Pancreatic cancer in adults:

Transcription

1 National Institute for Health and Care Excellence Final Pancreatic cancer in adults: diagnosis and management Appendix E February 018 Final Developed by the National Guideline Alliance, hosted by the Royal College of Obstetricians and Gynaecologists

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3 Contents Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn. Copyright NICE 018. All rights reserved. Subject to Notice of rights. NICE 018. All rights reserved. Subject to Notice of rights.

4 Contents Contents Appendix E:... 5 E.1 People with jaundice... 5 E. People without jaundice but with a pancreatic abnormality... 6 E. Pancreatic cysts... 7 E.4 People with inherited high risk of pancreatic cancer... 8 E.5 Referral to specialist multidisciplinary teams... 9 E.6 Staging E.7 Psychological support needs E.8 Pain... 1 E.9 Nutritional interventions... 1 E.10 Biliary obstruction E.11 Duodenal obstruction E.1 Neo-adjuvant treatment E.1 Resectable and borderline resectable pancreatic cancer E.14 Adjuvant treatment E.15 Follow-up for people with resected pancreatic cancer E.16 Management of locally advanced pancreatic cancer... 0 E.17 Management of metastatic pancreatic cancer

5 1 Appendix E: E.1 People with jaundice identified, N= 9404 Additional articles from other sources, N= 1 assessed for eligibility, N= Excluded (inc. duplicate), N= 98 review, N= 6 review, N=

6 E. 1 People without jaundice but with a pancreatic abnormality identified, N= 9404 assessed for eligibility, N= 10 Excluded (inc. duplicates), N= 974 review, N= 1 review, N= 109 6

7 E. 1 Pancreatic cysts identified, N= 9404 Additional articles from other sources, N= 1 assessed for eligibility, N= 19 Excluded (inc. duplicates), N= 975 review, N= 5 studies plus systematic reviews review, N=96 7

8 E.4 1 People with inherited high risk of pancreatic cancer identified, N= 40 Duplicates excluded, N= 9 assessed for eligibility, N= 59 Excluded, N= review, N= 18 review, N= 41 8

9 E.5 1 Referral to specialist multidisciplinary teams identified, N= 170 Duplicates excluded, N= assessed for eligibility, N= 40 Excluded, N= 1688 review, N= 0 review, N= 40 9

10 E.6 1 Staging identified, N= 9404 Additional articles from other sources, N= 1 assessed for eligibility, N= 16 Excluded, N= 978 review, N= 0 review, N= 97 10

11 E.7 1 Psychological support needs identified, N= 48 Duplicates excluded, N= 1 assessed for eligibility, N= 67 Excluded, N= 40 Additional studies identified by GC, N= Publications included from search, N= 1 review, N= 55 review, N= 14 11

12 E.8 1 Pain Final identified, N=1117 assessed for eligibility, N= 6 Excluded, N= 1081 review, N= 7 6 studies plus 1 systematic review review, N=9 1

13 E.9 1 Nutritional interventions identified, N= 9 assessed for eligibility, N= 45 Excluded, N= 47 review, N= 11 review, N= 4 1

14 E.10 1 Biliary obstruction identified, N= 78 Duplicates excluded, N= 8 assessed for eligibility, N= 01 Excluded, N= 574 Additional studies from reference of full copies, N= 4 Publications included from search, N= 18 review, N= 18 review, N= 14

15 E.11 1 Duodenal obstruction identified, N= 0 Duplicates excluded, N= 10 assessed for eligibility, N= 7 Excluded, N= 11 review, N= 6 (5 studies plus 1 systematic review) review, N= 67 15

16 E.1 1 Neo-adjuvant treatment identified, N= assessed for eligibility, N= 6 Excluded (inc. duplicates), N=1457 review, N= 6 review, N= 0 4 studies plus systematic reviews 16

17 E.1 1 Resectable and borderline resectable pancreatic cancer identified, N= 4 Duplicates excluded, N= 50 assessed for eligibility, N= 158 review, N= 16 (15 systematic review and 1 RCT) Additional articles, N= 1 review, N= 14 Excluded, N=07 (not relevant population, design, intervention, comparison, outcomes, unable to retrieve) 17

18 E.14 1 Adjuvant treatment identified, N= assessed for eligibility, N=146 Excluded (inc. duplicates), N= 1446 intervention, comparison, review, N= 17 review, N= 19 18

19 E.15 1 Follow-up for people with resected pancreatic cancer identified, N= 484 Duplicates excluded, N= 10 assessed for eligibility, N= 8 Excluded, N= 46 review, N= review, N= 6 19

20 E.16 1 Management of locally advanced pancreatic cancer identified, N= assessed for eligibility, N=6 Excluded (inc. duplicates), N=14547 outcomes, unable review, N= 18 review, N= 44 0

21 E.17 1 Management of metastatic pancreatic cancer identified, N= assessed for eligibility, N= 114 Excluded (inc. duplicates), N= outcomes, unable review, N= 40 review, N=