Article
Oncology
Hanxin Feng, Chunbo Yang, Feng Xu, Yang Zhao, Tianqiang Jin, Zeyuan Wei, Dexin Wang, Chaoliu Dai
Summary: This study compared the therapeutic efficacy of resection (RES) and microwave ablation (MWA) for hepatocellular carcinoma (HCC) within the Milan criteria. The results showed that MWA had similar survival outcomes to RES for HCC within the Milan criteria, but had a lower hospital stay and less blood loss.
Review
Surgery
Seong Wook Shin, Keun Soo Ahn, Sang Woo Kim, Tae-Seok Kim, Yong Hoon Kim, Koo Jeong Kang
Summary: This study found that liver resection (LR) is more effective than local ablation therapies (such as RFA, MWA, and RFA plus TACE) in treating HCC within the Milan criteria. Specifically, LR has better 5-year recurrence-free survival and lower local recurrence rates compared to local ablation therapies.
Article
Oncology
Ning-Ning Zhang, Jian Zheng, Ying Wu, Jia-Yu Lv, Shu-Wen Zhang, Ya-Min Zhang, Wen-Tao Jiang, Tian-Qiang Song, Victoria Kim, Samer Tohme, Tian Liu, Wei Zhang, Jie Gu, Ze-Yu Wang, Yu-Hong Suo, Shuai Wang, Wang Li, Li Zhang, Yan Xie, Yong-He Zhou, Jian-Yong Liu, Yi-Bo Qiu, Zhong-Yang Shen, Ji-Hui Hao, David Geller, Wei Lu
Summary: This study aimed to develop a prognostic calculator to compare the long-term outcomes of liver transplantation (LT), resection (LR), and ablation (LA) as treatment options for early hepatocellular carcinoma (HCC) patients. The study found that LT resulted in significantly higher recurrence-free survival (RFS) and HCC-specific survival (HSS) rates compared to LR and LA, and LR had significantly better outcomes than LA. For multinodular HCC with a diameter ≤3 cm, LR and LA showed similar effectiveness. A prognostic calculator was developed based on preoperative clinical factors to evaluate RFS, recurrence within the Milan criteria (RWM), and HSS at different time intervals for all three treatment options.
Review
Gastroenterology & Hepatology
Jin Hean Koh, Darren Jun Hao Tan, Yuki Ong, Wen Hui Lim, Cheng Han Ng, Phoebe Wen Lin Tay, Jie Ning Yong, Mark D. Muthiah, Eunice X. Tan, Ning Qi Pang, Beom Kyung Kim, Nicholas Syn, Alfred Kow, Brian K. P. Goh, Daniel Q. Huang
Summary: Mortality after LR for HCC is nearly 50% higher compared to LT. Survival between LR and LT were similar in uninodular disease. The risk of recurrence after LR is threefold that of LT.
HEPATOBILIARY SURGERY AND NUTRITION
(2022)
Review
Medicine, General & Internal
Pierluigi Toniutto, Elisa Fumolo, Ezio Fornasiere, Davide Bitetto
Summary: This review discusses the current data on pretransplant criteria for liver transplantation in HCC patients exceeding the Milan Criteria, based on tumor morphological and histological characteristics validated in clinical practice. It also evaluates the role of HCC biological markers and tumor response to downstaging procedures as new tools for selecting patients with a tumor burden outside of the Milan Criteria for liver transplantation.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Bo-wen Zhuang, Wei Li, Wei Wang, Bin Li, Ming-de Lu, Ming Kuang, Xiao-hua Xie, Xiao-yan Xie
Summary: The study evaluated the treatment effect of RFA compared to LT and SR for HCC patients within Milan criteria using adjusted RMST. Results showed that the survival benefit of SR over RFA was approximately half that of LT over RFA.
EUROPEAN RADIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Pinghua Yang, Fei Teng, Shilei Bai, Yong Xia, Zhihao Xie, Zhangjun Cheng, Jun Li, Zhengqing Lei, Kui Wang, Baohua Zhang, Tian Yang, Xuying Wan, Hao Yin, Hao Shen, Timothy M. Pawlik, Wan Yee Lau, Zhiren Fu, Feng Shen
Summary: This study compared the prognosis of hepatocellular carcinoma (HCC) patients undergoing liver resection (LR) and liver transplantation (LT) based on predicted risks of microvascular invasion (MVI). The results showed that LT had better 5-year recurrence rate and 5-year overall survival rate than LR for patients with high or low risk of MVI. However, there was no significant difference in prognosis between LT and LR for patients with low MVI risk.
