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| 1 | Survival outcomes of liver transplantation for hepatocellular carcinoma in patients with normal, high and very high preoperative alpha-fetoprotein levels显示文摘AIM To investigate the impact of alpha-fetoprotein(AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient survival.METHODS Data of adult patients who received liver transplant(LT) for hepatocellular carcinoma(HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes. Patients were mostly listed for LT based on Milan or UCSF criteria. For the purpose of this study, normal AFP level was defined as AFP value < 10 ng/m L, high AFP level was defined as AFP value ≥ 10 to < 400 ng/m L, and very highAFP level was defined as AFP ≥ 400 ng/m L. The patients were divided into these 3 groups accordingly. Survival rates were plotted as Kaplan-Meier curves and compared by log-rank analysis. Continuous variables were expressed as median(interquartile range). Categorical variables were compared by Spearman's test. Discriminative analysis was used to define the lowest value of AFP that could affect the overall survival in study population. Statistical significance was defined by a P value of < 0.05.RESULTS Totally 250 adult patients underwent LT for HCC in the study period. Eight-four of them received deceaseddonor LT and 166 had living-donor LT. The patients were divided into 3 groups: Group A, AFP < 10 ng/m L(n = 83); Group B, AFP ≥ 10 to < 400 ng/m L(n = 131); Group C, AFP ≥ 400 ng/m L(n = 36). The commonest etiology was hepatitis-B-related cirrhosis. The Model for End-stage Liver Disease scores in these groups were similar(median, 13 vs 13 vs 12; P = 0.745). The time to operation in Group A was longer(median, 94 vs 31 vs 35 d; P = 0.001). The groups were similar in hospital mortality(P = 0.626) and postoperative complication(P = 0.702). Pathology of explants showed that the 3 groups had similar numbers of tumor nodules, but the tumors in Group C were larger(A: 2.5 cm, B: 3.0 cm, C: 4.0 cm; P = 0.003). Group C had a bigger proportion of patients who were beyond Milan criteria(P = 0.010). Poor differentiation and vascular permeation were also more common in this group(P = 0.017 and P = 0.003 respectively). It also had poorer 5-year survival(A: 85.5%, B: 82.4%, C: 66%; P = 0.029). The 5-year disease-free survival was 84.3% in Group A, 80.1% in Group B, and 61.1% in Group C. Receiver operating characteristic area under the curve for AFP in predicting tumor recurrence was 0.685. The selected cut-off value was 54 ng/m L for AFP(C-index 0.685; 95%CI: 0.592-0.779; sensitivity 0.595; specificity 0.687). On discriminative analysis, AFP value of 105 ng/m L was shown to affect the overall survival of the patients.CONCLUSION HCC patients with a high preoperative AFP level had inferior survival after LT. AFP level of 54 ng/m L was associated with disease recurrence, and AFP level of 105 ng/m L was found to be the cut-off value for overall survival difference. | Wong Hoi She Albert Chi Yan Chan Tan To Cheung Chung Mau Lo Kenneth Siu Ho Chok | 2018 | World Journal of Hepatology2018，10，2： | 7 |
| 2 | Molecular basis of von Hippel-Lindau syndrome in Chinese patients显示文摘背景 Von Hippel-Lindau ( VHL )症候群是预先安排的正染色体的主导的家庭癌症症候群影响个人到在用南部的汉语的 VHL 的基因基础大部分是的各种各样的 organs.The 的多重瘤 unknown.In 这研究,我们在九无关的南部的中国 families.Methods 描绘了 VHL 的变化光谱有 VHL 的临床的特征的九 probands ,二征兆并且八个无征状的家庭成员在这 study.Prenatal | SIU Wai-kwan MA Ronald Ching-wan LAM Ching-wan MAK Chloe Miu YUEN Yuet-ping LO Fai-man Ivan CHAN Kin-wan LAM Siu-fung LING Siu-cheung TONG Sui-fan SO Wing-yee CHOW Chun-chung TANG Mary Hoi-yin TAM wing-hung CHAN Albert Yan-wo | 2011 | Chinese Medical Journal2011，，2： | 6 |
