Molecular Markers for Tumor Recurrence after Hepatectomy for Hepatocellular Carcinoma

Huichuan Sun  Liver Cancer Institute and Zhongshan Hospital,
Fudan University, Shanghai, China

Tumor recurrence remains a serious problem in patients after hepatectomy for hepatocellular carcinoma (HCC), therefore, identifying of patients with a high risk of recurrence is the first step to prevent recurrence. Meanwhile, the emerging role of molecular targeting therapy requires the treatment is applied on an individual basis. Molecular markers to predict the risk of recurrence consist of several categories of risk factors, such as patient factors and tumor factors considering the role of active interaction between tumor and host in carcinogenesis and tumor progression or metastasis. To add to the complexity, tumor recurrence may come from a real new tumor originated from an irrelevant carcinogenesis, and an occult residual cancer related with the initial one, which is also regarded as the early recurrence (residual cancer) and late recurrence (multicentric cancer) based on the time to recurrence.

Molecular markers from tumor tissues or tumor cells still remain the mainstay to predict the risk of recurrence based on the conception that the behavior of a tumor cell is predominantly determined by its specific genome/gene expressions. A large number of individual genes or gene expression signatures (a set of genes) have been identified to associate with either recurrence or invasiveness and metastasis feature, which is used as a surrogate marker for recurrence.

The recent progress in this field is the role of peri-tumoral liver tissue has been recognized, however, it also needs to discrete its role in predicting the risk of occult residual cancer or de novo carcinogenesis, because the results came from either HBV or HCV predominant populations.

So far, the significance of molecular markers for tumor recurrence is still within the lab to help us to understand the mechanisms. When the hype becomes a hope is still a question.