Carl Schmidt1, J Wallis Marsh. 1. Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA.
Abstract
PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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. SUMMARY: 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.
PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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. SUMMARY: 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.