| 3 | Initial experience with stereotactic body radiotherapy for intrahepatic hepatocellular carcinoma recurrence after liver transplantation显示文摘BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently encountered.Graft hepatectomy is technically challenging and is associated with high morbidity.Stereotactic body radiation therapy(SBRT)has been shown to be safe and effective for the treatment of primary HCC.However,its role in HCC recurrence in a liver graft remains unclear.AIM To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver transplantation.METHODS A retrospective study was conducted.From 2012 to 2018,6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital,the University of Hong Kong.The primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response,as assessed with the Modified response Evaluation Criteria for Solid Tumours criteria.Patients were monitored for treatment related toxicities and graft dysfunction.RESULTS A total of 9 treatment courses were given for 13 tumours.The median tumour size was 2.3 cm(range 0.7-3.6 cm).Two(22%)patients had inferior vena cava tumour thrombus.The best local treatment response was:5(55%)complete response,1(11%)partial response and 3(33%)stable disease.After a median follow up duration of 15.5 mo,no local progression or mortality was yet observed.The median time to overall disease progression was 6.5 mo.There were 6 regional progression in the liver graft(67%)and 2 distant progression in the lung(22%).There was no grade 3 or above toxicity and there was no graft dysfunction after SBRT.CONCLUSION SBRT appears to be safe in this context.Regional progression is the mode of failure. | Kin Pan Au Chi Leung Chiang Albert Chi Yan Chan Tan To Cheung Chung Mau Lo Kenneth Siu Ho Chok | 2020 | World Journal of Clinical Cases2020，8，13： | 3 |
| 4 | 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 |
| 5 | Anterior Approach Versus Conventional Approach Right Hepatic Resection for Large Hepatocellular Carcinoma: A Prospective Randomized Controlled Study显示文摘 | Chi Leung Liu Sheung Tat Fan Siu Tim Cheung Chung Mau Lo Irene O. Ng John Wong | 2006 | Annals of Surgery2006，，2： | 2 |
| 6 | Bile duct anastomotic stricture after adult‐to‐adult right lobe living donor liver transplantation显示文摘 | Kenneth Siu Ho Chok See Ching Chan Tan To Cheung William Wei Sharr Albert Chi Yan Chan Chung Mau Lo Sheung Tat Fan | 2011 | Liver Transpl2011，，1： | 2 |
| 7 | 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 |
| 8 | Cancer Genome Scanning in Plasma: Detection of Tumor-Associated Copy Number Aberrations, Single-Nucleotide Variants, and Tumoral Heterogeneity by Massively Parallel Sequencing显示文摘 | Chan K C Allen Jiang Peiyong Zheng Yama W L Liao Gary J W Sun Hao Wong John Siu Shing Shun N Chan Wing C Chan Stephen L Chan Anthony T C Lai Paul B S Chiu Rossa W K Lo Y M D | 2013 | Clinical Chemistry2013，，1： | 2 |
| 9 | 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 |
| 10 | Degradable transport network: travel time budget of travelers with heterogeneous risk aversion 显示文摘 | Lo H K Luo X W Siu B W Y | 2006 | Transportation Research Part B2006，40，9： | 1 |
| 11 | Nodal detection in malignant melanoma of the vigina using laparoscopic ultrasonography显示文摘 | Shing - shun N siu Keith K Lo | 2004 | Gynecol Oncol2004，92，3： | 1 |
| 12 | Degradable transportation network: travel time budget of travelers with heterogeneous risk aversion 显示文摘 | Lo H K Luo X W Siu B W Y | 2006 | Transportation Research Part B2006，40，9： | 1 |
| 13 | Electro-acupuncture potentiates the disulphide-reducing activities of thioredoxin system by increasing thioredoxin expression in ischemia-reperfused rat brains 显示文摘 | Siu FK Lo SC Leung MC | 2005 | Life Sci2005，77，4： | 1 |
| 14 | Doubly uncertain transport network: Degradable capacity and stochastic demand 显示文摘 | Siu B W Y Lo H K | 2008 | European Journal of Operational Research2008，191，1： | 1 |
| 15 | Doubly uncertain transportation network:degradable capacity and stochastic demand显示文摘 | Siu B W Y Lo H K | | 0，，01： | 1 |
| 16 | Degradable transport network: Travel time budget of travelers with heterogeneous risk aversion显示文摘 | Lo H K Luo X W Siu B W Y | 2006 | Transportation Research Part B2006，40，9： | 1 |
| 17 | Is common iliac lymph node dissection necessary in early stage cervical carcinoma显示文摘 | Siu SSN Cheung TH Lo KWK | 2006 | Gynecol Oncol2006，103，： | 1 |
| 18 | Degradable transport network: traveltime budget of travelers with heterogeneous risk aversion显示文摘 | LO H K LUO X W SIU B W Y | 2006 | Trans-portation Research Part B: Methodological2006，40，9： | 1 |
| 19 | Degradable transport network: travel time budget of travelers with heterogeneous risk aversion显示文摘 | LO H K LUO X W SIU B W Y | 2006 | Transportation Research B2006，，40： | 1 |
| 20 | Doubly uncertain transportation network : degradable capacity and stochastic demand 显示文摘 | SIU B W Y LO H K | 2008 | European Journal of Operational Research2008，191，1： | 1 |
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