Scoping review of clinical practice guidelines on the management of benign liver tumours.

Published on Aug 1, 2021in BMJ Open Gastroenterology
· DOI :10.1136/BMJGAST-2020-000592
Martijn P D Haring5
Estimated H-index: 5
Frans J. C. Cuperus8
Estimated H-index: 8
+ 2 AuthorsVincent E de Meijer22
Estimated H-index: 22
OBJECTIVE Benign liver tumours (BLT) are increasingly diagnosed as incidentalomas. Clinical implications and management vary across and within the different types of BLT. High-quality clinical practice guidelines are needed, because of the many nuances in tumour types, diagnostic modalities, and conservative and invasive management strategies. Yet, available observational evidence is subject to interpretation which may lead to practice variation. Therefore, we aimed to systematically search for available clinical practice guidelines on BLT, to critically appraise them, and to compare management recommendations. DESIGN A scoping review was performed within MEDLINE, EMBASE, and Web of Science. All BLT guidelines published in peer-reviewed, and English language journals were eligible for inclusion. Clinical practice guidelines on BLT were analysed, compared, and critically appraised using the Appraisal of Guidelines, Research and Evaluation (AGREE II) checklist regarding hepatic haemangioma, focal nodular hyperplasia (FNH), and hepatocellular adenoma (HCA). Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations (PRISMA) for scoping reviews were adhered to. RESULTS The literature search yielded unique 367 papers, 348 were excluded after screening of title/abstract, and 16 after full-text screening. Three guidelines were included: the American College of Gastroenterology (ACG; 2014), Brazilian Society of Hepatology (SBH; 2015), and European Association for the Study of the Liver (EASL; 2016). There was no uniformity in the assessment methods for grading and gravity of recommendations between guidelines. Among observed differences were: (1) indications for biopsy in all three tumours; (2) advices on contraceptive pills and follow-up in FNH and HCA; (3) use of an individualised approach to HCA; (4) absence of recommendations for treatment of HCA in men; and (5) approaches to HCA subtype identification on magnetic resonance imaging. CONCLUSION Recognising differences in recommendations can assist in harmonisation of practice standards and identify unmet needs in research. This may ultimately contribute to improved global patient care.
#1Belle V. van Rosmalen (UvA: University of Amsterdam)H-Index: 3
#2Alicia Furumaya (UvA: University of Amsterdam)H-Index: 1
Last. Theo van VoorthuizenH-Index: 1
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Background & aims null Hepatocellular adenomas (HCA) rarely occur in males, and if so, are frequently associated with malignant transformation. Guidelines are based on small numbers of patients and advise resection of HCA in male patients, irrespective of size or subtype. This nationwide retrospective cohort study is the largest series of HCA in men correlating (immuno)histopathological and molecular findings with the clinical course. null Methods null Dutch male patients with available histolog...
2 CitationsSource
#1Martijn P D Haring (UMCG: University Medical Center Groningen)H-Index: 5
#2Christiaan S Spijkerboer (UMCG: University Medical Center Groningen)
Last. Vincent E de Meijer (UMCG: University Medical Center Groningen)H-Index: 22
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Abstract Background Hepatocellular adenomas (HCA) are benign liver tumors at risk of hemorrhage. The influence of pregnancy on HCA growth and potential bleeding remains unclear. This study investigates HCA-associated behavior and bleeding complications during or shortly after pregnancy. Methods (I) Single center retrospective cohort study of HCA during and after pregnancy. (II) Systematic literature review. Results The retrospective study included 11 patients, of which 4 with HCA ≥5cm. In only t...
1 CitationsSource
#1Monika Sarkar (UCSF: University of California, San Francisco)H-Index: 14
#2Carla W. Brady (Duke University)H-Index: 6
Last. Norah A. Terrault (SC: University of Southern California)H-Index: 87
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#1Joerg Fuchs (University of Tübingen)H-Index: 23
#2Steven W. Warmann (University of Tübingen)H-Index: 25
Last. Andreas Schmidt (University of Tübingen)H-Index: 8
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Abstract Benign liver tumors in children are far less frequent than their malignant counterparts. Recently, there have been advances of diagnostic procedures and novel treatments with improved classification as a result. While malignant pediatric liver tumors have been comprehensively addressed by multicentre international tumor trials, benign tumors have more usually relied upon individualised workup and treatment. Due to the rarity and heterogeneity of these different entities, large studies a...
