Validation of Hong Kong liver cancer staging system in resectable HCC

Tan To CHEUNG 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.-

How to plan surgical extent based on clinical factors?

Cheung Tan To 한국간담췌외과학회 2017 한국간담췌외과학회 학술대회지 Vol.2017 No.3

Learning Laparoscopic Liver Resection for Liver Cancer

Tan To Cheung Korean Society of Gastrointestinal Cancer 2017 Journal of digestive cancer reports Vol.5 No.1

The number of laparosocpic liver resection performed every years has been increasing. There is a trend than more major hepatectomy and complex liver resection is being reported. However there has been a major obstacles in many centers because open liver resection is still considered as a gold standard and many surgeons are still getting used to the old method of liver resection. To start a new procedure, education and training is essential in order to achieve a good outcome without compromising the safety of the patients. A gradual progression is crucial in order to avoid dreadful complication. The development of the consensus meeting and difficulty score has facility the understanding of safe practice in the development of laparoscopic liver resection. In a long run, development of registry system will improve transparency and safety of this operation.

Osteoporosis in East Asia: Current issues in assessment and management

Elaine Y.N. Cheung,Kathryn C.B. Tan,Ching-Lung Cheung,Annie W.C. Kung 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.3

The greatest burden of hip fractures around the world is expected to occur in East Asia, especially China. However, there is a relative paucity of information on the epidemiology and burden of fractures in East Asia. Osteoporosis is greatly under-diagnosed and under-treated, even among the highest-risk subjects who have already suffered fractures. The accessibility to bone densitometry, the awareness of the disease by professionals and the public, and the use and reimbursement of drugs are some of the areas which need improvement especially. Cost-effective analysis on screening strategy and intervention thresholds based on local epidemiology data and economic status are available only in Japan. In addition, clinical risk factor models for the assessment of fracture probability may be ethnic specific. Further research is needed to develop a cost-effective risk assessment strategy to identify high-risk individuals for screening and treatment based on local data. Moreover, inadequate calcium and vitamin D intake is still an issue faced by this region.

Endovascular Management of Hepatic Artery Pseudoaneurysms: A Case Series

Pui Lam Cheung,Yat Sing Lee,Chong Boon Tan,Hin Yue Lau,Chi Wai Siu,Chik Xing Chan,Wai Tat Chan,Cheuk Him Ho 대한혈관외과학회 2023 Vascular Specialist International Vol.39 No.1

Although rare, hepatic artery aneurysms are associated with a high morbidity and mortality, necessitating a prompt diagnosis. A significant proportion of hepatic artery aneurysms are pseudoaneurysms, and the major risk factors of which have already been identified in previous literatures. Presentation can be variable, but diagnosis almost relies entirely on computed tomography and digital subtraction angiography. The endovascular approach has progressively become the preferred option due to its better performance when compared to the traditional surgical approach. However, formulation of an endovascular treatment plan for these lesions remains difficult as multiple factors should be considered to identify the best endovascular treatment modality. Five cases of pseudoaneurysm due to recent Whipple operation, hepatobiliary infections, and underlying malignancy are presented in this article to illustrate the effectiveness and complexity of endovascular treatment in this disease entity.

Development and validation of the Chinese osteoporosis screening algorithm (COSA) in identification of people with high risk of osteoporosis

Ching-Lung Cheung,Gloria HY.Li,Hang-Long Li,Constance Mak,Kathryn CB. Tan,Annie WC. Kung 대한골다공증학회 2023 Osteoporosis and Sarcopenia Vol.9 No.1

Objectives: To enhance the public awareness and facilitate diagnosis of osteoporosis, we aim to develop a new Chinese Osteoporosis Screening Algorithm (COSA) to identify people at high risk of osteoporosis. Methods: A total of 4747 postmenopausal women and men aged ≥ 50 from the Hong Kong Osteoporosis Study were randomly split into a development (N = 2373) and an internal validation cohort (N = 2374). An external validation cohort comprising 1876 community-dwelling subjects was used to evaluate the positive predictive value (PPV). Results: Among 11 predictors included, age, sex, weight, and history of fracture were significantly associated with osteoporosis after correction for multiple testing. Age- and sex-stratified models were developed due to the presence of significant sex and age interactions. The area under the curve of the COSA in the internal validation cohort was 0.761 (95% CI, 0.711-0.811), 0.822 (95% CI, 0.792-0.851), and 0.946 (95% CI, 0.908-0.984) for women aged < 65, women aged ≥ 65, and men, respectively. The COSA demonstrated improved reclassification performance when compared to Osteoporosis Self-Assessment Tool for Asians. In the external validation cohort, the PPV of COSA was 40.6%, 59.4%, and 19.4% for women aged < 65, women aged ≥ 65, and men, respectively. In addition, COSA > 0 was associated with an increased 10-year risk of hip fracture in women ≥ 65 (OR, 4.65; 95% CI, 2.24-9.65) and men (OR, 11.51; 95% CI, 4.16-31.81). Conclusions: We have developed and validated a new osteoporosis screening algorithm, COSA, specific for Hong Kong Chinese.

Is Adjuvant Transarterial Chemoembolization Useful for Hepatocellular Carcinoma?