GASTROENTEROLOGY REPORT
(2023)
Article
Gastroenterology & Hepatology
Qunfang Zhou, Xiaohui Wang, Ruixia Li, Chenmeng Wang, Juncheng Wang, Xiaoyan Xie, Yali Li, Shaoqiang Li, Xianhai Mao, Ping Liang
Summary: This study aimed to evaluate the efficacy of combined use of RFA and sorafenib in the treatment of recurrent hepatocellular carcinoma. The study found that the RFA-sorafenib group had significantly better survival outcomes compared to the RFA group. Additionally, a quantitative risk score system was established to accurately screen out patients who would benefit from RFA-sorafenib treatment.
JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Alexander Clevewood Ng
Summary: This article discusses the feasibility of adhering to the Brazil-Milan Criteria in determining liver transplantation for HCC patients, highlighting the potential risks of disregarding the number of tumor nodules in patients and its impact on disease recurrence potential.
ANNALS OF HEPATOLOGY
(2021)
Article
Oncology
Jan-Paul Gundlach, Michael Linecker, Henrike Dobbermann, Felix Wadle, Thomas Becker, Felix Braun
Summary: Liver transplantation is the only definitive treatment for hepatocellular carcinoma in cirrhosis. The use of Milan-criteria and labMELD in selecting patients for transplantation has limitations. This study found that liver transplantation for patients with hepatocellular carcinoma, regardless of Milan-criteria, had comparable outcomes and cost-effectiveness. Extended criteria donor grafts were favored for patients outside the Milan-criteria with low labMELD.
Article
Oncology
Bleuenn Brusset, Jerome Dumortier, Daniel Cherqui, Georges-Philippe Pageaux, Emmanuel Boleslawski, Ludivine Chapron, Jean-Louis Quesada, Sylvie Radenne, Didier Samuel, Francis Navarro, Sebastien Dharancy, Thomas Decaens
Summary: The study compared the agreement for the criteria and outcomes of liver transplantation before and after the adoption of the AFP model, finding a longer waiting time and higher rate of bridging therapies after the AFP model was implemented, leading to poorer patient outcomes.
Article
Gastroenterology & Hepatology
Maria Conticchio, Riccardo Inchingolo, Antonella Delvecchio, Letizia Laera, Francesca Ratti, Maximiliano Gelli, Ferdinando Anelli, Alexis Laurent, Giulio Vitali, Paolo Magistri, Giacomo Assirati, Emanuele Felli, Taiga Wakabayashi, Patrick Pessaux, Tullio Piardi, Fabrizio di Benedetto, Nicola de'Angelis, Javier Briceno, Antonio Rampoldi, Rene Adam, Daniel Cherqui, Luca Antonio Aldrighetti, Riccardo Memeo
Summary: In elderly patients (> 70 years) with HCC in Milan criteria, surgical resection provided better long-term oncological outcomes compared to radiofrequency ablation, despite a longer length of stay and a higher rate of severe postoperative complications.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Review
Gastroenterology & Hepatology
Zhe Jia, Haitao Zhang, Ning Li
Summary: Comparing the clinical efficacy of RFA and SR in HCC patients meeting the Milan criteria showed similar overall survival and disease-free survival rates between the two treatments, but RFA had advantages in treatment-related complications.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Oncology
Shu-Yein Ho, Po-Hong Liu, Chia-Yang Hsu, Yi-Hsiang Huang, Jia- Liao, Chien-Wei Su, Ming-Chih Hou, Teh-Ia Huo
Summary: Tumor burden score (TBS), estimated by the diameter and number of tumor nodules, is a feasible prognostic marker for HCC patients within the Milan criteria. Among patients with low TBS, radiofrequency ablation (RFA) should be considered the priority treatment modality.
Review
Oncology
Christos D. Kakos, Ioannis A. Ziogas, Charikleia D. Demiri, Stepan M. Esagian, Konstantinos P. Economopoulos, Dimitrios Moris, Georgios Tsoulfas, Sophoclis P. Alexopoulos
Summary: Hepatocellular carcinoma is a common primary liver cancer in children. Liver transplantation is the only potentially curative option for children with unresectable hepatocellular carcinoma, and favorable survival rates have been observed post transplantation. Further research is needed to establish appropriate selection criteria for liver transplantation in pediatric HCC.
Article
Surgery
Yvette Chong, Ye-Xin Koh, Jin-Yao Teo, Peng-Chung Cheow, Pierce K. Chow, Alexander Y. Chung, Chung-Yip Chan, Brian K. P. Goh
Summary: The study found that patients with previous non-liver-related abdominal surgery undergoing MILR did not have inferior outcomes compared to patients without previous abdominal surgery. Measures of operative difficulty and complication rates were comparable between the two groups and subgroups.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Review
Emergency Medicine
Amelia Xin Chun Goh, Jun Wei Yeo, Jocelyn Fangjiao Gao, Marcus Eng Hock Ong, Shu-Ling Chong, Fahad Javaid Siddiqui, Andrew Fu Wah Ho
Summary: This study aimed to compare the effectiveness and safety of different anaesthetic methods for the closed reduction of paediatric forearm fractures in the emergency setting. However, the current data are insufficient to guide the choice of anaesthetic method. Further adequately powered trials are needed to provide more evidence.