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#1Timo Alexander Auer (Charité)H-Index: 3
#2Uli Fehrenbach (Charité)H-Index: 5
Last. Timm DeneckeH-Index: 38
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To differentiate subtypes of hepatocellular adenoma (HCA) based on enhancement characteristics in gadoxetic acid (Gd-EOB) magnetic resonance imaging (MRI). Forty-eight patients with 79 histopathologically proven HCAs who underwent Gd-EOB-enhanced MRI were enrolled (standard of reference: surgical resection). Two blinded radiologists performed quantitative measurements (lesion-to-liver enhancement) and evaluated qualitative imaging features. Inter-reader variability was tested. Advanced texture a...
4 CitationsSource
#1Marcia P. Gaspersz (EUR: Erasmus University Rotterdam)H-Index: 10
#2Anne J. Klompenhouwer (EUR: Erasmus University Rotterdam)H-Index: 6
Last. Jan N.M. IJzermans (EUR: Erasmus University Rotterdam)H-Index: 74
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Abstract Background & Aims The presence of hepatocellular adenoma (HCA) in pregnant women requires special consideration, as it has been reported to carry the risk of growth and clinically significant haemorrhage. In this prospective study we assessed aspects of growth of HCA Methods This was a multicentre prospective cohort study in pregnant women with suspected HCA 20%) was closely monitored with ultrasound-examinations throughout pregnancy. Results Eighteen of 66 included women were excluded ...
6 CitationsSource
#1Mirelle Bröker (Erasmus University Medical Center)H-Index: 2
#2Pavel Taimr (Erasmus University Medical Center)H-Index: 2
Last. Roy S. Dwarkasing (Erasmus University Medical Center)H-Index: 3
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OBJECTIVE. The purpose of this article is to compare contrast-enhanced sonography (CEUS) with sulfur hexafluoride with MRI with the liver-specific contrast agent gadobenate dimeglumine in the diagn...
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#1Julian Marcon (LMU: Ludwig Maximilian University of Munich)H-Index: 8
#2Anno Graser (LMU: Ludwig Maximilian University of Munich)H-Index: 27
Last. Michael Staehler (LMU: Ludwig Maximilian University of Munich)H-Index: 55
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Objectives Various imaging methods have been evaluated regarding non-invasive differentiation of renal cell carcinoma (RCC) subtypes. Dual-energy computed tomography (DECT) allows iodine concentration (IC) analysis as a correlate of tissue perfusion. Microvascular density (MVD) in histopathology specimens is evaluated to determine intratumoral vascularization. The objective of this study was to assess the potential of IC and MVD regarding the differentiation between papillary and clear cell RCC ...
32 CitationsSource
#1Kofi-Buaku Atsina (Thomas Jefferson University)H-Index: 3
#2Laurence Parker (Thomas Jefferson University)H-Index: 44
Last. David C. Levin (Thomas Jefferson University)H-Index: 54
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OBJECTIVE. The purpose of this study was to examine the degree to which nonradiologist physicians provide formal interpretations for advanced imaging and to consider whether adequate training can b...
33 CitationsSource
#1Martijn P D Haring (UMCG: University Medical Center Groningen)H-Index: 5
Last. Vincent E de Meijer (UMCG: University Medical Center Groningen)H-Index: 22
view all 6 authors...
: Hepatocyte nuclear factor 1A (HNF1A) maturity-onset diabetes of the young (MODY) is a monogenetic, autosomal dominantly inherited form of diabetes. HNF1A-MODY is associated with HNF1A-inactivated hepatocellular adenoma (H-HCA) formation. Hepatocellular adenoma (HCA) are benign liver tumours and related complications are rare but serious: hepatic haemorrhage and malignant transformation. Guidelines recommend resection of all HCA in men and do not take any co-occurring metabolic disorders into a...
4 CitationsSource
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