Publications by authors named "Tan-To Cheung"
Background: Hepatocellular carcinoma (HCC) recurrence frequently occurs after curative surgery. Histological microvascular-invasion (MVI) predicts recurrence but cannot provide pre-operative prognostication, whereas clinical prediction scores have variable performances.
Methods: Recurr-NET, a multimodal multiphasic residual-network random survival forest deep-learning model incorporating pre-operative CT and clinical parameters, was developed to predict HCC recurrence.
Article Synopsis
- A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
- The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
- Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
Background & Aims: Combined F-fluorodeoxyglucose (FDG) and C-acetate (dual-tracer) positron-emission tomography/computed tomography (PET/CT) is being increasingly performed for the management of hepatocellular carcinoma (HCC), although its role is not well defined. Therefore, we evaluated its effectiveness in (i) staging, (ii) characterization of indeterminate lesions on conventional imaging, and (iii) detection of HCC in patients with unexplained elevations in serum alpha-fetoprotein (AFP) levels.
Methods: We retrospectively assessed 525 consecutive patients from three tertiary centers between 2014 and 2020.
Article Synopsis
- The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
- It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
- The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
Recompensation in MASLD-related cirrhosis via metabolic bariatric surgery.
Trends Endocrinol Metab
June 2024
Article Synopsis
- People with a serious liver problem called decompensated cirrhosis don’t usually do well and have a high chance of dying from it.
- There is growing interest in using a type of surgery called metabolic bariatric surgery (MBS) to help people improve their liver health, especially those with a related condition called MASLD.
- This article talks about how MBS could help these patients, the challenges it has, and the need for more research to understand it better.
Article Synopsis
- The study investigates the risk factors and outcomes related to open conversion during minimally invasive liver resections (MILR), especially in minor hepatectomies, highlighting its association with inferior results.
- Analysis was conducted on data from over 10,500 patients who underwent laparoscopic or robotic liver resections from 2004 to 2020, identifying key independent predictors for open conversion.
- Results show that patients who required open conversion experienced longer recovery times, increased blood loss, higher complications, and elevated 90-day mortality rates compared to those who had successful minimally invasive surgeries.
Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.
Methods: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.
Options and survival benefits of conversion therapy for unresectable hepatocellular carcinoma.
World J Gastroenterol
May 2024
Article Synopsis
- In a study by Wu, patients with a type of liver cancer that couldn't be removed were treated with a method called TACE to make their tumors easier to remove later.
- They created a prediction tool (called a nomogram) that helps figure out how long these patients might live after treatment.
- However, it's hard to say if the results apply to everyone because they only looked at patients who had surgery after TACE and not those who couldn't have TACE at all.
Sorted-Cell Sequencing on HCC Specimens Reveals EPS8L3 as a Key Player in CD24/CD13/EpCAM-Triple Positive, Stemness-Related HCC Cells.
Cell Mol Gastroenterol Hepatol
August 2024
Background & Aims: Hepatocellular carcinoma (HCC) is a heterogeneous cancer with varying levels of liver tumor initiating or cancer stem cells in the tumors. We aimed to investigate the expression of different liver cancer stem cell (LCSC) markers in human HCCs and identify their regulatory mechanisms in stemness-related cells.
Methods: We used an unbiased, single-marker sorting approach by flow cytometry, fluorescence-activated cell sorting, and transcriptomic analyses on HCC patients' resected specimens.
Background: Intraoperative indocyanine green (ICG) fluorescence imaging has been shown to be a new and innovative way to illustrate the optimal resection margin in hepatectomy for hepatocellular carcinoma. This study investigated its accuracy in resection margin determination by looking into the correlation of ICG intensity gradients with pathological examination results of resected specimens.
Methods: This was a prospective, single-center, non-randomized controlled study.
Impact of neoadjuvant chemotherapy on short-term outcomes after simple and complex minimally invasive minor hepatectomy for colorectal liver metastases: A propensity-score matched and coarsened exact matched study.
Eur J Surg Oncol
June 2024
Article Synopsis
- Minimally invasive liver surgery has become more common over the last 30 years, especially for treating colorectal liver metastases, but the effects of neoadjuvant chemotherapy on surgical outcomes are not well understood.
- A study analyzed a large database of nearly 5,000 patients who underwent minimally invasive liver surgeries to compare outcomes between those who received neoadjuvant chemotherapy and those who did not.
- The results showed that neoadjuvant chemotherapy did not significantly affect the short-term surgical outcomes in patients undergoing these liver procedures.
Objective: This study is to examine the impact of perioperative (intraoperative/postoperative) blood transfusion on the outcomes of curative hepatectomy for hepatocellular carcinoma. Hepatectomy is a well-established curative treatment for hepatocellular carcinoma, and blood transfusion cannot always be avoided in treating the disease.
