Publications by authors named "Darren Jun Hao Tan"
Background: Major society guidelines recommend transarterial chemoembolization (TACE) as the standard of care for intermediate-stage hepatocellular carcinoma (HCC) patients. However, predicting treatment response remains challenging.
Aims: As artificial intelligence (AI) may predict therapeutic responses, this systematic review aims to assess the performance and effectiveness of radiomics and AI-based models in predicting TACE outcomes in patients with HCC.
Background & Aims: The epidemiology of adult primary liver cancer continues to evolve, owing to the increasing prevalence of metabolic disease, rising alcohol consumption, advances in vaccination for HBV, and antiviral therapy for HCV. Disparities in care and the burden of liver cancer between populations persist. We assess trends in the burden of liver cancer and contributions by various etiologies across 204 countries and territories from 2010 to 2021.
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- - The study investigates the risk of hepatocellular carcinoma (HCC) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and a low fibrosis-4 index (FIB-4), which is used to assess liver health.
- - Out of 613 participants diagnosed with MASLD-related HCC, 13% had a low FIB-4, with 26% among those without cirrhosis, indicating potential missed cases for further evaluation.
- - The findings suggest that current guidelines may fail to identify over a quarter of MASLD-related HCC patients without cirrhosis who present a low FIB-4, highlighting a need for updated clinical pathways.
Article Synopsis
- Chronic liver disease is a significant risk factor for cholangiocarcinoma (CCA), but its prevalence among CCA patients was previously unclear.
- A meta-analysis included data from 118,068 CCA patients, finding that about 25% had chronic liver disease and over 10% had cirrhosis.
- The study revealed a stronger association between chronic liver disease and intrahepatic CCA compared to extrahepatic CCA, except for primary sclerosing cholangitis, which was linked to extrahepatic forms.
Background: Although the burden of alcohol-associated hepatocellular carcinoma (HCC) is increasing with rising alcohol consumption, clinical presentation and outcomes of alcohol-associated HCC have not been systematically assessed. We aimed to determine the prevalence, clinical characteristics, surveillance rates, treatment allocation, and outcomes of alcohol-associated HCC.
Methods: Medline and Embase were searched from inception to January 2023.
Article Synopsis
- - The study analyzed data from the United Network for Organ Sharing between 2000 and 2022 to evaluate how the causes of liver disease impact liver transplantation outcomes for individuals with hepatocellular carcinoma (HCC), focusing on differences between men and women.
- - Findings revealed that nonalcoholic steatohepatitis (NASH) is the fastest-growing cause of liver disease in women and has surpassed chronic hepatitis C as the leading cause for both genders on transplant waitlists.
- - Women with HCC experience longer wait times for liver transplants and have lower rates of receiving transplants compared to men, though they tend to have better posttransplant survival rates when suffering from NASH-related HCC.
Background: Chronic infection with hepatitis C virus (HCV) has a long-term impact on hepatic consequences. A comprehensive evaluation of the global burden of HCV-related health outcomes can help to develop a global HCV prevention and treatment program.
Methods: We used the 2019 Global Burden of Disease (GBD) Study to comprehensively investigate burden and temporal trends in incidence, mortality and disability-adjusted life-years (DALYs) of HCV-related diseases, including liver cancer and cirrhosis and other liver diseases across 264 countries and territories from 2010 to 2019.
The Global Burden of Alcohol-associated Cirrhosis and Cancer in Young and Middle-aged Adults.
Clin Gastroenterol Hepatol
September 2024
Alcohol is a substance that impacts premature mortality and morbidity. The liver is invariably subjected to the impact of alcohol, which can result in cirrhosis and cancer. Alcohol also has detrimental effects that extend beyond the liver.
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- * Out of 19 studies with nearly 19,000 participants, it was found that 53.8% of individuals practiced alcohol abstinence, which significantly improved their overall survival compared to those who continued drinking.
- * The research concludes that while abstinence is linked to better health outcomes, only about half of those with this condition manage to stay abstinent.
Article Synopsis
- The study investigates the significant burden of alcohol-related issues like liver disease and alcohol use disorder (AUD) among young women, a demographic identified as particularly vulnerable compared to men.
- Utilizing data from the Global Burden of Disease Study 2019, researchers analyzed prevalence, mortality, and disability-adjusted life years of alcohol-associated cirrhosis, liver cancer from alcohol, and AUD in young women, with findings organized by region and sociodemographic factors.
- Results show that AUD has the highest prevalence rates, followed by alcohol-associated cirrhosis and liver cancer; Central Europe shows the highest burdens, indicating an urgent need for targeted public health strategies to address these issues in young women.
Background: High body mass index (BMI) is a major risk factor for cancer development, but its impact on the global burden of cancer remains unclear.
Methods: We estimated global and regional temporal trends in the burden of cancer attributable to high BMI, and the contributions of various cancer types using the framework of the Global Burden of Disease Study.
Results: From 2010 to 2019, there was a 35 % increase in deaths and a 34 % increase in disability-adjusted life-years from cancers attributable to high BMI.
