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Article: Is hepatic resection justified for non-colorectal non-neuroendocrine liver metastases? A systematic review and meta-analysis.

Ng, Kelvin K C / Cheng, Nicole M Y / Lok, Hon-Ting / Kung, Janet W C / Fung, Andrew K Y / Chan, Stephen L

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

2022 Volume 21, Issue 3, Page(s) 160–172

Abstract: Background: Hepatic resection (HR) is effective for colorectal or neuroendocrine liver metastases. However, the role of HR for non-colorectal non-neuroendocrine liver metastases (NCNNLM) is unknown. This study aims to perform a systematic review and ... ...

Abstract	Background: Hepatic resection (HR) is effective for colorectal or neuroendocrine liver metastases. However, the role of HR for non-colorectal non-neuroendocrine liver metastases (NCNNLM) is unknown. This study aims to perform a systematic review and meta-analysis on long-term clinical outcomes after HR for NCNNLM. Methods: electronic search was performed to identify relevant publications using PRISMA and MOOSE guidelines. Primary outcomes were 3- and 5-year overall survival (OS) and disease-free survival (DFS). Secondary outcomes were post-operative morbidity and 30-day mortality. Results: There were 40 selected studies involving 5696 patients with NCNNLM undergone HR. Pooled data analyses showed that the 3- and 5-year OS were 40% (95% CI 0.35-0.46) and 32% (95% CI 0.29-0.36), whereas the 3- and 5-year DFS were 28% (95% CI 0.21-0.36) and 24% (95% CI 0.20-0.30), respectively. The postoperative morbidity rate was 28%, while the 30-day mortality was 2%. Subgroup analysis on HR for gastric cancer liver metastasis revealed the 3-year and 5-year OS of 39% and 25%, respectively. Conclusions: HR for NCNNLM may achieve satisfactory survival outcome in selected patients with low morbidities and mortalities. However, more concrete evidence from prospective study is warrant in future.
MeSH term(s)	Humans ; Prospective Studies ; Hepatectomy/adverse effects ; Liver Neoplasms/surgery ; Liver Neoplasms/pathology ; Disease-Free Survival ; Colorectal Neoplasms/pathology
Language	English
Publishing date	2022-06-17
Publishing country	Scotland
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2102927-1
ISSN	1479-666X
ISSN	1479-666X
DOI	10.1016/j.surge.2022.05.003
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Zs.A 5756: Show issues

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Article ; Online: Comparison of clinical outcome between laparoscopic and open hepatectomy of high difficulty score for hepatocellular carcinoma: a propensity score analysis.

Ng, Kelvin K C / Cheng, Kai-Chi / Kung, Janet W C / Ho, Kit-Man / Lok, Hon-Ting / Fung, Andrew K Y / Chong, Charing C N / Cheung, Sunny Y S / Lee, Kit-Fai / Wong, John / Lai, Paul B S

Surgical endoscopy

2023 Volume 38, Issue 2, Page(s) 857–871

Abstract: Background: Laparoscopic liver resection (LLR) of high difficulty score is technically challenging. There is a lack of clinical evidence to support its applicability in terms of the long-term survival benefits. This study aims to compare clinical ... ...

Abstract	Background: Laparoscopic liver resection (LLR) of high difficulty score is technically challenging. There is a lack of clinical evidence to support its applicability in terms of the long-term survival benefits. This study aims to compare clinical outcomes between LLR and the open liver resection of high difficulty score for hepatocellular carcinoma (HCC). Materials and methods: From 2010 to 2020, using Iwate criteria, 424 patients underwent liver resection of high difficulty score by the laparoscopic (n = 65) or open (n = 359) approach. Propensity score (PS) matching was performed between the two groups. Short-term and long-term outcomes were compared between PS-matched groups. Univariate and multivariate analyses were performed to identify prognostic factors affecting survival. Results: The laparoscopic group had significantly fewer severe complications (3% vs. 10.8%), and shorter median hospital stays (6 days vs. 8 days) than the open group. Meanwhile, the long-term oncological outcomes were comparable between the two groups, in terms of the tumor recurrence rate (40% vs. 46.1%), the 5-year overall survival rate (75.4% vs. 76.2%), and the 5-year recurrence-free survival rate (50.3% vs. 53.5%). The high preoperative serum alpha-fetoprotein level, multiple tumors, and severe postoperative complications were the independent poor prognostic factors associated with worse overall survival. The surgical approach (Laparoscopic vs. Open) did not influence the survival. Conclusion: LLR of high difficulty score for selected patients with HCC has better short-term outcomes than the open approach. More importantly, it can achieve similar long-term survival outcomes as the open approach.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular ; Liver Neoplasms ; Hepatectomy/adverse effects ; Propensity Score ; Retrospective Studies ; Neoplasm Recurrence, Local/surgery ; Laparoscopy/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Length of Stay ; Treatment Outcome
Language	English
Publishing date	2023-12-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10634-5
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Zs.A 2214: Show issues

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Article: Novel use of the falciform ligament for reconstruction of the inferior vena cava and its tributary.

