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| 1 | Importance of surgical margin in the outcomes of hepatocholangiocarcinoma显示文摘AIM To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma(HCC-CC).METHODS Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from1995 to 2014 were reviewed.Patients with pathologically confirmed HCC-CC were included for analysis.Demographic,biochemical,operative and pathological data were analyzed against survival outcomes. RESULTSForty-two patients were included for analysis.The median age was 53.5 years.There were 29 males.Hepatitis B virus was identified in 73.8%of the patients.Most patients had preserved liver function.The median preoperative indocyanine green retention rate at 15 min was 10.2%.The median tumor size was 6.5 cm.Major hepatectomy was required in over 70%of the patients.Hepaticojejunostomy was performed in 6 patients.No hospital death occurred.The median hospital stay was 13 d.The median follow-up period was 32 mo.The 5-year disease-free survival and overall survival were 23.6%and 35.4%respectively.Multifocality was the only independent factor associated with diseasefree survival[P<0.001,odds ratio 4,95%confidence interval(CI):1.9-8.0].In patients with multifocal tumor(n=20),resection margin of≥1 cm was associated with improved 1-year disease-free survival(40%vs 0%;log-rank,P=0.012).CONCLUSIONHCC-CC is a rare disease with poor prognosis.Resection margin of 1 cm or above was associated with improved survival outcome in patients with multifocal HCC-CC. | Ka Wing Ma Kenneth Siu Ho Chok | 2017 | World Journal of Hepatology2017，9，13： | 5 |
| 2 | Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis显示文摘BACKGROUND Small-for-size grafts (SFSGs) in living donor liver transplantation (LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking. AIM To evaluate the impact of small-for-size liver grafts on medium-term and longterm graft survival in adult to adult LDLT. METHODS A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on PubMed, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival. Incidence of small-for-size syndrome and short term mortality were also extracted. RESULTS This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31 (95% confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies. CONCLUSION SFSG is associated with inferior medium-term but not long-term graft survival. Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures. Close follow-up for graft function is warranted within 3 years after liver transplantation. | Ka Wing Ma Kelly Hiu Ching Wong Albert Chi Yan Chan Tan To Cheung Wing Chiu Dai James Yan Yue Fung Wong Hoi She Chung Mau Lo Kenneth Siu Ho Chok | 2019 | World Journal of Gastroenterology2019，25，36： | 3 |
| 3 | Role of C11-FDG dual-tracer PET-CT scan in metastatic screening of hepatocellular carcinoma-a cost-effectiveness analysis显示文摘Background:We aimed to identify predictive factors for positron emission tomography(PET)-detected hepatocellular carcinoma(HCC)metastasis and a cost-effective approach to preoperative PET-computed tomography(CT)for detecting metastasis.Methods:Clinicopathological and survival data of HCC patients having PET-CT with 18F-fludeoxyglucose(FDG)and 11C-acetate(ACT)following contrast-enhanced CT/magnetic resonance imaging(MRI)for preoperative tumor staging were reviewed.Binary logistic regression was performed to identify predictive factors for PET-detected metastasis.A cost-benefit analysis model was built for the incurred costs and the impact of PET-CT findings on treatment strategy was studied.Results:Totally 152 patients were analyzed.Dual-tracer PET-CT detected metastasis in 17 patients(11%).By multivariate analysis,alpha-fetoprotein(AFP)≥400 ng/mL[relative risk(RR):4.30,95%confidence interval(CI):1.41-13.15,P=0.011]and bilobar disease(RR:3.94,95%CI:1.24-12.52,P=0.014)were independent predictive factors for PET-detected metastasis.PET-CT findings altered the treatment strategy for 12 patients(7.9%);three partial hepatectomies,eight episodes of transarterial chemoembolization(TACE)and one episode of ablation were avoided,with an estimated cost-saving of US$91,000,$150,000 and$10,600 respectively.Had the PET-CT been performed only for patients with AFP≥400 ng/mL or bilobar disease(n=74),metastasis would have been confirmed in 14 patients(18.9%),and the cost-saving per patient was estimated at US$1,070.Conclusions:Dual-tracer PET-CT is cost-effective and useful for preoperative HCC staging in patients with AFP≥400 ng/mL or bilobar disease.Its routine use in preoperative workup for all HCC patients is not recommended.Unilobar disease with AFP<400 ng/mL can achieve good negative predictive value for PET-detected metastasis.Screening patients with either factor can avoid unnecessary procedures and is thus cost-effective for preoperative HCC workup. | Kevin K.W.Chu Albert C.Y.Chan Ka Wing Ma Wong Hoi She Wing Chiu Dai Kenneth S.H.Chok Tan To Cheung Chung Mau Lo | 2021 | Hepatobiliary Surgery and Nutrition2021，10，3： | 2 |
