessment, development, and evaluation approach for better understanding of the current guidelines.

Results The guidelines show algorithms for the diagnosis, treatment, and chemotherapy of pancreatic cancer and address 7 subjects: diagnosis, surgical therapy, adjuvant therapy, radiation therapy, chemotherapy, stent therapy, and palliative medicine. They include 51 clinical questions and 76 statements. There are statements corresponding to clinical questions, evidence levels, recommended strengths, and agreement rates.

Conclusions These guidelines represent the most standard clinical and practical management at this time in Japan. This is the English synopsis of the Clinical Practice Guidelines for Pancreatic Cancer 2016 in Japanese, which aims to disseminate the Japanese guidelines worldwide for the introduction of Japanese clinical management of these diseases.

From the *Clinic of Fukuoka Government Building, Hamanomachi Hospital, Fukuoka; †Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital; ‡Department of Gastroenterology, Tokyo Women's Medical University; §Department of Medical Oncology, Faculty of Medicine, Kyorin University; ∥Department of Radiation Oncology, National Cancer Center Hospital, Tokyo; ¶Department of Gastroenterology, JA Onomichi General Hospital, Onomichi; #Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai; and **Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Japan.

Received for publication September 10, 2016; accepted December 13, 2016.

Address correspondence to: Koji Yamaguchi, MD, PhD, Clinic of Fukuoka Government Building, Hamanomachi Hospital, 2-11-1 Hakataekihigashi, Hakataku, Fukuoka 812-0013, Japan (e-mail: yamaguch01@gmail.com).

The funding of the guidelines was supported mainly by the Japan Pancreas Society (President, T. Shimosegawa) and partially by Health and Labour Sciences Research Grant: “Research on dissemination effectiveness of cancer clinical practical guidelines from the perspective of the cancer registry: changes in clinical practice trends and treatment outcome,” 2013 (principle investigator, Professor K. Hirata, Sapporo Medical University) and “Research on the promotion of nation-wide spread of cancer clinical practical guidelines and on the ideal way of cancer clinical guidelines project,” 2014 (principal investigator, Professor K. Hirata, Sapporo Medical University).

Conflict of interest statement: Members received lecture fee (500,000 yen or more), manuscript fee (500,000 yen or more), and other remuneration (50,000 yen or more) from Asahi Kasei Corp; Bayer Yakuhin, Ltd; Chugai Pharmaceutical Co, Ltd; Eisai Co, Ltd; Eli Lilly Japan Co, Ltd; Fujifilm Holdings Corp; Kyowa Hakko Kirin Co, Ltd; Merck Serono Co, Ltd; Ono Pharmaceutical Co, Ltd; Sumitomo Dainippon Pharma Co, Ltd; Taiho Pharmaceutical Co, Ltd; and Yakult Pharmaceutical Industry Co, Ltd. Institutional departments where the authors were affiliated received research funding (1,000,000 yen or more), scholarship endowment (1,000,000 yen or more), and payment (2,000,000 yen or more) from Ajinomoto Co, Inc; Astellas Pharma Inc; AstraZeneca K.K.; Bayer Yakuhin, Ltd; Boston Scientific Japan K.K.; Bristol-Myers Squibb K.K.; Century Medical, Inc; Chugai Pharmaceutical Co, Ltd; Daiichi Sankyo Co, Ltd; Eisai Co, Ltd; Eli Lilly Japan Co, Ltd; Fujifilm Holdings Corp, GlaxoSmithKline K.K.; Covidien Inc; Hitachi Medical Corp; Janssen Pharmaceutical K.K.; Johnson & Johnson, Junken Medical Co, Ltd; Kowa Company, Ltd; Kyowa Hakko Kirin Co, Ltd; Merck Serono Co, Ltd; Merck Sharp & Dohme K.K.; Mochida Pharmaceutical Co, Ltd; NanoCarrier Co, Ltd; Nippon Boehringer Ingelheim Co, Ltd; Nippon Chemical Industrial Co, Ltd; Nippon Zoki Pharmaceutical Co, Ltd; Novartis Pharma Co, Ltd; OncoTherapy Science, Inc; Ono Pharmaceutical Co, Ltd; Otsuka Pharmaceutical Co, Ltd; Otsuka Pharmaceutical Factory, Inc; Pfizer Inc; Piolax Medical Devices, Inc; Sanofi K.K.; J-Pharma Co, Ltd; Shionogi & Co, Ltd; Sumitomo Dainippon Pharma Co, Ltd; Taiho Pharmaceutical Co, Ltd; Taisho Toyama Pharmaceutical Co, Ltd; Takeda Bio Development Center Ltd; Takeda Pharmaceutical Co, Ltd; Teijin Pharma Ltd; Torii Pharmaceutical Co, Ltd; Tsumura & Co; Yakult Pharmaceutical Industry Co, Ltd; Zeon Corp; and Zeria Pharmaceutical Co, Ltd.

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