Kung, Janet W C / Chong, Charing C N / Lee, Kit-Fai / Wong, John / Lai, Paul B S / Ng, Kelvin K C

Journal of vascular surgery cases and innovative techniques

2021 Volume 7, Issue 3, Page(s) 425–428

Abstract: Tumor invasion into the inferior vena cava (IVC) and hepatic vein (HV) is challenging in cancer surgery with curative intent. Appropriate techniques for venous reconstruction are essential. We have described in detail a novel technique of fashioning an ... ...

Abstract	Tumor invasion into the inferior vena cava (IVC) and hepatic vein (HV) is challenging in cancer surgery with curative intent. Appropriate techniques for venous reconstruction are essential. We have described in detail a novel technique of fashioning an interposition tube graft using the falciform ligament to reconstruct the IVC and HV. The falciform ligament maintains all the benefits of an autologous tissue graft, with the added advantage of its flexibility in customizing graft dimensions. Its use in IVC and HV reconstruction has rarely been reported. The short-term outcomes with this tube graft are promising.
Language	English
Publishing date	2021-06-06
Publishing country	United States
Document type	Journal Article
ISSN	2468-4287
ISSN	2468-4287
DOI	10.1016/j.jvscit.2021.05.010
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Article ; Online: The Impact of Involved Resection Margin on Recurrence and Survival After Pancreaticoduodenectomy for Periampullary Carcinoma, with Emphasis on Pancreatic Head Carcinoma.

Lee, Kit-Fai / Lok, Hon-Ting / Fung, Andrew K Y / Kung, Janet W C / Lo, Eugene Y J / Chong, Charing C N / Wong, John / Ng, Kelvin K C / Lai, Paul B S

World journal of surgery

2022 Volume 47, Issue 3, Page(s) 717–728

Abstract: Background: The supposed adverse effect of involved resection margin during pancreaticoduodenectomy (PD) for periampullary carcinoma or pancreatic head carcinoma (CaP) on long-term oncological outcomes is still inconclusive.: Methods: This is a ... ...

Abstract	Background: The supposed adverse effect of involved resection margin during pancreaticoduodenectomy (PD) for periampullary carcinoma or pancreatic head carcinoma (CaP) on long-term oncological outcomes is still inconclusive. Methods: This is a retrospective study on periampullary carcinoma undergoing PD. Patients with R0 (margin clear) resection were compared to patients with R1 (microscopically directly involved margin) resection. Patients with gross involved margin (R2 resection) were excluded. Long-term oncological outcomes measured included incidence and site of recurrent disease, overall survival (OS) and disease-free survival (DFS). A subgroup analysis was made on patients with CaP. Results: Between January 2003 and December 2019, 203 PD were identified for present study. The incidence of R1 resection was common (12% in periampullary carcinoma and 20% in CaP). In periampullary carcinoma, R1 resection had greater proportion of CaP, lesser proportion of carcinoma of ampulla (CaA), more perineural invasion, more lymph node (LN) metastasis. R1 group had a shorter OS and DFS, but no difference in the incidence and site of recurrent disease. In the subgroup of CaP (91 patients), R1 group did not differ from R0 group except for more LN metastasis. There was no difference in incidence and site of recurrent disease, OS and DFS. On multivariable analysis, R1 resection was not an independent factor for OS and DFS for periampullary carcinoma or for CaP only. Conclusion: Involved resection margin was not uncommon. It was not associated with higher incidence of recurrent disease including local recurrence, and was not an independent prognosticator for OS and DFS.
MeSH term(s)	Humans ; Pancreaticoduodenectomy/adverse effects ; Retrospective Studies ; Pancreatic Neoplasms/pathology ; Carcinoma/surgery ; Duodenal Neoplasms/surgery ; Prognosis ; Pancreatic Neoplasms
Language	English
Publishing date	2022-11-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-022-06816-2
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Zs.A 1336: Show issues

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Article ; Online: Intraductal papillary neoplasm of the bile duct: the role of single-operator cholangioscopy.