The scarcity of liver grafts has prompted developments in living donor liver transplantations (LDLT), with previous literature illustrating similar outcomes in recipients compared to deceased donor transplants. However, significant concerns regarding living donor morbidity and mortality have yet to be examined comprehensively. This study aims to provide estimates of the incidence of various outcomes in living liver donors.
View Article and Find Full Text PDFBackground/aims: Proton pump inhibitors (PPIs) are frequently prescribed to cirrhotic patients, but there is limited longitudinal evidence regarding their effects. This study aimed to assess the impact of PPIs on adverse events in cirrhotic patients.
Methods: A comprehensive search was conducted using the Medline and Embase databases to identify relevant articles.
Background: Emerging data suggest that outcomes for advanced hepatocellular carcinoma (HCC) treated with sorafenib may have improved over time. We aimed to provide robust, time-to-event estimates of survival outcomes for sorafenib in advanced HCC.
Summary: In this systematic review and individual patient data meta-analysis of randomized-controlled trials (RCTs), we searched MEDLINE and Embase from inception till September 2022 for RCTs that provided data for overall survival (OS) and progression-free survival (PFS) for sorafenib monotherapy as first-line systemic therapy for advanced HCC.
Background: Preliver transplant diabetes mellitus (pre-LT DM) is a common comorbidity in LT recipients associated with poorer post-transplant survival. However, its relationship with other important outcomes, including cardiovascular and renal outcomes, remains unclear. This meta-analysis aims to provide an updated analysis of the impact of pre-LT DM on key post-LT outcomes.
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- Bariatric surgery is a key treatment for severely obese patients with nonalcoholic fatty liver disease (NAFLD), but there is limited data on how different surgical procedures impact histological outcomes related to NAFLD.
- A meta-analysis of 31 studies found that both foregut bypass and restrictive bariatric procedures significantly improved liver fibrosis, but foregut bypass showed better results for reducing liver fat and body mass index.
- Foregut bypass also led to lower levels of certain liver enzymes compared to restrictive procedures, suggesting it may be the more effective option for improving metabolic and histological parameters in NAFLD patients.
Article Synopsis
- The study investigates the long-term risks associated with metabolic dysfunction-associated steatotic liver disease (MASLD) by analyzing data from 129 original studies comparing MASLD patients to those without the condition.* -
- Results indicate that individuals with MASLD have a higher risk of various complications, including cardiovascular issues, metabolic disorders (like diabetes and hypertension), chronic kidney disease, and certain cancers, with those having advanced liver disease at an even greater risk.* -
- The findings highlight the need for comprehensive treatment approaches for MASLD due to its serious multisystem effects on health.*
Background: Non-alcoholic fatty liver disease (NAFLD) represents a significant health threat worldwide. The growing trend towards an aging population, along with an alarming rise in obesity and diabetes, may have significant implications for the burden of NAFLD.
Aim: To assess the impact of NAFLD on the elderly.
Importance: Emerging data suggest that the incidence of early-onset cancers, defined as cancers diagnosed in people younger than 50 years, is increasing, but updated data are limited.
Objective: To characterize the patterns in the incidence of early-onset cancers in the US from 2010 to 2019 and provide granular data on the cancers with the fastest-growing incidence rates.
Design, Setting, And Participants: This population-based cohort study analyzed data from 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries from January 1, 2010, to December 31, 2019.
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, with type 2 diabetes mellitus (T2DM) as a major predictor. Insulin resistance and chronic inflammation are key pathways in the pathogenesis of T2DM leading to NAFLD and vice versa, with the synergistic effect of NAFLD and T2DM increasing morbidity and mortality risks. This meta-analysis aims to quantify the prevalence of NAFLD and the prevalence of clinically significant and advanced fibrosis in people with T2DM.
View Article and Find Full Text PDFBackground: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease globally. While the prevalence, impact, and causes of mortality have been described in various meta-analyses, a systematic all-encompassing umbrella review has yet to be conducted to consolidate the evidence on outcomes associated with NAFLD.
Methods: Search was conducted on Medline and Embase for meta-analysis investigating associated complications and causes of mortality in NAFLD patients.
Background: Liver transplantation (LT) offers patients with decompensated cirrhosis the best chance at long-term survival. With the rising prevalence of diabetes, further clarity is needed on the impact of receiving a liver allograft from a donor with diabetes on post-LT outcomes. This study aims to evaluate the impact of donor diabetes on clinical outcomes after LT.
View Article and Find Full Text PDFThe use of immune checkpoint inhibitors (ICIs) targeting PD-L1/PD-1 and CTLA-4 has transformed the oncology practice of hepatocellular carcinoma. However, only 25-30% of the patients with advanced HCC treated with atezolizumab-bevacizumab or tremelimumab-durvalumab (STRIDE) respond initially, and mechanistic biomarkers and novel treatment strategies are urgently needed for patients who present with or acquire resistance to first-line ICI-based therapies. The recent approval of the STRIDE regimen has also engendered new questions, such as patient selection factors (e.
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