Korean Urologic Oncology Society Guidelines: Does Angioembolization Improve the Quality of Life for Renal Cell Carcinoma Patients With Intractable Symptoms Who Are Unfit for Surgery?

J. Ku, H. Gu, Seong Hyeon Yu, E. Hwang, M. Han, J. Jung, Hunju Lee, Myung Ha Kim, C. Kwak, S. I. Kim
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Abstract

Purpose: There is a lack of guidelines for using angioembolization to manage renal cell carcinoma (RCC) patients with intractable symptoms. Therefore, the Korean Urologic Oncology Society (KUOS) developed a set of recommendations for angioembolization for RCC patients with intractable symptoms who are unfit for surgery.Materials and Methods: A rigorous systematic review was performed and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology was used to rate the certainty of the evidence for the patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of KUOS members involved in the guideline development process.Results: The guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to angioembolization by using a single clinical question: Does angioembolization improve the quality of life for RCC patients with intractable symptoms who are unfit for surgery?Conclusions: The guideline development panel suggests angioembolization for RCC patients with intractable symptoms compared with supportive therapies, including systemic treatment (very low certainty of evidence, weak recommendation).
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韩国泌尿肿瘤学会指南:血管栓塞术是否能改善不适合手术的顽固性肾癌患者的生活质量?
目的:目前缺乏使用血管栓塞治疗肾细胞癌(RCC)患者顽固性症状的指南。因此,韩国泌尿肿瘤学会(KUOS)制定了一套推荐血管栓塞治疗不适合手术的顽固性肾癌患者。材料和方法:进行了严格的系统评价,并使用GRADE(推荐、评估、发展和评价分级)方法对患者结局证据的确定性进行评级,并将证据发展为建议。指导小组、指南制定小组、系统审查小组和外部审查小组由参与指南制定过程的KUOS成员组成。结果:该指南通过一个单一的临床问题:血管栓塞是否能改善有难治性症状且不适合手术的RCC患者的生活质量,来解决与血管栓塞相关的益处、危害、患者的价值观和偏好、成本和资源?结论:指南制定小组建议,与包括全身治疗在内的支持疗法(证据确定性极低,弱推荐)相比,血管栓塞治疗难治性症状的RCC患者。
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