Pancreatic cancer
1. The Code focuses more on the clinical manifestations combined with the auxiliary examinations such as impactology, and does not involve laparoscopy as proposed in the US (NCCN) guidelines, which is more in line with the Chinese national conditions.
2. The Code lists the possible complications of surgical procedures and detailed management principles, adds the content related to interventional treatment, clarifies the indications for total pancreatic resection, including tumors with larger scope and multicenter occurrence, such as some neuroendocrine tumors, and gives a report template from gross to microscopic for postoperative pathological assessment. Chen Changhuai, Department of Oncology, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine
The Code needs further improvement, including: the Code emphasizes preoperative yellowing reduction, but in practice, it is mostly recommended in cases of preoperative biliary tract infection and fever, and there is no international consensus on this. The recommendation of “age >75 years is a contraindication to radical surgery” in the Code is subject to further discussion.
Liver cancer
1. The Code is very suitable for China’s national conditions, in which the roadmap of liver cancer diagnosis, the map of multidisciplinary comprehensive treatment model and the flow of liver cancer treatment provide us with detailed steps, which make the diagnosis and treatment more scientific.
2. The Specification points out that methemoglobin must be checked among liver cancer monitoring and screening indicators, emphasizes that non-invasive clinical diagnosis of HCC can be adopted, and lists the most influential TNM stage and Barcelona stage according to the actual situation, and stresses the influence of liver function and physical condition on patients’ prognosis.
3. The Specification systematically clarifies the norms of clinical diagnosis and treatment of hepatocellular carcinoma in terms of screening of high-risk groups, diagnosis, staging and treatment of hepatocellular carcinoma, mentions the importance of individualized treatment by multidisciplinary and comprehensive treatment machines, and clarifies the indications for radiotherapy.
4. The Specification proposes that the causes of liver cancer are related to hepatitis B virus, aflatoxin, water pollution, etc., which provides ideas for the prevention of liver cancer.