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Digestive Disease Interventions 2017; 01(02): 055-065
DOI: 10.1055/s-0037-1603577
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Genetics of Hepatocellular Carcinoma: Risk Stratification, Clinical Outcome, and Implications for Therapy

Ismail Labgaa
1   Division of Liver Diseases, Mount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
2   Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland
,
Sara Torrecilla
1   Division of Liver Diseases, Mount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
3   Liver Cancer Translational Research Laboratory, BCLC Group, IDIBAPS, Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Catalonia, Spain
,
Iris Martinez-Quetglas
1   Division of Liver Diseases, Mount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
3   Liver Cancer Translational Research Laboratory, BCLC Group, IDIBAPS, Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Catalonia, Spain
,
Daniela Sia
1   Division of Liver Diseases, Mount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
› Author Affiliations
Further Information

Publication History

27 December 2016

25 April 2017

Publication Date:
05 June 2017 (online)

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Abstract

Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is a highly heterogeneous disease with a dismal prognosis. During the last decade, significant efforts to elucidate the genetic background of HCC have led to the identification of the major genomic aberrations driving the disease. Nonetheless, only few of them (∼30%) are currently amenable for treatment. Two clear-cut gene expression based HCC molecular classes, namely “proliferation” and “nonproliferation,” have been described. The “proliferation” class is characterized by enrichment in poor prognostic signatures, a more aggressive phenotype, and poorer outcome. In addition, exposure-specific mutational patterns have been identified (smoking, alcohol, aflatoxin B, etc.), whereas molecular signatures from the surrounding cirrhotic liver and single nucleotide polymorphisms have been linked with HCC occurrence. Despite such advances, no molecular biomarker has yet been incorporated in clinical decision-making. In this review, the authors summarize the most recent molecular findings in HCC pointing toward prospects for translating this knowledge into specific clinical interventions.

Keywords

liver cancer - genomics - precision medicine - heterogeneity - molecular classes - prognosis