( Wong Hoi She ),( Cheung Tan To ),( Simon H. Y. Tsang ),( Wing Chiu Dai ),( Albert C. Y. Chan ),( Kenneth S. H. Chok ),( Kelvin K. C. Ng ),( Chung Mau Lo ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Hepatectomy is the well-established curative treatment for hepatocellular carcinoma (HCC). However, adjuvant therapy is still controversial. This study tried to look into the effect of transarterial chemoembolization (TACE) in patients receiving hepatectomy for HCC. Methods: This is a retrospective study held in a single institution using prospectively maintained database for all the patients who underwent hepatectomy for HCC between January 2000 - December 2015. The perioperative details, pathological data and outcome were studied. Patients were matched at 1:10 ratio with comparable tumor size, number, indocyanine green retention test at 15 minutes, Child’s grading and tumor staging. The Kaplan-Meier method was used for survival analysis. The log-rank test was used for survival comparison. Results: There were total 1316 patients underwent hepatectomy for HCC. 38 patients with TACE were identified, and matched with 380 patients without TACE. The patients’ characteristics including age, sex, comorbidity, Child’s grading, ICG, tumor size and numbers were the same. The median sizes of the tumor were similar (9cm in TACE vs 8cm). There was no difference in terms of intraoperative management, extent of hepatectomy and postoperative complications. There were more patients with margin involvement in TACE group (23.7% vs 7.9%, p=0.004). The staging of the disease showed no significant difference in both groups. The disease free survival was similar (12.6 (TACE) vs 10.1months, p=0.794). There was no difference in overall survival with median survival of 27.8 (TACE) vs 36.9 months (5-year overall survival of 27.9% vs 41.2%, p=0.941). Conclusions: Margin involvement was known to be adverse factor for survival. Adjuvant TACE may benefit high-risk HCC patients with margin involvement as shown to have similar survival for those patients without margin involvement.

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Hong Kong perspective

Rex Wan-Hin Hui,Lung-Yi Mak,Tan-To Cheung,Victor Ho-Fun Lee,Wai-Kay Seto,Man-Fung Yuen 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.2

Hepatocellular carcinoma (HCC) is a major public health burden in Hong Kong, and chronic hepatitis B is the most common HCC etiology in our region. With the high case load, extensive local expertise on HCC has been accumulated. This article summarized local guidelines and real-life practice on HCC management in Hong Kong. For HCC surveillance, liver ultrasound and serum alpha-fetoprotein for periodic screening is recommended in viral hepatitis or cirrhotic patients, and this is adhered to in clinical practice. HCC diagnosis is not covered in local guidelines, yet our practice is in-line with regional guidelines, where diagnosis is usually achieved by cross-sectional imaging and without the need for histology. Our guidelines recommend using the Hong Kong Liver Cancer Staging for pre-treatment staging, yet we routinely use other widely-adopted systems such as the Barcelona Clinic Liver Cancer Staging and the Tumor-Node-Metastasis Staging as well. Our local guidelines have provided clear treatment algorithms for the whole range of HCC therapies, including resection, ablation, transplant, transarterial chemoembolization, transarterial radioembolization, stereotactic body radiation therapy, targeted therapy, and immunotherapy. Real-life treatment choices are largely in line with the guidelines, although treatment protocols are individualized, and availability of specific therapies can vary between centers. Overall, HCC guidelines in Hong Kong are tailored based on local expertise and our unique patient population. The guidelines are up-to-date and provide practical pathways to assist our routine practice. Regular updates of local guidelines are warranted to account for the rapidly evolving paradigm of HCC management.

PREDICTING THE USAGE OF ONLINE FOOD DELIVERY SERVICES: A META-ANALYTIC STRUCTURAL EQUATION MODELING STUDY

Weisheng Chiu,Badu-Baiden Frank,Peter Kim Tan Cheung 글로벌지식마케팅경영학회 2023 Global Marketing Conference Vol.2023 No.07

With the development of information technology, online food delivery services have significantly changed people’s food consumption patterns. The outbreak of COVID-19 has further facilitated the development due to restaurant restrictions and social distancing measures. Due to the emergence of online food delivery services, scholars have paid increasing attention to this popular topic, and a large number of studies have examined which factors are related to consumers’ intention to use online food delivery services. However, previous studies showed inconsistent findings, and relationships between variables lack a comprehensive understanding. Therefore, this study aimed to develop a research model and examine the factors influencing consumers’ intention to use online food delivery services. By reviewing and analyzing 52 studies with 53 independent samples (N = 22,937), the meta-analytic structural equation modeling approach was carried out to assess the research model. The findings indicate that two attributes of online food delivery services (i.e., convenience and price-saving orientation) play different roles in the research model. Specifically, convenience significantly impacted perceived ease of use but had no direct impact on perceived usefulness. Price-saving orientation significantly influenced both perceived ease of use and perceived usefulness. Moreover, relationships between perceived ease of use, perceived usefulness, and perceived trust were significant, and these factors ultimately significantly led to the intention to use food delivery services. The findings contribute to theoretical advancement in the extant literature on food delivery services and help firms develop to provide better food delivery services for consumers’ continuous usage.

The use of 18F-FDG positron emission tomography to predict tumour recurrence in hepatocellular carcinoma patients after hepatectomy

Jun ZHENG,Tiffany CL WONG,Jeff WC DAI,Albert CY CHAN,Tan-To CHEUNG,Chung-Mau LO 한국간담췌외과학회 2022 Annals of hepato-biliary-pancreatic surgery Vol.26 No.-