| 4 | Liver transplantation:would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion?显示文摘Background:Hepatocellular carcinoma(HCC)with portal vein tumour thrombus(PVTT)signifies advanced disease,whether LT confers any survival superiority over resection remains uncertain.Methods:A propensity score matched(PSM)analysis of liver transplantation(LT)and liver resection(LR)for HCC with PVTT was performed.Results:A consecutive series of 88 patients who received either LT(10 DDLTs and 3 LDLTs)or LR(n=75)respectively were recruited.Before PSM,the LT group has a higher MELD score(17.3 vs.7.8,P<0.001),lower serum AFP levels(96 vs.2,164 ng/mL,P=0.017)and smaller tumour size(4 vs.10 cm,P<0.001).The 5-year overall survival for LT and LR were 55.4%and 15.9%respectively(P=0.007).After matching for serum AFP levels and tumour size,1-,3-and 5-year overall survival for LT were 81 ng/mL,3.9 cm,80%,70%and 70%and the corresponding rates for LR were 1,417 ng/mL,5.3 cm,51.8%,19,6%and 9.8%(P value=0.12,0.27 and 0.009 respectively).Conclusions:LT is associated with significantly better oncological outcomes in HCC patients with PVTT involving the lobar or segmental level.A modest expansion of selection criteria to include small HCC with segmental PVTT should be considered. | Ka Wing Ma Albert Chi Yan Chan Kenneth Siu Ho Chok Wong Hoi She Tan To Cheung Wing Chiu Dai James Yan Yue Fung Chung Mau Lo | 2021 | Hepatobiliary Surgery and Nutrition2021，10，3： | 2 |
| 5 | Validated model for prediction of recurrent hepatocellular carcinoma after liver transplantation in Asian population显示文摘BACKGROUND Liver transplantation(LT) is regarded as the best treatment for both primary and recurrent hepatocellular carcinoma(HCC). Post-transplant HCC recurrence rate is relatively low but significant, ranging from 10%-30% according to different series. When recurrence happens, it is usually extrahepatic and associated with poor prognosis. A predictive model that allows patient stratification according to recurrence risk can help to individualize post-transplant surveillance protocol and guidance of the use of anti-tumor immunosuppressive agents.AIM To develop a scoring system to predict HCC recurrence after LT in an Asian population.METHODS Consecutive patients having LT for HCC from 1995 to 2016 at our hospital were recruited. They were randomized into the training set and the validation set in a60:40 ratio. Multivariable Cox regression model was used to identity factors associated with HCC recurrence. A risk score was assigned to each factor according to the odds ratio. Accuracy of the score was assessed by the area under the receiver operating characteristic curve.RESULTS In total, 330 patients were eligible for analysis(183 in training and 147 invalidation). Recurrent HCC developed in 14.2% of them. The median follow-up duration was 65.6 mo. The 5-year disease-free and overall survival rates were78% and 80%, respectively. On multivariate analysis, alpha-fetoprotein > 400 ng/mL [P = 0.012, hazard ratio(HR) 2.92], sum of maximum tumor size and number(P = 0.013, HR 1.15), and salvage LT(P = 0.033, HR 2.08) were found to be independent factors for disease-free survival. A risk score was calculated for each patient with good discriminatory power(c-stat 0.748 and 0.85, respectively,in the training and validation sets). With the derived scores, patients were classified into low-(0–9), moderate-(> 9–14), and high-risk groups(> 14), and the risk of HCC recurrence in the training and validation sets was 10%, 20%, 54%(cstat 0.67) and 4%, 22%, 62%(c-stat 0.811), accordingly. The risk stratification model was validated with chi-squared goodness-of-fit test(P = 0.425).CONCLUSION A validated predictive model featuring alpha-fetoprotein, salvage LT, and the sum of largest tumor diameter and total number of tumor nodule provides simple and reliable guidance for individualizing postoperative surveillance strategy. | Ka Wing Ma Wong Hoi She Albert Chi Yan Chan Tan To Cheung James Yan Yue Fung Wing Chiu Dai Chung Mau Lo Kenneth Siu Ho Chok | 2019 | World Journal of Gastrointestinal Oncology2019，11，4： | 2 |
| 6 | JAK - STAT and intesti- nal mucosal immunology显示文摘 | Heneghan AF Pierre JF Kenneth KA | 2013 | JAKSTAT2013，2，25： | 1 |