EMERGENCY MEDICINE JOURNAL
(2022)
Article
Critical Care Medicine
Julia Yu Xin Ng, Zariel Jiaying Sim, Fahad Javaid Siddiqui, Nur Shahidah, Benjamin Sieu-Hon Leong, Ling Tiah, Yih Yng Ng, Audrey Blewer, Shalini Arulanandam, Shir Lynn Lim, Marcus Eng Hock Ong, Andrew Fu Wah Ho
Summary: This study aimed to investigate the characteristics and clinical outcomes of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) initiated for non-out-of-hospital cardiac arrest (OHCA) cases in the Singapore population. The study found that 40.0% of patients recognized as having OHCA were not actually in cardiac arrest, and 52.7% of these patients received DA-CPR. Results showed that chest compressions initiated by dispatchers on patients not in cardiac arrest did not result in any reported complications and were not associated with in-hospital mortality.
Article
Multidisciplinary Sciences
Weiwei Zhai, Hannah Lai, Neslihan Arife Kaya, Jianbin Chen, Hechuan Yang, Bingxin Lu, Jia Qi Lim, Siming Ma, Sin Chi Chew, Khi Pin Chua, Jacob Josiah Santiago Alvarez, Pauline Jieqi Chen, Mei Mei Chang, Lingyan Wu, Brian K. P. Goh, Alexander Yaw-Fui Chung, Chung Yip Chan, Peng Chung Cheow, Ser Yee Lee, Juinn Huar Kam, Alfred Wei-Chieh Kow, Iyer Shridhar Ganpathi, Rawisak Chanwat, Jidapa Thammasiri, Boon Koon Yoong, Diana Bee-Lan Ong, Vanessa H. de Villa, Rouchelle D. Dela Cruz, Tracy Jiezhen Loh, Wei Keat Wan, Zeng Zeng, Anders Jacobsen Skanderup, Yin Huei Pang, Krishnakumar Madhavan, Tony Kiat-Hon Lim, Glenn Bonney, Wei Qiang Leow, Valerie Chew, Yock Young Dan, Wai Leong Tam, Han Chong Toh, Roger Sik-Yin Foo, Pierce Kah-Hoe Chow
Summary: This study investigated intra-tumor heterogeneity in hepatocellular carcinoma (HCC) using a large prospective surgical cohort. The results showed that phenotypic heterogeneity had a different trajectory across stages and diversified rapidly in some patients. Interestingly, phenotypic heterogeneity was found to be more informative in predicting patient survival than genomic heterogeneity, highlighting the importance of studying phenotypic evolution in cancer types.
NATIONAL SCIENCE REVIEW
(2022)
Article
Health Care Sciences & Services
Nan Liu, Feng Xie, Fahad Javaid Siddiqui, Andrew Fu Wah Ho, Bibhas Chakraborty, Gayathri Devi Nadarajan, Kenneth Boon Kiat Tan, Marcus Eng Hock Ong
Summary: This study aims to develop a dynamic and interpretable System for Emergency Risk Triage (SERT) using large-scale electronic health records (EHRs) and machine learning. The study will develop three scores using an interpretable machine learning-based AutoScore and compare them with established clinical scores and black box machine learning models.
JMIR RESEARCH PROTOCOLS
(2022)
Review
Medicine, General & Internal
Xuan Rong Tang, Pin Pin Pek, Fahad Javaid Siddiqui, Rahul Malhotra, Yu Heng Kwan, Ling Tiah, Andrew Fu Wah Ho, Marcus Eng Hock Ong
Summary: This study conducted a systematic review on the reasons why older persons visit emergency departments (ED) in Singapore. The major determinants were found to be individual factors, while the evaluation of societal determinants was lacking.
ANNALS ACADEMY OF MEDICINE SINGAPORE
(2022)
Review
Multidisciplinary Sciences
Sze Ling Chan, Jin Wee Lee, Marcus Eng Hock Ong, Fahad Javaid Siddiqui, Nicholas Graves, Andrew Fu Wah Ho, Nan Liu
Summary: The aim of this scoping review is to summarize the current landscape and understanding of implementation of prediction models in the emergency department (ED). Most existing studies have focused on model development and validation, lacking knowledge on the real-world performance of these models in clinical practice. This review will use a specific framework and checklist to select and analyze relevant literature, summarizing the implementation outcomes and contextual determinants of prediction models used in the ED.
