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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 322-325页

作者： Billy ho Hung Cheung Wong hoi She siu lun ho Albert Chi Yan Chan Chung Mau Lo Tan To Cheung Department of Surgery The University of Hong KongHong KongChina Department of Pathology The University of Hong KongHong KongChina

To the Editor:Extraovarian primary peritoneal carcinoma(EOPPC)is an uncommon malignancy with many similarities to epithelial ovarian carcinoma in histological,clinical,and etiological aspects[1].This phenomenon is explained by their common embryonal origin,in which both develop from the coelomic epithelium in the early embryological *** their similarities,the incidence of EOPPC is significantly lower than that of epithelial ovarian carcinoma(6.78 cases per million vs.120.5 cases per million)[1].

关键词： peritoneal invasion metastasis

Ileocolonic mucormycosis in adult immunocompromised patients:A surgeon's perspective

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World Journal of Gastroenterology 2010年第9期16卷 1165-1170页

作者： Oswens siu-Hung Lo Wai-lun Law Division of Colorectal Surgery Department of SurgeryUniversity of Hong Kong Medical CentreQueen Mary Hospital

We report three cases of ileocolic mucormycosis in adult immunocompromised patients presenting as acute *** patients underwent laparotomy but two of them died from multiorgan failure before the diagnoses were *** diagnosis of gastrointestinal mucormycosis is rarely suspected,and antemortem diagnosis is made in only 25%-50% of *** cases illustrate the difficulty encountered by surgeons in managing acute abdomen in neutropenic patients with hematological *** management of colonic mucormycosis in the published literature is also reviewed.

关键词： Gastrointestinal mucormycosis Colon Immunocompromised Surgery

Cancer stem-like cells in Epstein-Barr virus-associated nasopharyngeal carcinoma

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Chinese Journal of Cancer 2014年第11期33卷 529-538页

作者： Samantha Wei-Man lun siu-Tim Cheung Kwok-Wai Lo Department of Anatomical and Cellular Pathology State Key Laboratory in Oncology in South ChinaPrince of Wales Hospital Department of Surgery The University of Hong Kong Li Ka Shing Institute of Health Science The Chinese University of Hong Kong

Although the Epstein-Barr virus(EBV) has spread to all populations in the world, EBV-associated nasopharyngeal carcinoma(NPC) is prevalent only in South China and Southeast Asia. The role of EBV in the malignant transformation of nasopharyngeal epithelium is the main focus of current researches. Radiotherapy and chemoradiotherapy have been successful in treating early stage NPC, but the recurrence rates remain high. Unfortunately, local relapse and metastasis are commonly unresponsive to conventional treatments. These recurrent and metastatic lesions are believed to arise from residual or surviving cells that have the properties of cancer stem cells. These cancer stem-like cells(CSCs) have the ability to selfrenew, differentiate, and sustain propagation. They are also chemo-resistant and can form spheres in anchorage-independent environments. This review summarizes recent researches on the CSCs in EBVassociated NPC, including the findings regarding cell surface markers, stem cell-related transcription factors, and various signaling pathways. In particular, the review focuses on the roles of EBV latent genes [latent membrane protein 1(LMP1) and latent membrane protein 2A(LMP2A)], cellular microRNAs, and adenosine triphosphate(ATP)-binding cassette chemodrug transporters in contributing to the properties of CSCs, including the epithelial-mesenchymal transition, stem-like transition, and chemo-resistance. Novel therapeutics that enhance the efficacy of radiotherapy and chemoradiotherapy and inhibitors that suppress the properties of CSCs are also discussed.

关键词：肿瘤干细胞 EB病毒鼻咽癌潜伏膜蛋白1 上皮细胞东南亚地区三磷酸腺苷 EBV

Multidisciplinary approach for post-liver transplant recurrence of hepatocellular carcinoma: A proposed management algorithm

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World Journal of Gastroenterology 2018年第45期24卷 5081-5094页

作者： Kin Pan Au Kenneth siu ho Chok Department of Surgery Queen Mary Hospital Department of Surgery and State Key Laboratory for Liver Research The University of Hong Kong

