Comprehensive Liver Cancer Clinic

Mission

To offer comprehensive diagnosis and treatment for liver cancer patients
by a dedicated multi-disciplinary team.

Liver cancer is prevalent in the Asia-Pacific region which accounts for up to 80% of the world’s total liver cancer cases. The treatment of liver cancer is particularly complex as it is a very heterogeneous disease and requires significant medical expertise to achieve optimal clinical outcome.

New therapies and more efficacious treatment combinations and approaches are continually being developed for liver cancer. The choice of the best treatment for an individual patient depends on many factors including the stage of the cancer, the general health of the patient and the availability of expertise and therapeutics. As with many other complex cancers, the best outcome with liver cancer occurs when the patient is looked after by a multi-disciplinary team of specialists with individual expertise in the different modalities of treatment relevant to liver cancer.

The heart of any clinical cancer program is the multi-disciplinary clinic and tumour board discussions. The Comprehensive Liver Cancer Clinic (CLCC) at the National Cancer Center Singapore brings all the different specialists together to work around the patient. Thus, this avoids multiple appointments with various specialists at different locations.

Patients attending the clinic may be seen by one or more of the relevant specialists at the same session where appropriate. Each case is different and hence the multi-disciplinary team will comprehensively assess the patient’s disease and treatment needs. The team then creates a consensus or joint treatment plan tailored for the patient based on the latest scientific evidence and the combined clinical experience of the team.

The CLCC as part of the comprehensive NCCS set-up is able to offer patients the benefits of its wealth of experience, all the latest scientific breakthroughs and access to clinical trials of new treatments.

Our Expertise:

We are dedicated to the diagnosis and treatment of:

  1. Primary liver cancer (hepatocellular, peripheral cholangiocarcinoma)
  2. Colon / rectal cancer that has spread to the liver
  3. Neuroendocrine / carcinoid tumours that have spread to the liver
  4. Gallbladder cancer
  5. Bile duct cancer (central and distal cholangiocarcinoma)

Disease conditions seen at the CLCC include:

Advanced liver cancer Surgical resection for liver cancer

All suspected or proven tumours in the liver:

  1. without confirmed diagnosis
  2. previously diagnosed with liver cancer now seeking confirmation
  3. without previous treatments
  4. with previous treatment but currently seeking consultation regarding possible surgical or regional therapy
  5. already been given a treatment plan or already treated but seeking a multi-disciplinary second opinion
  6. previously treated liver tumour now with recurrences
  7. secondary liver tumour with a known or suspected primary tumour elsewhere (e.g. colorectal, neuro-endocrine/carcinoid, GIST) now seeking multi-disciplinary treatment with or without other surgical specialists e.g. colorectal surgeon
  8. Suspected or proven masses or tumours related to the liver e.g. gallbladder tumours, bile duct tumours (cholangiocarcinoma), pancreatic tumours

The most advanced therapies are available for patients:

  1. Surgical Resection (open and minimally invasive)
  2. Liver Transplantation
  3. Radiofrequency Ablation
  4. Selective Internal Radiation Therapy (SIRT) or radio-embolization
  5. Trans-catheter Arterial Chemo-Embolization (TACE) with/without drug-eluting beads
  6. Systemic Chemotherapy – molecular targeted and cytotoxic
  7. Stereotactic radiotherapy

Our Doctors:

Surgical Oncology
Prof Pierce Chow Kah Hoe Co-Director / Senior Consultant
Dr Brian Goh Kim Poh Senior Consultant
Medical Oncology
Dr Choo Su Pin Co-Director / Senior Consultant
Assoc Prof Toh Han Chong Senior Consultant
Dr David Tai Wai-Meng Consultant
Radiation Oncology
Assoc Prof Michael Wang Lian Chek Senior Consultant
Nuclear Medicine
Dr David Ng Senior Consultant
Dr Anthony Goh Soon Whatt Senior Consultant
Dr Kelvin Loke Siu Hoong Consultant
Dr Sean Yan Xuexian Consultant
Dr Thang Sue Ping Associate Consultant
Interventional Radiology
Assoc Prof Tay Kiang Hiong Senior Consultant
Dr Richard Lo Hoau Gong Senior Consultant
Dr Tan Bien Soo Senior Consultant
Dr Apoorva Gogna Consultant
Dr Farah G Irani Consultant
Oncologic Radiology
Dr Thng Choon Hua Senior Consultant
Pathology
Assoc Prof Tony Lim Kiat Hon Senior Consultant

Operation Hours and Location:

Our specialists hold daily consultation sessions from Mondays to Fridays, 8 am to 6 pm, at National Cancer Centre Singapore SOC D Clinic, Level 2.