Article
Public, Environmental & Occupational Health
Sean Shao Wei Lam, Ahmad Reza Pourghaderi, Hairil Rizal Abdullah, Francis Ngoc Hoang Long Nguyen, Fahad Javaid Siddiqui, John Pastor Ansah, Jenny G. Low, David Bruce Matchar, Marcus Eng Hock Ong
Summary: This article describes the development of a dynamic simulation framework in Singapore during the COVID-19 pandemic to support agile resource planning. The study data was derived from Singapore General Hospital and public domain sources, and the models were calibrated against historical data. Several variants of the model were rapidly developed to adapt to the quickly changing situation, enabling the quick deployment of resources to sustain high-quality health services.
FRONTIERS IN PUBLIC HEALTH
(2022)
Article
Substance Abuse
Zhenghong Liu, Desmond Ren-Hao Mao, Stephanie Fook-Chong, Charles Chia Meng Mak, Xi Xiang Esther Tan, Jun Tian Wu, Kelvin B. Tan, Marcus Eng Hock Ong, Fahad J. Siddiqui
Summary: This study aims to characterize trends in emergency department visits involving acute and chronic alcohol consumption in Singapore from 2007 to 2016. The findings reveal a significant increase in the number and costs of alcohol-related visits, with men and older men being at higher risk.
DRUG AND ALCOHOL REVIEW
(2022)
Review
Multidisciplinary Sciences
Xuan Rong Tang, Faraz Zarisfi, Pin Pin Pek, Fahad Javaid Siddiqui, Rahul Malhotra, Yu Heng Kwan, Tiah Ling, Andrew Fu Wah Ho, Marcus Eng Hock Ong
Summary: This paper presents a protocol for a systematic review of the determinants of emergency department (ED) utilization among community-dwelling older adults aged 65 years and above. It applies Andersen and Newman's model of healthcare utilization and aims to provide other conceptual frameworks for healthcare utilization. The study proposes a holistic approach for understanding the factors that influence ED utilization by older persons.
Editorial Material
Cardiac & Cardiovascular Systems
Marcus Eng Hock Ong, Fahad Javaid Siddiqui
Summary: Bystander CPR is crucial in saving lives of out-of-hospital cardiac arrest patients, but the rates are low possibly due to factors like recipient's race/ethnicity and location of the event.
NATURE REVIEWS CARDIOLOGY
(2023)
Article
Social Sciences, Interdisciplinary
Ashish Kumar, Zhenghong Liu, John Pastor Ansah, Yih Yng Ng, Benjamin Sieu-Hon Leong, David Bruce Matchar, Marcus Eng Hock Ong, Fahad Javaid Siddiqui
Summary: Globally, Emergency Care Systems (ECS) are critical resources that require careful use due to the potential for demand to exceed capacity. In Singapore, policymakers are considering the introduction of Alternate Care Service Pathways (ACSPs) to address overcrowding in Emergency Departments (EDs). However, developing ACSPs is costly and carries the risk of unintended consequences.
Review
Critical Care Medicine
Yong Yi Tan, Zhuo Xun Chua, Guan Hin Loo, Jamie Si Pin Ong, Jia Hao Lim, Fahad Javaid Siddiqui, Nicholas Graves, Andrew Fu Wah Ho
Summary: This study conducted a systematic review and meta-analysis to determine the effectiveness of sterile gloves in preventing wound infections during wound repair procedures in the emergency department compared to clean gloves. The results showed that there was no additional protection against wound infections with the use of sterile gloves. However, the study was limited by the lack of data on antibiotic history and the time between wound repair and follow-up in the included studies.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2023)
Article
Medicine, General & Internal
Nan Liu, Mingxuan Liu, Xinru Chen, Yilin Ning, Jin Wee Lee, Fahad Javaid Siddiqui, Seyed Ehsan Saffari, Andrew Fu Wah Ho, Sang Do Shin, Matthew Huei-Ming Ma, Hideharu Tanaka, Marcus Eng Hock Ong
Summary: This study developed an interpretable prehospital ROSC (P-ROSC) score based on Asian OHCA patients, which can predict the probability of prehospital ROSC and only uses five variables.
Article
Medicine, General & Internal
Nan Liu, Yilin Ning, Marcus Eng Hock Ong, Seyed Ehsan Saffari, Hyun Ho Ryu, Kentaro Kajino, Chih-Hao Lin, Sarah Abdul Karim, G. V. Ramana Rao, Andrew Fu Wah Ho, Shir Lynn Lim, Fahad Javaid Siddiqui
Summary: Gender disparities in receiving BCPR exist in Pan-Asian communities, with differences between home and public locations.