Methods: A retrospective study of patients having curative hepatectomy for hepatocellular carcinoma from January 2010 to December 2019 at a single center was conducted.
Article Synopsis
- Researchers studied the effects of a drug called nivolumab on patients with a type of liver cancer called hepatocellular carcinoma (HCC) before surgery.
- They found that this treatment helped many patients, with some showing significant tumor damage after using the drug.
- Scientists also discovered a way to predict how well patients would respond to the treatment using tests on their blood.
Reciprocal interactions between malignant cells and macrophages enhance cancer stemness and M2 polarization in HBV-associated hepatocellular carcinoma.
Theranostics
January 2024
The tumor microenvironment of cancers has emerged as a crucial component in regulating cancer stemness and plays a pivotal role in cell-cell communication. However, the specific mechanisms underlying these phenomena remain poorly understood. We performed the single-cell RNA sequencing (scRNA-seq) on nine HBV-associated hepatocellular carcinoma (HCC) patients.
View Article and Find Full Text PDFComparison of post-hepatectomy long-term survival outcome between non-colorectal non-neuroendocrine and colorectal liver metastases: A population-based propensity-score matching analysis.
Surgeon
April 2024
Background: Hepatectomy is an established treatment for colorectal liver metastasis (CLM) or neuroendocrine liver metastasis. However, its role in non-colorectal non-neuroendocrine liver metastasis (NCNNLM) is controversial. This study aims to compare long-term survival outcomes after hepatectomy between NCNNLM and CLM in a population-based cohort.
View Article and Find Full Text PDFArticle Synopsis
- Scientists found that a gene called FAT4 helps prevent liver cancer, and when it's missing, cancer can happen more easily.
- They used special techniques to see how removing FAT4 affected liver cells and found that this loss changed how the cells stuck together and caused changes that can lead to tumors.
- The study suggests FAT4 loss changes cancer signals in the cells, leading to worse outcomes for patients, and researchers think this information could help in understanding and treating liver cancer better.
Article Synopsis
- This study assessed how liver cirrhosis (LC) influences the challenges of minimally invasive liver resection (MILR), specifically for minor surgeries involving primary liver tumors in anterolateral segments.
- Conducted from 2004 to 2021 across 60 centers, the research involved 3,675 patients, with varying degrees of cirrhosis classified as Child A and Child B.
- Results indicated that patients with Child A cirrhosis faced higher risks of complications, such as increased blood loss and rates of open conversion, while those with Child B cirrhosis had longer hospital stays and more significant morbidity; overall, the severity of LC complicates the surgical process, highlighting the need for better difficulty
Article Synopsis
- Minimally invasive liver resections (MILR) can reduce blood loss and recovery time compared to traditional methods, but the impact of cirrhosis on these procedures is not fully understood.
- A study reviewed data from 2534 patients who underwent minimally invasive major liver surgeries worldwide, focusing on outcomes related to different levels of cirrhosis.
- Results showed that advanced cirrhosis leads to higher blood transfusion rates, more postoperative complications, and longer hospital stays, suggesting that cirrhosis severity should be considered in future assessments of surgical difficulty in MILR.*
Background: Our clinical practice of laparoscopic liver resection (LLR) had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma (HCC) over open liver resection (OLR), but the underlying mechanisms are not clear. This study was to find out whether systemic inflammation plays an important role.
Methods: A total of 103 patients with early-stage HCC under liver resection were enrolled (LLR group, n = 53; OLR group, n = 50).
Background: The finding of pancreatic cystic lesions (PCL) on incidental imaging is becoming increasingly common. International studies report a prevalence of 2.2-44.
View Article and Find Full Text PDFBackground: Currently, surgical resection is the mainstay for colorectal liver metastases (CRLM) management and the only potentially curative treatment modality. Prognostication tools can support patient selection for surgical resection to maximize therapeutic benefit. This study aimed to develop a survival prediction model using machine learning based on a multicenter patient sample in Hong Kong.
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- The study investigates how cirrhosis and portal hypertension (PHT) affect the complexity and outcomes of minimally invasive liver surgery in specific liver segments.
- It examines a large patient group, revealing that those with cirrhosis experienced more complications and required more blood transfusions during surgery.
- The findings suggest that the presence of cirrhosis and PHT should be considered when evaluating the difficulties and risks associated with minimally invasive liver resections.
Article Synopsis
- Tumor size (TS) impacts intraoperative outcomes in laparoscopic major hepatectomy (L-MH), with this study aiming to clarify its effects and find optimal TS cutoffs for assessing surgical difficulty.
- The analysis, which included 1396 patients from a larger pool of 3008 undergoing L-MH, identified two critical TS cutoffs at 50 mm and 100 mm that segmented patients into three distinct groups.
- Results showed that larger TS correlated with increased open conversion rates, longer operation times, higher blood loss, and more intraoperative blood transfusions, while postoperative complications remained similar across the groups.