A large number of liver transplants have been performed for hepatocellular carcinoma(HCC), and recurrence is increasingly encountered. The recurrence of HCC after liver transplantation is notoriously difficult to manage. We hereby propose multi-disciplinary management with a systematic approach. The patient is jointly managed by the transplant surgeon, physician, oncologist and radiologist. Immunosuppressants should be tapered to the lowest effective dose to protect against rejection. The combination of a mammalian target of rapamycin inhibitor with a reduced calcineurin inhibitor could be considered with close monitoring of graft function and toxicity. Comprehensive staging can be performed by dual-tracer positron emission tomography-computed tomography or the combination of contrast computed tomography and a bone scan. In patients with disseminated recurrence, sorafenib confers survival benefits but is associated with significant drug toxicity. Oligo-recurrence encompasses recurrent disease that is limited in number and location so that loco-regional treatments convey disease control and survival benefits. Intra-hepatic recurrence can be managed with graft resection, but significant operative morbidity is expected. Radiofrequency ablation and stereotactic body radiation therapy(SBRT) are effective alternative strategies. In patients with more advanced hepatic disease, regional treatment with trans-arterial chemoembolization or intra-arterial Yttrium-90 can be considered. For patients with extra-hepatic oligorecurrence, loco-regional treatment can be considered if practical. Patients with more than one site of recurrence are not always contraindicated for curative treatments. Surgical resection is effective for patients with pulmonary oligo-recurrence, but adequate lung function is a prerequisite. SBRT is a non-invasive and effective modality that conveys local control to pulmonary and skeletal oligo-recurrences.

关键词： Hepatocellular carcinoma Recurrence Liver transplantation

Minimally invasive donor hepatectomy, are we ready for prime time?

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World Journal of Gastroenterology 2018年第25期24卷 2698-2709页

作者： Kin Pan Au Kenneth siu ho Chok Department of Surgery Queen Mary Hospital Department of Surgery and State Key Laboratory for Liver Research The University of Hong Kong

Minimally invasive surgery potentially reduces operative morbidities. however, pure laparoscopic approaches to donor hepatectomy have been limited by technical complexity and concerns over donor safety. Reducedwound donor hepatectomy, either in the form of a laparoscopic-assisted technique or by utilizing a minilaparotomy wound, i.e., hybrid approach, has been developed to bridge the transition to pure laparoscopic donor hepatectomy, offering some advantages of minimally invasive surgery. To date, pure laparoscopic donor left lateral sectionectomy has been validated for its safety and advantages and has become the standard in experienced centres. Pure laparoscopic approaches to major left and right liver donation have been reported for their technical feasibility in expert hands. Robotic-assisted donor hepatectomy also appears to be a valuable alternative to pure laparoscopic donor hepatectomy, providing additional ergonomic advantages to the surgeon. Existing reports derive from centres with tremendous experience in both laparoscopic hepatectomy and donor hepatectomy. The complexity of these procedures means an arduous transition from technical feasibility to reproducibility. Donor safety is paramount in living donor liver transplantation. Careful donor selection and adopting standardized techniques allow experienced transplant surgeons to safely accumulate experience and acquire proficiency. An international prospective registry will advance the understanding for the role and safety of pure laparoscopic donor hepatectomy.

关键词： laparoscopic donor hepatectomy living donor liver transplantation minimally invasive surgery

Sarcopenia in pancreatic cancer–effects on surgical outcomes and chemotherapy

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World Journal of Gastrointestinal Oncology 2019年第7期11卷 527-537页

作者： Miu Yee Chan Kenneth siu ho Chok Department of Surgery Queen Mary Hospital 102 Pokfulam Road Hong Kong China Department of Surgery and State Key Laboratory for Liver Research The University of Hong Kong Hong Kong China

Sarcopenia is found in up to 65% of pancreatic cancer patients. The definition and diagnostic methods for sarcopenia have changed over the years, and the measurement of skeletal muscle mass with cross-sectional imaging has become the most popular way of assessment, although the parameters measured vary among different studies. It is still debatable that there is an association between sarcopenia and postoperative pancreatic fistula, but most studies showed a higher risk in patients with sarcopenic obesity. Long-term survival is worse in sarcopenic patients, as shown by meta-analysis. Sarcopenia is also associated with decreased survival and higher toxicity in patients receiving chemotherapy, and chemotherapy also tends to potentiate sarcopenia. Treatment for sarcopenia still remains an area for research, although oral supplements, nutritional modifications and exercise training have been shown to improve sarcopenia.

