Molecular signature for HCC: role in predicting outcomes after liver transplant and selection for potential adjuvant treatment.
OBJECTIVE
To summarize recent advances in molecular analysis of hepatocellular carcinoma (HCC) that offer improved diagnostic capability and prognostic information regarding risk of recurrence after liver transplantation.


RESULTS
Revised radiologic criteria have been recently proposed offering liver transplantation to more patients with HCC. Improved prognostic information regarding risk of recurrent HCC after liver transplantation has been demonstrated using fractional allelic imbalance studies from tumor DNA, genomics analysis and measures of systemic inflammation. New adjuvant therapies may benefit selected patients with high-risk HCC in combination with liver transplantation.


CONCLUSIONS
HCC is an aggressive malignancy, and molecular studies allowing more information about recurrence patterns and tumor biology will aid in prognostication, decisions about therapy and new drug discovery. Multimodality approaches including effective adjuvant therapies combined with curative therapy such as liver transplantation will be necessary for high-risk patients to achieve prolonged survival.
Schmidt
Carl
C
Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA.
Marsh
J Wallis
JW
D014408:Biomarkers, Tumor / Q000235:genetics*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015972:Gene Expression Regulation, Neoplastic; D005820:Genetic Testing; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D011237:Predictive Value of Tests; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D014408:Biomarkers, Tumor