| 7 | Sentinel lymph node mapping in breast cancer, using subareolar injection of blue dye显示文摘 | Kenneth KA | 1999 | J Am Coll Surg1999，189，6： | 1 |
| 8 | Optimization of a long-period grating-based Mach–Zehnder interferometer for temperature measurement显示文摘 | Samer K. Abi Kaed Bey Tong Sun Kenneth T.V. Grattan | 2006 | Optics Communications2006，，1： | 1 |
| 9 | Assessment of Fibrosis by Transient Elastography Compared With Liver Biopsy and Morphometry in Chronic Liver Diseases显示文摘 | Grace Lai–Hung Wong Vincent Wai–Sun Wong Paul Cheung–Lung Choi Anthony Wing–Hung Chan Richard Hoi–Leong Chum Henry Kai–Wing Chan Kenneth Ka–Ki Lau Angel Mei–Ling Chim Karen Ka–Lam Yiu Francis Ka–Leung Chan Joseph Jao–Yao Sung Henry Lik–Yuen Chan | 2008 | Clinical Gastroenterology and Hepatology2008，，9： | 1 |
| 10 | Baseline gut microbiota and metabolome predict durable immunogenicity to SARS-CoV-2 vaccines显示文摘The role of gut microbiota in modulating the durability of cOVID-19 vaccine immunity is yet to be characterised.In this cohort study,we collected blood and stool samples of 121 BNT162b2 and 40 CoronaVac vaccinees at baseline,1 month,and 6 months post vaccination(p.v).Neutralisation antibody,plasma cytokine and chemokines were measured and associated with the gut microbiota and metabolome composition. | Ye Peng Lin Zhang Chris K.P.Mok Jessica Y.L.Ching Shilin Zhao Matthew K.L.Wong Jie Zhu Chunke Chen Shilan Wang Shuai Yan Biyan Qin Yingzhi Liu Xi Zhang Chun Pun Cheung Pui Kuan Cheong Ka Long Ip Adrian C.H.Fung Kenneth K.Y.Wong David S.C.Hui Francis K.L.Chan Siew C.Ng Hein M.Tun | 2023 | Signal Transduction and Targeted Therapy2023，8，10： | 0 |
| 11 | Experience of living donor liver transplantation for hepatocellular carcinoma in the University of Hong Kong Hospital显示文摘Aim:To describe the current practise of living donor liver transplantation(LDLT)for hepatocellular carcinoma(HCC),including the patient selection criteria,surgical techniques,management of small-for-size syndrome,postoperative complications,and the results of our units,in the Liver Transplant Centre of Queen Mary Hospital,Hong Kong,one of the high-volume centres for LDLT in Asia.Methods:Our centre practises careful selection for HCC patients using the University of California,San Francisco(UCSF)criteria,supplemented by alpha-fetoprotein level and the model for end-stage liver disease score.Slight flexibility is offered to enthusiastic donors and recipients in LDLT while balancing the risks and benefits.We pioneered in using the extended right lobe graft and the novel hepatic venoplasty technique,which lessen the risk of hyperperfusion and small-for-size syndrome with improved overall recipient survival.Data were collected prospectively and presented as the mean values and ranges,or the number of patients in proportion of total patient population.Results:Of our patients,74.9% met the UCSF criteria,and 64.5% met the Milan criteria.A 5-year overall and disease-free survival rate of 78.9% and 76.3% were achieved.Conclusion:LDLT is an ideal treatment for HCC in Hong Kong with regard to the critical organ shortage and high demand for transplantation.The current surgical techniques and post-transplant surveillance contribute to the positive outcome. | Janice Hoi Man Mok Ka Wing Ma Kenneth Siu Ho Chok | 2022 | Hepatoma Research2022，8，1： | 0 |
| 12 | Erratum:Defining the role of laparoscopic liver resection in elderly HCC patients:a propensity score matched analysis显示文摘This is an Erratum of the publsihed paper:Defining the role of laparoscopic liver resection in elderly HCC patients:a propensity score matched analysis.The ethical approval and consent to participation information were missing in the DECLARATIONS section due to the production issue.The original article has been updated. | Phoenix Wai Yan Wong Ka Wing Ma Tan To Cheung Wong Hoi She Wing Chiu Dai Albert Chi YanChan Kenneth Siu Ho Chok Chung Mau Lo | 2022 | Hepatoma Research2022，8，1： | 0 |