关键词： Sarcopenia Pancreatic cancer Clinical outcomes Surgical outcomes Chemotherapy Radiotherapy

Structure and species composition of tree stands on verges and slopes along a major highway in hong Kong

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Journal of Forestry Research 2023年第5期34卷 1347-1358页

作者： Louis Shing Him Lee Hao Zhang Kathy Tze Kwun Ng Shun Cheong Lo Alan siu lun Yu Faculty of Design and Environment Technological and HigherEducation Institute of Hong KongHong KongPeople’s Republic of China Landscape Division Highways DepartmentHong KongPeople’s Republic of China Greening Landscape and Tree Management SectionDevelopment BureauHong KongPeople’s Republic of China

Arboricultural research focusing on transport land use was lacking in hong *** highway slopes were registered in the Systematic Identification of Maintenance Responsibility of Slopes in the Territory(SIMAR),abbreviated as SIMAR *** aimed to analyze patterns in the structure and species composition of the tree stock along a highway in hong Kong and examined how a slope registration system could help explain the characteristics of urban *** 53 slopes and 52 verges along San Tin Highway,hong Kong were randomly *** trees on each slope and verge were collectively sampled as a tree *** variables,namely tree abundance,species richness,maximum tree height,Shannon-Wiener diversity,Simpson's dominance,and Pielou's evenness were measured for each *** addition,a limited visual tree risk assessment was *** 7,209 trees in 23 species were *** richness was low,ranging from one to eight species per *** and non-SIMAR slopes were *** slopes had significantly higher species richness,diversity,evenness but lower dominance,with mean difference of 1.41 species,0.17,0.17 *** slopes were associated with lower tree risk *** training regression models,boosting as an ensemble method arbitrarily raised the explanatory power and the predictive accuracy of some *** height,length,angle and area could be significant predictors of the biodiversity-related *** research can sample more habitat characteristics related to the structure and species composition of slopes and verges which were important components of urban forestry.

关键词： Highway greenery Roadside tree management Tree risk assessment Monospecific urban forest Slope geophysical environment Urban forests

Surgical cystogastrostomy: Is it still worthwhile?

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World Journal of Gastroenterology 2024年第17期30卷 2298-2301页

作者： Kin Pan Au Kenneth siu ho Chok Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong 999077China Department of Surgery The Chinese University of Hong KongHong Kong 999077China

The article by Ker et al explores the treatment of peripancreatic fluid collection(PFC).The use of percutaneous drainage,endoscopy,and surgery for managing PFC are *** drainage is noted for its low risk profile,while endoscopic cystogastrostomy is more effective due to the wider orifice of the metallic *** cystogastrostomy is a definitive treatment with a reduced need for reintervention,especially for cases with extensive collections and significant *** choice of treatment modality should be tailored to individual patient characteristics and disease factors,considering the expertise available.

关键词： Endoscopic cystgastrostomy Surgical cystgastrostomy Pancreatitis Pancreatic necrosis Peripancreatic collection

Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?

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World Journal of Gastroenterology 2019年第27期25卷 3563-3571页

作者： Kevin Ka Wan Chu Kenneth siu ho Chok Department of Surgery Queen Mary HospitalHong KongChina Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong KongChina

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.

关键词： Hepatocellular carcinoma Aged Clinical outcome Surgery Hepatectomy

Mammalian target of rapamycin inhibitors after post-transplant hepatocellular carcinoma recurrence:Is it too late?

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World Journal of Gastrointestinal Surgery 2020年第4期12卷 149-158页

作者： Kin Pan Au Kenneth siu ho Chok Department of Surgery Queen Mary HospitalHong Kong 999077China Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong Kong 999077China

BACKGROUND Mammalian target of rapamycin(mTOR)inhibitors have been shown to reduce the risk of tumour recurrence after liver transplantation for hepatocellular carcinoma(HCC).however,their role in established post-transplant HCC recurrence is *** To investigate whether mTOR inhibitor offers a survival benefit in posttransplant HCC *** A retrospective study of 143 patients who developed HCC recurrence after liver transplantation was *** were divided into 2 groups based on whether they had received mTOR inhibitor-based *** primary endpoint was post-recurrence *** Seventy-nine(55%)patients received an mTOR inhibitor-based immunosuppressive regime,while 64(45%)patients did *** mTOR inhibitor group had a lower number of recurrent tumours(2 vs 5,P=0.02)and received more active treatments including radiotherapy(39 vs 22%,P=0.03)and targeted therapy(59 vs 23%,P<0.001).The median post-recurrence survival was 21.0±4.1 mo in the mTOR inhibitor group and 11.2±2.5 mo in the control *** Cox regression analysis confirmed that mTOR inhibitor therapy was independently associated with improved post-recurrence survival(P=0.04,OR=0.482,95%CI:0.241-0.966).The number of recurrent tumours and use of other treatment modalities did not affect *** survival difference was observed between mTOR inhibitor monotherapy and combination therapy with calcineurin *** mTOR inhibitors prolonged survival after post-transplant HCC recurrence.

关键词： Mammalian target of rapamycin inhibitor Hepatocellular carcinoma Recurrence Liver transplant Survival Outcomes