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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 | 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 | 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 |
| 4 | 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 |
| 5 | Developing a trust inventory for construction contracting显示文摘 | Sai On Cheung Wei Kei Wong Tak Wing Yiu Hoi Yan Pang | 2010 | International Journal of Project Management2010,,2: | 1 |
| 6 | A framework for trust in construc- tion contracting显示文摘 | Wong Wei Kei Cheung Sai On Yiu Tak Wing Pang Hoi Yan | 2008 | International Journal of Pro- ject Management2008,26,8: | 1 |
| 7 | Developing a trust inventory for construction contracting 显示文摘 | Cheung Sai On Wong Wei Kei Yiu Tak Wing Pang Hoi Yan | 2011 | International Journal of Project Management2011,29,2: | 1 |
| 8 | Upfront consolidation treatment with 131I-mIBG followed by myeloablative chemotherapy and hematopoietic stem cell transplantation in high-risk neuroblastoma显示文摘Importance:131I-metaiodobenzylguanidine(131I-mIBG)has a significant targeted antitumor effect for neuroblastoma.However,currently there is a paucity of data for the use of 131I-mIBG as a'front-line'therapeutic agent in those patients with newly diagnosed high-risk neuroblastoma as part of the conditioning regimen for myeloablative chemotherapy(MAC).Objective:To evaluate the feasibility of upfront consolidation treatment with 131I-mIBG plus MAC and hematopoietic stem cell transplantation(HSCT)in high-risk neuroblastoma patients.Methods:A retrospective,single-center study was conducted from 2003-2019 on newly diagnosed high-risk neuroblastoma patients without progressive disease(PD)after the completion of induction therapy.They received 131I-mIBG infusion and MAC followed by HSCT.Results:A total of 24 high-risk neuroblastoma patients were enrolled with a median age of 3.0 years at diagnosis.After receiving this sequential consolidation treatment,3 of 13 patients who were in partial response(PR)before 131I-mIBG treatment achieved either complete response(CR)(n=1)or very good partial response(VGPR)(n=2)after HSCT.With a median follow-up duration of 13.0 months after 131I-mIBG therapy,the 5-year event-free survival and overall survival rates estimated were 29%and 38%for the entire cohort,and 53%and 67%for the patients who were in CR/VGPR at the time of 131I-mIBG treatment.Interpretation:Upfront consolidation treatment with 131I-mIBG plus MAC and HSCT is feasible and tolerable in high-risk neuroblastoma patients,however the survival benefit of this 131I-mIBG regimen is only observed in the patients who were in CR/VGPR at the time of 131I-mIBG treatment. | Jianhua Feng Frankie WT Cheng Alex WK Leung Vincent Lee Eva WM Yeung Hoi Ching Lam Jeanny Cheung Grace KS Lam Terry TW Chow Carol LS Yan Chi Kong Li | 2020 | Pediatric Investigation2020,4,3: | 1 |
| 9 | Teacher Efficacy:A Comparative Study of Hong Kong and Shanghai Primary In-Service Teachers显示文摘 | Hoi Yan Cheung | 2008 | Australian Educational Researcher2008,,1: | 1 |
| 10 | 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 |
| 11 | In-Home Drug Storage by Older Adults显示文摘Globally,in-home drug-storage compliance is often unsatisfactory,especially among older adults,and can lead to negative health outcomes.This study used a cross-sectional and descriptive design to examine inhome drug-storage compliance among older adults.Convenience sampling was used to recruit 117 older adults in Hong Kong.An in-home drugstorage checklist was used to assess the in-home drug-storage environments(light,temperature,and humidity)and drug-storage methods(drug safety,packaging,information,and expiration)of each older adult.The findings showed that Hong Kong older adults’overall compliance rate in drug storage was 87.25%,and their compliance rate for drug-storage methods(84.59%)was lower than that for drug-storage environments(97.02%).Older adults who were of advanced age,who were less educated or who lived alone demonstrated lower in-home drug-storage compliance.This indicates the need to revise existing health-education strategies to encourage in-home drug-storage compliance.Healthcare professionals should assess older adults’drug-storage compliance to identify less compliant subgroups and deliver specific drug-storage support as required.Family members should also be involved in this process. | Lori Suet Hang Lo Linda Yin King Lee Irene Yuen Fung Wong Yuen Yan Lai Hoi Tong Au Tsz Ying Wong Chui Ping Chueng Wai Lam Shek Choi Yi Wong Hoi Lam Chan Hon Sze Cheuk Nga Hing Mark Shu Ching Wong Wing Yan Cheung | 2020 | Journal of Geriatric Medicine2020,2,3: | 0 |