Kung, Janet W C / Parks, Rowan W / Ireland, Hamish M / Kendall, Timothy J / Church, Nicholas I

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy

2017 Volume 3, Issue 2, Page(s) 55–57

Language	English
Publishing date	2017-12-13
Publishing country	United States
Document type	Journal Article
ISSN	2468-4481
ISSN (online)	2468-4481
DOI	10.1016/j.vgie.2017.10.006
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Article ; Online: The epidemiology of HIV infection among female sex workers in Nairobi, Kenya: A structural determinants and life-course perspective.

Beattie, Tara S / Adhiambo, Wendy / Kabuti, Rhoda / Beksinska, Alicja / Ngurukiri, Pauline / Babu, Hellen / Kung'u, Mary / Nyamweya, Chrispo / Mahero, Anne / Irungu, Erastus / Muthoga, Peter / Seeley, Janet / Kimani, Joshua / Weiss, Helen A / Kaul, Rupert

PLOS global public health

2024 Volume 4, Issue 1, Page(s) e0001529

Abstract: High HIV prevalence among female sex workers (FSWs) is heavily influenced by structural determinants (e.g. criminalisation of sex work; violence) and significant life events (e.g. orphanhood, teenage pregnancy). This study aims to understand the ... ...

Abstract	High HIV prevalence among female sex workers (FSWs) is heavily influenced by structural determinants (e.g. criminalisation of sex work; violence) and significant life events (e.g. orphanhood, teenage pregnancy). This study aims to understand the epidemiology of HIV among FSWs in Nairobi, Kenya using a structural determinants and life-course perspective. Baseline cross-sectional survey data were collected June-December 2019 for the Maisha Fiti study with 1003 FSWs (aged 18-45 years). Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression with a hierarchical modelling approach. HIV prevalence was 28.0%, and increased with age (<25 years 5.7%, 25-34 years 19.0%, ≥35 years 40.6%). In adjusted analyses, HIV seroprevalence was associated with childhood and adolescence including violence from militia or soldiers (AOR = 1.60; 95%CI:1.00-2.53), young age at sexual debut (≤15 years old vs. ≥18 years AOR = 0.57; 95%CI:0.39-0.84) and teenage pregnancy (AOR = 1.37; 95%CI:1.00-1.88). For adulthood the factors included lower SES score (lowest vs. highest tertile AOR = 0.63; 95%CI:0.40-0.98); reduced housing insecurity (AOR = 0.52; 95%CI:0.54-0.79); lower alcohol/drug use score (AOR = 0.44; 95%CI:0.31-0.61); and a longer duration of selling sex (0-5 years vs. ≥11 years AOR = 2.35; 95%CI:1.44-3.82). Among HIV-negative FSWs, prevalence of HIV risk factors was high (recent hunger 32.3%; internalised 67.7% and experienced 66.0% sex work stigma; recent police arrest 30.1%; recent physical or sexual violence 65.6%, condomless last sex intimate partner 71.1%; harmful alcohol or substance use 49.1%). Only 24.6% of HIV-negative FSWs reported taking PrEP. Taken together, adverse events in childhood and adolescence were associated with increased odds of living with HIV, and were more strongly associated with HIV serostatus than adulthood structural or behavioural risk factors. HIV-negative FSWs remain at high risk of HIV acquisition. This study highlights the importance of addressing adverse events throughout the life course to reduce HIV risk, and the need to continue multi-level HIV prevention and treatment efforts.
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0001529
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Article ; Online: Stem cells and liver repair.

Kung, Janet W C / Forbes, Stuart J

Current opinion in biotechnology

2009 Volume 20, Issue 5, Page(s) 568–574

Abstract: The liver has considerable inherent regenerative capacity through hepatocyte division and hepatic progenitor cell proliferation. In chronic disease regeneration eventually fails and liver transplantation is the only curative treatment. Current work aims ... ...

Abstract	The liver has considerable inherent regenerative capacity through hepatocyte division and hepatic progenitor cell proliferation. In chronic disease regeneration eventually fails and liver transplantation is the only curative treatment. Current work aims to restore liver mass and functionality either through transplantation of stem cell derived hepatocyte-like cells or by stimulating endogenous liver repair. Human embryonic stem cells (ESCs) and adult somatic cells can be differentiated into hepatocyte-like cells with potential use in drug testing, bio-artificial livers and transplantation. These cells still have some limitations in functionality, understanding further human liver development and improving tissue culture is required. The use of stem cells and their progeny in animal models of liver disease has been encouraging and stimulated clinical trials to commence.
MeSH term(s)	Animals ; Artificial Organs ; Cell Differentiation ; Humans ; Liver/cytology ; Liver/physiology ; Liver/surgery ; Regeneration ; Stem Cell Transplantation
Language	English
Publishing date	2009-10-17
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1052045-4
ISSN	1879-0429 ; 0958-1669
ISSN (online)	1879-0429
ISSN	0958-1669
DOI	10.1016/j.copbio.2009.09.004
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Zs.A 3071: Show issues

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Article ; Online: Liver development, regeneration, and carcinogenesis.

