The pathogenesis of hepatocellular carcinoma (HCC) is a complex process. During the last decade, advances in genomic technologies enabled delineation of the genomic landscape of HCC, resulting in the identification of the common underlying molecular alterations. The tumor microenvironment, regulated by inflammatory cells, including cancer cells, stromal tissues, and the surrounding extracellular matrix, has been extensively studied using molecular data. The integration of molecular, immunological, histopathological, and clinical findings has provided clues to uncover predictive biomarkers to enhance responses to novel therapies. Herein, we provide an overview of the current HCC genomic landscape, previously identified gene signatures that are used routinely to predict prognosis, and an immune-specific class of HCC. Since biomarker-driven treatment is still an unmet need in HCC management, translation of these discoveries into clinical practice will lead to personalized therapies and improve patient care, especially in the era of targeted and immunotherapies.
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Most cases of hepatocellular carcinoma (HCC) occur in the Asia-Pacific region and in patients
with underlying hepatitis B and C viral infection. Although surgical resection is the gold
standard for treatment of HCC, only a few patients are surgical candidates because of their
lack of hepatic reserve. Liver transplantation, which eradicates HCC and replaces damaged
noncancerous hepatic parenchyma, is regarded as the best treatment for HCC in patients
with decompensated liver cirrhosis. However, the shortage of donors limit its widespread
use. Furthermore, the long waiting time for liver transplantation allow for tumor progression
and reduce patient survival. Given this long wait, there is a reasonable clinical need in the
meantime for minimally invasive methods to avoid progression of HCC in patients with
decompensated liver cirrhosis. We herein offer our experiences of therapeutic efficacy and
complications of the procedure and the changes in liver function before and after TACE and
radiofrequency ablation in patients with HCC and decompensated liver cirrhosis, defined as a
Child-Pugh-Turcotte score above 7. (J Liver Cancer 2014;14:139-142)
Tumor size is one of the most important factors for decision of therapeutic plan and prognosis of hepatocellular carcinoma
(HCC). If the diagnosis of HCC is made earlier in its small size, the prognosis is better. However the diagnosis of small HCC
is not easy because small HCC lacks the typical clinical and radiologic feature. We experienced two cases of small HCC less than
1 cm that was confirmed after first treatment.