Monday Tuesday Wednesday Thursday Friday
Dr Choo Su Pin
Prof Pierce Chow
Assoc Prof Toh Han Chong
Dr Brian Goh
Dr Choo Su Pin
Dr David Tai
Prof Pierce Chow
Dr Choo Su Pin
Dr David Tai
Prof Pierce Chow
Assoc Prof Toh Han Chong

To schedule for an appointment, please contact us at 6436 8088 from Mondays to Fridays (8.30 am to 5.30 pm) and Saturdays (8.30 am to 12.30 pm). For further enquiries, please email us at clcc@nccs.com.sg.


List of Publications

Clinical
1. Cost-Effectiveness Analysis of Liver Resection Versus Transplantation for Early Hepatocellular Carcinoma within the Milan Criteria. Lim, K. C., V. W. Wang, F. J. Siddiqui, L. M. Shi, S. Y. Chan, H. C. Oh, S. B. Tan, and P. K. Chow. Hepatology, (2014) 10.1002/hep.27135.
2. Multicenter Phase II Study of Sequential Radioembolization-Sorafenib Therapy for Inoperable Hepatocellular Carcinoma . Chow, Pierce K. H., Donald Y. H. Poon, Maung-Win Khin, Harjit Singh, Ho-Seong Han, Anthony S. W. Goh, Su-Pin Choo, Hee-Kit Lai, Richard H. G. Lo, Kiang-Hiong Tay, Teong-Guan Lim, Mihir Gandhi, Say-Beng Tan, Khee-Chee Soo, and Group for the Asia-Pacific Hepatocellular Carcinoma Trials. PLoS ONE 9, no. 3 (2014): e90909.
3. Survival and Pattern of Tumor Progression with Yttrium-90 Microsphere Radioembolization in Predominantly Hepatitis B Asian Patients with Hepatocellular Carcinoma . Khor, AndrewYu-Keat, Ying Toh, JohnCarson Allen, DavidChee-Eng Ng, Yung-Hsiang Kao, Guili Zhu, Su-Pin Choo, RichardHoau-Gong Lo, Kiang-Hiong Tay, Jin-Yao Teo, BrianKim-Poh Goh, MarkChristiaan Burgmans, FarahGillian Irani, AnthonySoon-Whatt Goh, and PierceKah-Hoe Chow. Hepatology International, (2014): 1936-0541
4. Treatment for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: The Emerging Role for Radioembolization Using Yttrium-90. Lau, W. Y., B. Sangro, P. J. Chen, S. Q. Cheng, P. Chow, R. C. Lee, T. Leung, K. H. Han, and R. T. Poon. Oncology 84, no. 5 (2013): 311-8.
5. Systematic Review of Outcomes of Liver Resection for Early Hepatocellular Carcinoma within the Milan Criteria. Lim, K. C., P. K. Chow, J. C. Allen, F. J. Siddiqui, E. S. Chan, and S. B. Tan. Br J Surg 99, no. 12 (2012): 1622-9.
6. Activity of Thalidomide and Capecitabine in Patients with Advanced Hepatocellular Carcinoma. SF Ang, SH Tan, HC Toh, DYH Poon, SYK Ong, KF Foo , SP Choo Am J Clin Oncol 2011, Mar2 ( in press) [IF 2.206]
7. Microvascular Invasion Is a Better Predictor of Tumor Recurrence and Overall Survival Following Surgical Resection for Hepatocellular Carcinoma Compared to the Milan Criteria . Lim, K. C., P. K. Chow, J. C. Allen, G. S. Chia, M. Lim, P. C. Cheow, A. Y. Chung, L. L. Ooi, and S. B. Tan. Ann Surg 254, no. 1 (2011): 108-13.]
8. Randomised Double-Blind Trial of Megestrol Acetate Vs Placebo in Treatment-Naive Advanced Hepatocellular Carcinoma. Chow, P. K., D. Machin, Y. Chen, X. Zhang, K. M. Win, H. H. Hoang, B. D. Nguyen, M. Y. Jin, R. Lobo, M. Findlay, C. H. Lim, S. B. Tan, M. Gandhi, and K. C. Soo. Br J Cancer 105, no. 7 (2011): 945-52.
9. A Novel Approach to Brachytherapy in Hepatocellular Carcinoma Using a Phosphorous32 (32p) Brachytherapy Delivery Device—a First-in-Man Study . Goh, Anthony Soon-Whatt, Alexander Yaw-Fui Chung, Richard Houa-Gong Lo, Te-Neng Lau, Sidney Wing-Kwong Yu, May Chng, Somanesan Satchithanantham, Susan Li-Er Loong, David Chee-Eng Ng, Beng-Choo Lim, Stephen Connor, and Pierce Kah-Hoe Chow. International journal of radiation oncology, biology, physics 67, no. 3 (2007): 786-792.
10. High-Dose Tamoxifen in the Treatment of Inoperable Hepatocellular Carcinoma: A Multicenter Randomized Controlled Trial. Chow, P. K., B. C. Tai, C. K. Tan, D. Machin, K. M. Win, P. J. Johnson, and K. C. Soo. Hepatology 36, no. 5 (2002): 1221-6.