Kung, Janet W C / Currie, Ian S / Forbes, Stuart J / Ross, James A

Journal of biomedicine & biotechnology

2010 Volume 2010, Page(s) 984248

Abstract: The identification of putative liver stem cells has brought closer the previously separate fields of liver development, regeneration, and carcinogenesis. Significant overlaps in the regulation of these processes are now being described. For example, ... ...

Abstract	The identification of putative liver stem cells has brought closer the previously separate fields of liver development, regeneration, and carcinogenesis. Significant overlaps in the regulation of these processes are now being described. For example, studies in embryonic liver development have already provided the basis for directed differentiation of human embryonic stem cells and induced pluripotent stem cells into hepatocyte-like cells. As a result, the understanding of the cell biology of proliferation and differentiation in the liver has been improved. This knowledge can be used to improve the function of hepatocyte-like cells for drug testing, bioartificial livers, and transplantation. In parallel, the mechanisms regulating cancer cell biology are now clearer, providing fertile soil for novel therapeutic approaches. Recognition of the relationships between development, regeneration, and carcinogenesis, and the increasing evidence for the role of stem cells in all of these areas, has sparked fresh enthusiasm in understanding the underlying molecular mechanisms and has led to new targeted therapies for liver cirrhosis and primary liver cancers.
MeSH term(s)	Animals ; Disease Models, Animal ; Fetus/cytology ; Fetus/embryology ; Humans ; Liver/cytology ; Liver/embryology ; Liver/pathology ; Liver Neoplasms/pathology ; Liver Regeneration ; Stem Cells/pathology
Language	English
Publishing date	2010-02-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2052552-7
ISSN	1110-7251 ; 1110-7243
ISSN (online)	1110-7251
ISSN	1110-7243
DOI	10.1155/2010/984248
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Zs.A 5540: Show issues

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Article ; Online: Violence across the Life Course and Implications for Intervention Design: Findings from the Maisha Fiti Study with Female Sex Workers in Nairobi, Kenya.

International journal of environmental research and public health

2023 Volume 20, Issue 11

Abstract: We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural-biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable ... ...

Abstract	We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural-biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sexual violence in the past 6 months. We found substantial overlap between violence in childhood, and recent intimate and non-intimate partner violence in adulthood, with 86.9% reporting one or more types of violence and 18.7% reporting all three. Recent physical or sexual violence (64.9%) was independently associated with life course factors, including a high WHO Adverse Childhood Experiences (ACE) score (AOR = 7.92; 95% CI:4.93-12.74) and forced sexual debut (AOR = 1.97; 95% CI:1.18-3.29), as well as having an intimate partner (AOR = 1.67; 95% CI:1.25-2.23), not having an additional income to sex work (AOR = 1.54; 95% CI:1.15-2.05), having four or more dependents (AOR = 1.52; 95% CI:0.98-2.34), recent hunger (AOR = 1.39; 95% CI:1.01-1.92), police arrest in the past 6 months (AOR = 2.40; 95% CI:1.71-3.39), condomless last sex (AOR = 1.46; 95% CI:1.02-2.09), and harmful alcohol use (AOR = 3.34; 95% CI:1.74-6.42). Interventions that focus on violence prevention during childhood and adolescence should help prevent future adverse trajectories, including violence experience and HIV acquisition.
MeSH term(s)	Adolescent ; Female ; Humans ; Sex Workers ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Kenya/epidemiology ; Life Change Events ; Violence/prevention & control ; Sexual Partners ; Risk Factors
Language	English
Publishing date	2023-06-03
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20116046
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Article ; Online: Conducting Violence and Mental Health Research with Female Sex Workers during the COVID-19 Pandemic: Ethical Considerations, Challenges, and Lessons Learned from the Maisha Fiti Study in Nairobi, Kenya.

International journal of environmental research and public health

2023 Volume 20, Issue 11

Abstract: Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance ... ...

Abstract	Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study (
MeSH term(s)	Female ; Humans ; Sex Workers/psychology ; Mental Health ; Pandemics ; Kenya/epidemiology ; Reproducibility of Results ; COVID-19/epidemiology ; Violence ; HIV Infections
Language	English
Publishing date	2023-05-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20115925
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