《2010BTS肺癌患者的基本管理指南》内容预览

The terms ‘operable’ and ‘resectable’The GDC noted that these terms were used by some multidis-ciplinary teams (MDTs). ‘Resectable’ indicates that the primarytumour can be completely excised by surgery with clear patho-logical margins. ‘Operable’ indicates that the patient has anacceptable risk of death or morbidity. These terms are useful tofocus attention on these aspects of surgical treatment. However,MDTs and patients may have different thresholds for operabilityand surgeons may have different thresholds for resection. Whatis important is the parameters set to de?ne thresholds and theimplication for the patient in terms of mortality and morbidity.This guideline has therefore not used these terms but ratheraddressed the thresholds, indicating where patient choice maybe pivotal.

Guideline development

The scope of the guideline was determined by the GDC andbased on the previous guideline and consultation with bothsocieties and with input from members from associated speci-alities including radiology, anaesthesia and pathology. The topicscovered by the scope are listed in appendix 1.The comprehensivesearch strategy (see appendix 2 in online supplement) found over5500 references revealed that, since the publication of the 2001guidelines, the evidence base for selection and management ofpatients suitable for radical treatment increased considerably.Evidence was graded according to the Scottish IntercollegiateGuidelines Network (SIGN) system (appendix 3). References arefollowed by the level of evidence in square brackets. Where it isnot appropriate to apply SIGN levels, the brackets contain N/A(not applicable).

The aim of this updated guideline is to assist in raising stan-dards of the delivery of radical treatments in the UK. The draftdocument was circulated to the membership of the BTS, themembership of the SCTS, and presented at BTS, SCTS andBritish Thoracic Oncology Group meetings. Comments wereincorporated into the ?nal draft from the Royal College ofPhysicians, the Association of Cancer Physicians, the RoyalCollege of Anaesthesia and Royal College of Pathologists.The guidelines will be reviewed 3 years from the date ofpublication.

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