Publications by authors named "Tanto Cheung"
Background And Aims: HCC recurrence frequently occurs after curative surgery. Histological microvascular invasion (MVI) predicts recurrence but cannot provide preoperative prognostication, whereas clinical prediction scores have variable performances.
Approach And Results: Recurr-NET, a multimodal multiphasic residual-network random survival forest deep-learning model incorporating preoperative 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: This study investigates the impact of margin status after colorectal liver metastasis (CLM) resection on outcomes of patients after neoadjuvant treatment versus those who underwent upfront resection.
Methods: An international collaborative database of CLM patients who underwent surgical resection was used. Proportional hazard regression models were created for single and multivariable models to assess the relationship between independent measures and median overall survival (mOS).
Background: Thermal ablation has recently become a key therapy for the treatment of colorectal liver metastasis (CLM). However, the role of ablation in combination with resection has not yet been firmly established. We hypothesize that in patients with CLM, those who undergo liver resection with ablation (RA) have similar outcomes compared with those who undergo liver resection only.
View Article and Find Full Text PDFBackground & 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.
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.
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.
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: 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 PDFArticle Synopsis
- 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.
Article Synopsis
- This study aimed to compare outcomes of robotic limited liver resections (RLLR) and laparoscopic limited liver resections (LLLR) for tumors in the posterosuperior liver segments, noting that previous research had not thoroughly examined the differences in performance and safety between the two approaches.
- An analysis of data from 3510 patients showed that RLLR had significant advantages over LLLR, including a lower rate of open conversions, reduced blood loss, and shorter operative times, even in patients with cirrhosis.
- Despite the improved perioperative outcomes for RLLR, postoperative metrics like readmission, morbidity, and mortality rates were similar between both surgical techniques.
Background And Objective: Hong Kong, like many parts of Asia, faces a high burden of hepatocellular carcinoma (HCC) caused by high endemic rates of hepatitis B virus infection. Hong Kong clinicians have developed a high level of expertise in HCC treatment across surgical, transarterial, ablative, radiotherapeutic and systemic modalities. This publication summarizes the latest evidence-based recommendations on how these modalities should be used.
View Article and Find Full Text PDFBackground: The impact of cirrhosis and portal hypertension on perioperative outcomes of minimally invasive left lateral sectionectomies remains unclear. We aimed to compare the perioperative outcomes between patients with preserved and compromised liver function (noncirrhotics versus Child-Pugh A) when undergoing minimally invasive left lateral sectionectomies. In addition, we aimed to determine if the extent of cirrhosis (Child-Pugh A versus B) and the presence of portal hypertension had a significant impact on perioperative outcomes.
View Article and Find Full Text PDFBackground: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies.
Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria.
Risk Factors and Outcomes of Open Conversion During Minimally Invasive Major Hepatectomies: An International Multicenter Study on 3880 Procedures Comparing the Laparoscopic and Robotic Approaches.
Ann Surg Oncol
August 2023
Article Synopsis
- Despite advancements in minimally invasive liver surgery, open surgeries are still common, and this study examines the factors that lead to conversions from minimally invasive techniques to open surgery during major hepatectomies.
- Data from 3880 surgical cases showed that 10.28% resulted in open conversions, with several risk factors identified, such as male sex, liver cirrhosis, and larger tumor sizes, which are linked to increased conversion risk.
- The study found that those who experienced open conversions had worse outcomes, including longer operation times and higher rates of postoperative complications, although robotic surgery had a lower conversion rate compared to laparoscopic techniques, it still led to significant challenges when conversions did occur.
Article Synopsis
- - The study investigates how body mass index (BMI) affects outcomes after laparoscopic left lateral sectionectomy (L-LLS), revealing that higher BMI levels (greater than 27kg/m²) lead to increased blood loss, longer operative times, and more open conversions during surgery.
- - A large sample of 2,183 patients from 59 centers worldwide was analyzed, showing that as BMI increases, so do certain negative surgical outcomes, but patient complications also exhibited a "U" shaped relationship—higher rates were seen in both underweight and obese individuals.
- - The findings suggest that BMI should be considered in evaluating the difficulty of L-LLS procedures and in future assessments of surgical risk and outcomes.
Article Synopsis
- Laparoscopic liver resections (LLR) and robotic liver resections (RLR) are effective techniques for treating large liver tumors (≥10 cm), and a multicenter study provides better understanding of their safety and application.
- A retrospective review of 971 patients from 42 centers between 2002-2020 revealed that 100 underwent RLR and 699 underwent LLR, with a focus on comparing perioperative outcomes.
- After matching for patient characteristics, the study found no significant differences in key outcomes between RLR and LLR, indicating both methods can be safely used with excellent results for large tumors.
Article Synopsis
- The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
- An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
- Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.