Evidence map›Paper›PMID 37957297›Full record

SynthesisSurgical endoscopy2023

SAGES/AHPBA guidelines for the use of microwave and radiofrequency liver ablation for the surgical treatment of hepatocellular carcinoma or colorectal liver metastases less than 5 cm.

Eugene P Ceppa, Amelia T Collings, Moustafa Abdalla, Edwin Onkendi, Daniel W Nelson, Ahmad Ozair, Emily Miraflor, Faique Rahman, Jake Whiteside, Mihir M Shah and 20 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors at 20 institutions in 4 countries.

Eugene P CeppaDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH541, Indianapolis, IN, 46202, USA. eceppa@iu.edu.ORCID 0000-0002-8368-2232
Amelia T CollingsHiram C. Polk, Jr. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Moustafa AbdallaDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Edwin OnkendiDepartment of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Daniel W NelsonDepartment of Surgery, William Beaumont Army Medical Center, El Paso, TX, USA.
Ahmad OzairKing George's Medical University, Lucknow, India.
Emily MiraflorUCSF East Bay Department of Surgery, UCSF, Oakland, CA, USA.
Faique RahmanJawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
Jake WhitesideDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH541, Indianapolis, IN, 46202, USA.
Mihir M ShahDivision of Surgical Oncology, Department of Surgery, Emory University Winship Cancer Institute, Atlanta, GA, USA.
Subhashini AylooDepartment of Surgery, Brown University, Providence, RI, USA.
Rebecca DirksDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH541, Indianapolis, IN, 46202, USA.
Sunjay S KumarDepartment of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.ORCID 0009-0005-7057-0097
Mohammed T AnsariSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Iswanto SucandyDigestive Health Institute, AdventHealth, Tampa, FL, USA.
Kchaou AliDepartment of Surgery A, Sfax Medical School, Sfax, Tunisia.
Sam DouglasDepartment of Surgery, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
Patricio M PolancoDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Timothy J VreelandDepartment of Surgery, Brooke Army Medical Center, San Antonio, TX, USA.
Joseph BuellDepartment of Surgery, Mission Health Care System, Asheville, NC, USA.
Ahmed M Abou-SettaUniversity of Manibota, Winnepeg, Canada.
Ziad AwadDepartment of Surgery, University of Florida, Jacksonville, FL, USA.
Choon Hyuck KwonDepartment of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
John B MartinieDepartment of Surgery, Atrium Health, Charlotte, NC, USA.
Fabio SbranaDepartment of Surgery, Chicago Medical School, Rosalind Franklin University, Chicago, IL, USA.
Aurora PryorDepartment of Surgery, Long Island Jewish Medical Center, Northwell Health, Great Neck, NY, USA.
Bethany J SlaterDepartment of Surgery, University of Chicago, Chicago, IL, USA.
William RichardsonDepartment of Surgery, Ochsner Clinic, Jefferson, LA, USA.
Rohan JeyarajahTCU/UNTHSC School of Medicine, Fort Worth, TX, USA.
Adnan AlseidiDepartment of Surgery, University of California, San Francisco, CA, USA.
Indiana University School of MedicineAdventHealth Tampa · USAtrium Medical Cente · USBrooke Army Medical Center · USBrown University · USCalifornia State University, East Bay · USCleveland Clinic · USEmory University · USHarvard University · USJawaharlal Nehru Medical College Hospital · INKing George's Medical University · INMission Health · USNaval Medical Center Portsmouth · USNorthwell Health · USOchsner Medical Center · USRosalind Franklin University of Medicine and Science · USTexas Tech University · USThe University of Texas Southwestern Medical Center · USThomas Jefferson University Hospital · USUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) represent the liver's two most common malignant neoplasms. Liver-directed therapies such as ablation have become part of multidisciplinary therapies despite a paucity of data. Therefore, an expert panel was convened to develop evidence-based recommendations regarding the use of microwave ablation (MWA) and radiofrequency ablation (RFA) for HCC or CRLM less than 5 cm in diameter in patients ineligible for other therapies.

methodsA systematic review was conducted for six key questions (KQ) regarding MWA or RFA for solitary liver tumors in patients deemed poor candidates for first-line therapy. Subject experts used the GRADE methodology to formulate evidence-based recommendations and future research recommendations.

resultsThe panel addressed six KQs pertaining to MWA vs. RFA outcomes and laparoscopic vs. percutaneous MWA. The available evidence was poor quality and individual studies included both HCC and CRLM. Therefore, the six KQs were condensed into two, recognizing that these were two disparate tumor groups and this grouping was somewhat arbitrary. With this significant limitation, the panel suggested that in appropriately selected patients, either MWA or RFA can be safe and feasible. However, this recommendation must be implemented cautiously when simultaneously considering patients with two disparate tumor biologies. The limited data suggested that laparoscopic MWA of anatomically more difficult tumors has a compensatory higher morbidity profile compared to percutaneous MWA, while achieving similar overall 1-year survival. Thus, either approach can be appropriate depending on patient-specific factors (very low certainty of evidence).

conclusionGiven the weak evidence, these guidelines provide modest guidance regarding liver ablative therapies for HCC and CRLM. Liver ablation is just one component of a multimodal approach and its use is currently limited to a highly selected population. The quality of the existing data is very low and therefore limits the strength of the guidelines.

Indexed as

Carcinoma, HepatocellularCatheter AblationColorectal NeoplasmsLiver NeoplasmsRadiofrequency AblationHumansMicrowavesRetrospective StudiesTreatment OutcomeColorectal liver metastasesGuidelineHepatocellular carcinomaLiver tumorMicrowave ablationRadiofrequency ablation

Identifiers

PMID37957297
OpenAlexW4388626640

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.