Translational
1. Deep Sequencing of the Hepatitis B Virus in Hepatocellular Carcinoma Patients Reveals Enriched Integration Events, Structural Alterations and Sequence Variations. Toh, S. T., Y. Jin, L. Liu, J. Wang, F. Babrzadeh, B. Gharizadeh, M. Ronaghi, H. C. Toh, P. K. Chow, A. Y. Chung, L. L. Ooi, and C. G. Lee. Carcinogenesis 34, no. 4 (2013): 787-98.
2. Altered Binding Site Selection of P53 Transcription Cassettes by Hepatitis B Virus X Protein. Chan, C., Y. Wang, P. K. Chow, A. Y. Chung, L. L. Ooi, and C. G. Lee. Mol Cell Biol 33, no. 3 (2013): 485-97.
3. Microrna-224 Is up-Regulated in Hepatocellular Carcinoma through Epigenetic Mechanisms. Wang, Y., H. C. Toh, P. Chow, A. Y. Chung, D. J. Meyers, P. A. Cole, L. L. Ooi, and C. G. Lee. FASEB J 26, no. 7 (2012): 3032-41.
4. Dovitinib demonstrates antitumor and antimetastatic activitiesin xenograft models of hepatocellular carcinoma. Huynh, H, P.K. Chow, W. M. Tai, S. P. Choo, A.Y.F.Chung, H.S.Ong, K.C.Soo, R.Ong, R.Linnartz, M.M.Shi. J Hepatol (2012) 56(3):595-601
5. Azd6244 Enhances the Anti-Tumor Activity of Sorafenib in Ectopic and Orthotopic Models of Human Hepatocellular Carcinoma (HCC). Huynh, H., V. C. Ngo, H. N. Koong, D. Poon, S. P. Choo, H. C. Toh, C. H. Thng, P. Chow, H. S. Ong, A. Chung, B. C. Goh, P. D. Smith, and K. C. Soo. J Hepatol 52, no. 1 (2010): 79-87. [IF 7.818]
6. Lethal-7 Is Down-Regulated by the Hepatitis B Virus X Protein and Targets Signal Transducer and Activator of Transcription 3. Wang, Y., Y. Lu, S. T. Toh, W. K. Sung, P. Tan, P. Chow, A. Y. Chung, L. L. Jooi, and C. G. Lee. J Hepatol 53, no. 1 (2010): 57-66.
7. Sorafenib and Rapamycin Induce Growth Suppression in Mouse Models of Hepatocellular Carcinoma. Huynh H, Ngo VC, Koong HN, Poon D, Choo SP, Thng CH, Chow P, Ong HS, Chung A, Soo K.C J Cell Mol Med. 2009 Aug;13(8B):2673-83.[IF 6.807]
8.

RAD001 (everolimus) inhibits tumor growth in xenograft models of human hepatocellular carcinoma. Hung H, KH P Chow, KC Soo, HC Toh, SP Choo, KF Foo, DPoon, VC Ngo,E Tran. J Cell Mol Med. 2009;13(7):1371-80. [IF6.807]

9. Sunitinib (Sutent, Su11248) Suppresses Tumor Growth and Induces Apoptosis in Xenograft Models of Human Hepatocellular Carcinoma. Huynh, H., V. C. Ngo, S. P. Choo, D. Poon, H. N. Koong, C. H. Thng, H. C. Toh, L. Zheng, L. C. Ong, Y. Jin, I. C. Song, A. P. Chang, H. S. Ong, A. Y. Chung, P. K. Chow, and K. C. Soo. Curr Cancer Drug Targets 9, no. 6 (2009): 738-47. [IF 5.129]
10. Effective Inhibition of Xenografts of Hepatocellular Carcinoma (Hepg2) by Rapamycin and Bevacizumab in an Intrahepatic Model. Ong, L. C., I. C. Song, Y. Jin, I. H. Kee, E. Siew, S. Yu, C. H. Thng, H. Huynh, and P. K. Chow. Mol Imaging Biol 11, no. 5 (2009): 334-42.

Useful Links:

CLCC Guidelines:

Levels of evidence for CLCC Guidelines: