Genes that can be measured directly adjacent to the site of a liver cancer can help predict survival among patients diagnosed with the most common type of liver cancer, hepatocellular carcinoma. These results were recently published in the New England Journal of Medicine.
The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats; the production of bile; the processing of hemoglobin and detoxification of numerous substances. Primary liver cancer starts in the cells of the liver and can spread, through blood or lymph vessels, to different parts of the body. Approximately 85% of all liver cancers that start in the liver (primary liver cancer) are classified as hepatocellular carcinoma (HCC). Treatment may include surgery, radiation therapy, radiofrequency ablation, cryosurgery, immunotherapy, systemic or local chemotherapy or a combination of therapies.
Researchers have been evaluating ways in which to identify patients who may be at a higher risk of developing a recurrence following surgery to remove HCC, as these patients may benefit from additional therapies following surgery. Conversely, patients at a low risk of developing a recurrence may be able to safely forego additional therapies.
Researchers from the United States and Spain recently conducted a clinical study to evaluate gene expressions and associated outcomes among patients with HCC. This study included tissue samples from both the cancer and adjacent tissue among patients diagnosed with HCC.
Gene expression of the cancer was not associated with survival. Gene expression of tissue adjacent to the cancer was associated with the risk of late recurrences.
The researchers concluded that they “envision the use of this test to identify the patients at highest risk for recurrence of hepatocellular carcinoma and to target intensive clinical follow-up or chemo-preventive strategies in such patients.” Future trials further evaluating gene expression profiles in HCC are warranted.
Reference: Hoshida Y, Villanueva A, Kobayashi M, et al. Gene Expression in Fixed Tissues and Outcome in Hepatocellular Carcinoma. New England Journal of Medicine. Early on-line publication October 15 2008.?DOI:10.1056/NEJMoa0804525.