| 13 | Donor ductal anomaly is not a contraindication to right liver lobe donation显示文摘Background:Data of living-donor liver transplantation(LDLT)suggested that donor ductal anomaly may contribute to postoperative biliary complications in recipients and in donors.This retrospective study aimed to determine if the occurrence of postoperative biliary stricture in donors or recipients in rightlobe LDLT(RLDLT)is related to donor biliary anatomy type.Methods:We analyzed our RLDLT recipients’clinical data and those of their graft donors.The recipients were divided into 2 groups:with and without postoperative biliary stricture.The 2 groups were compared.The primary endpoints were donor biliary anatomy type and postoperative biliary complication incidence;the secondary endpoints were 1-,3-and 5-year graft and patient survival rates.Results:Totally 127 patients were included in the study;25(19.7%)of them developed biliary anastomotic stricture.In these 25 patients,16 had type A biliary anatomy,3 had type B,2 had type C,3 had type D,and 1 had type E.In the 127 donors,96(75.6%)had type A biliary anatomy,13(10.2%)had type B,6(4.7%)had type C,10(7.9%)had type D,and 2(1.6%)had type E.Biliary stricture was seen in 2 donors,who had type A biliary anatomy.None of the recipients or donors developed bile leakage.No association between the occurrence of postoperative biliary stricture and donor biliary anatomy type was found(P=0.527).Conclusions:The incidence of biliary stricture in donors or recipients after RLDLT was not related to donor biliary anatomy type.As postoperative complications were similar in whatever type of donor bile duct anatomy,donor ductal anomaly should not be considered a contraindication to donation of right liver lobe. | Kenneth SH Chok James YY Fung Wing Chiu Dai Sui Ling Sin Ka Wing Ma Albert CY Chan Tan To Cheung Chung Mau Lo | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，4： | 0 |
| 14 | Resection of T4 hepatocellular carcinomas with adjacent structures, is it justified?显示文摘BACKGROUND: T4 hepatocellular carcinoma(HCC) with invasion to adjacent structure(s) may require resection of not only the tumor but also the invaded structure(s). This study aims to assess whether such combined resection for T4 HCC is justifiable.METHODS: Adult patients with T4 HCC were divided into three groups. Group 1: tumors and invaded adjacent structures were resected together if histopathologically confirmed tumor invasion; group 2: same as group 1 but histopathologically confirmed tumor adhesion; group 3: tumor resection only. Group comparisons were made.RESULTS: Totally 144 patients were included in the study.There were 71, 14 and 59 patients in groups 1, 2 and 3, respectively. The groups were comparable in demographics, complication and survival. Ten hospital deaths occurred(5, 0 and 5 in groups 1, 2 and 3, respectively; P=0.533). The 5-year overall survival(hospital mortality excluded) was 17.8% in group 1,14.3% in group 2, and 28.9% in group 3(P=0.191). The 5-year disease-free survival was 10.4% in group 1 and 14.5% in group 3(no data for group 2 yet)(P=0.565). On multivariate analysis,macrovascular invasion and poor differentiation were risk factors for survival whereas combined resection did not impact patients' survival. CONCLUSIONS: Combined resection achieved survival outcomes similar to tumor resection only. Patients with tumor invasion and those with tumor adhesion had comparable survival after combined resection. At centers with the required expertise, combined resection should be attempted to treat T4 HCCs with clinically suspected invasion of adjacent structures. | Kenneth SH Chok Ka Kin Ng Tan To Cheung Albert CY Chan See Ching Chan Chung Mau Lo | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，1： | 0 |
| 15 | Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?显示文摘In view of the increasing life expectancy in different parts of the world, a larger proportion of elderly patients with hepatocellular carcinoma(HCC) requiring oncological treatment is expected. The clinicopathological characteristics of HCC in elderly patients and in younger patients are different. Elderly patients, in general, also have more comorbidities. Evaluation of the efficacy of different HCC treatment options in elderly patients is necessary to optimize treatment outcomes for them. Treatment modalities for HCC include hepatectomy, liver transplantation, radiofrequency ablation, transarterial chemoembolization, and molecular-targeted therapy with sorafenib. In this review, current evidence on the risks and outcomes of the different HCC treatments for elderly patients are discussed. According to data in the literature, elderly patients and younger patients benefited similarly from HCC treatments. More clinical data are needed for the determination of selecting criteria on elderly HCC patients to maximize their chance of getting the most appropriate and effective treatments. As such,further studies evaluating the outcomes of different HCC treatment modalities in elderly patients are warranted. | Kevin Ka Wan Chu Kenneth Siu Ho Chok | 2019 | World Journal of Gastroenterology2019，25，27： | 0 |
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