Chinese Medical Association Guidelines for Clinical Diagnosis and Treatment of Lung Cancer (2023 Edition) has been released in July 2023. Based on the 2022 edition, the 2023 edition of the guideline has been updated in the aspects of lung cancer screening, pathology, surgical standards, neoadjuvant therapy, targeted therapy and treatment of advanced lung cancer. This article will give a brief introduction to these updated parts.
Pituitary Society released an international consensus statement on the diagnosis and management of prolactin-secreting adenoma (PRLoma) on September 5, 2023, providing recommendations based on the latest evidence-based approach for the screening, diagnosis, treatment and management of PRLoma. This consensus statement not only updated the clinical epidemiology, pathogenesis, clinical symptoms, complications, diagnostic criteria, and treatment progress of pituitary PRLoma, but also focused on special populations such as pregnant women, postmenopausal women, children/adolescents, transgender patients, as well as the treatment of special types such as cystic and invasive pituitary PRLoma. This article aims to help neurosurgeons, endocrinologists, and related healthcare professionals standardize the diagnosis and treatment of PRLoma by interpreting the updated section of the consensus.
On January 11, 2022, the European Society of Vascular Surgery (ESVS) completed its first update in the “European Society for Vascular Surgery 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs” since 2015. Based on the existing literatures and expert consensus, the guidelines added and revised the treatment strategies, postoperative monitoring, and postoperative anticoagulation of superficial venous insufficiency of the lower extremities and pelvic venous diseases. The new and modified parts will be interpreted.
Based on peer-reviewed systematic reviews and randomized controlled trials published between January 2000 and June 2019 with regards to the management of glenohumeral joint osteoarthritis (GJO), the American Academy of Orthopaedic Surgeons (AAOS) established the clinical practice guidelines for the treatment of GJO. The guidelines provided practice recommendations including risk factors, non-surgical treatment, surgical treatment, prosthesis selection, and perioperative management for GJO. The recommendations were graded according to different evidence strength. This paper interprets the guidline in order to provide reference for domestic medical workers.
In recent years, the worldwide incidence rate of peripheral arterial and aortic diseases has increased year by year, significantly increasing the cardiovascular mortality and incidence rate of the whole population. In the past, peripheral arterial and aortic diseases were often more prone to missed diagnosis and delayed treatment compared to coronary artery disease. The 2024 ESC guidelines for the management of peripheral arterial and aortic diseases for the first time combines peripheral arterial and aortic diseases, integrating and updating the 2017 guidelines for peripheral arterial disease and the 2014 guidelines for aortic disease. The aim is to provide standardized recommendations for the management of systemic arterial diseases, ensuring that patients can receive coherent and comprehensive diagnosis and treatment, thereby improving prognosis. This article interprets the main content of the guideline in order to provide reference and assistance for the clinical diagnosis and treatment of peripheral arterial and aortic diseases in China at the current stage.
The Universal Definition and Classification of Heart Failure consensus has proposed the universal definition, classification and staging criteria of heart failure. The prevalence of heart failure is still increasing, and the phenotype of heart failure with preserved ejection fraction (HFpEF) is becoming more and more common. Neuro-endocrine antagonists are effective in treating patients with heart failure with reduced ejection fraction (HFrEF). However, there is no effective drug that can improve the clinical prognosis of patients with HFpEF. The pathophysiological mechanism of HFpEF involves metabolic-inflammatory mechanism disorders, epicardial fat tissue accumulation, and coronary microvascular dysfunction. The exploratory treatment of these mechanisms requires further research to confirm whether it is beneficial to patients with HFpEF. In addition, the improvement of ejection fraction and the recovery of cardiac function in patients with HFrEF after treatment cannot interrupt the drug treatment of heart failure.
Lung cancer is the malignant tumor with the highest incidence rate in men and the highest mortality rate in men and women in China, and the incidence and mortality rates are still increasing. Lung cancer screening is an important initiative for early detection of lung cancer and improvement of prognosis. The National Comprehensive Cancer Network (NCCN) updates the NCCN Clinical Practice Guidelines for Lung Cancer Screening annually, and the 2023 V2 edition was released in May 2023. The guidelines are based on the latest research advances and high-level evidence-based medical evidence to establish screening criteria for lung cancer, especially for non-small cell lung cancer, which is the most common and highly regarded type of lung cancer, and has received widespread attention from physicians worldwide. In this article, the latest version of the guideline will be interpreted based on China's national situation and Chinese lung cancer screening guidelines, with the aim of providing an updated reference for lung cancer screening in China.
In recent years, with the clinical application of minimally invasive surgical techniques and comprehensive preoperative treatment, the survival rate of locally advanced esophageal cancer has significantly improved. However, the treatment of metastatic esophagogastric cancer still relies mainly on systemic therapy, and immunotherapy combined with chemotherapy has become a first-line treatment option, prolonging the survival of patients with metastatic esophageal cancer. Oligometastatic esophageal cancer is expected to bring survival benefits through systemic therapy combined with local treatment. The 2024 European clinical practice guidelines for oligometastatic esophagogastric cancer have been officially released, which standardize the definition, diagnosis, and treatment of oligometastatic esophageal cancer for further prospective studies. The authors interpret this guideline, especially by reviewing the clinical evidence of oligometastatic esophageal squamous cell carcinoma, to provide reference for the diagnosis and treatment of oligometastatic esophageal cancer in China.
National Comprehensive Cancer Network (NCCN) has updated and released the latest content of NCCN guidelines version 1. 2023 thymomas and thymic carcinomas (known as "guidelines"). The guideline sets standards for the diagnosis and treatment of thymoma and thymic carcinoma based on high quality clinical evidence and the latest advances in research. There have been some updates and revisions in the latest two versions of the guidelines, mainly focusing on the principles of radiotherapy, the principles of systematic therapy, multidisciplinary participation and the improvement of some footnotes, compared with the first version of the guidelines in 2022. In this paper, the contents of the new guideline will be interpreted in order to provide reference for the work of thymoma and thymic carcinoma in our country at the present stage.
The incidence of thyroid cancer has increased significantly worldwide in recent years, and it has become one of the top ten malignant tumors. The relevant guidelines for thyroid cancer have been formulated one after another. Surgery is an important method for the treatment of thyroid cancer. Standardized surgery can effectively improve the prognosis and quality of life, while inappropriate treatment will increase the risk of recurrence and reduce the survival rate. In 2022, the first domestic guideline for thyroid cancer covering all pathological types, “CACA Guidelines for Holistic Integrative Management of Thyroid Cancer” was officially released. Compared with the previous guidelines, the recommendations of the CACA guidelines are more in line with China’s national conditions, focusing on the integration of multidisciplinary resources, and minimizing the risk of complications while ensuring the treatment effect.