Minireviews
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 7, 2014; 20(1): 142-147
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.142
Targeting of circulating hepatocellular carcinoma cells to prevent postoperative recurrence and metastasis
Yu Zhang, Zhi-Long Shi, Xia Yang, Zheng-Feng Yin
Yu Zhang, Zhi-Long Shi, Xia Yang, Zheng-Feng Yin, Molecular Oncology Laboratory, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China
Author contributions: Zhang Y and Shi ZL contributed equally to the literature review; Zhang Y, Shi ZL and Yang X wrote the manuscript; and Yin ZF designed the review and revised the manuscript.
Supported by Grants from the China National Key Projects for Infectious Disease, No. 2012ZX10002012-10; The National High-Tech Research and Development Program of China, No. 2007AA02Z461; and the National Natural Science Foundation of China, Nos. 30772513, 81172207 and 81272669
Correspondence to: Zheng-Feng Yin, MD, PhD, Molecular Oncology Laboratory, Eastern Hepatobiliary Surgery Hospital, 225 Changhai Road, Shanghai 200438, China. yinzfk@aliyun.com
Telephone: +86-21-81875354 Fax: +86-21-81875354
Received: September 4, 2013
Revised: October 16, 2013
Accepted: November 28, 2013
Published online: January 7, 2014
Processing time: 138 Days and 6.5 Hours
Abstract

Currently, the main treatment for hepatocellular carcinoma (HCC) involves the surgical removal of tumors or liver transplantation. However, these treatments are often not completely curative, as they are associated with a risk for postoperative recurrence and metastasis. Circulating tumor cells (CTCs) are increasingly recognized as the main source for recurrence and metastasis after radical hepatectomies are performed. Many studies have demonstrated the association between the presence of either pre- or postoperative CTCs and an increased risk for HCC recurrence. To improve the therapeutic outcome of HCC, a personalized, comprehensive and multidisciplinary approach should be considered, involving the application of appropriate diagnostic and therapeutic measures targeting HCC CTCs in different stages throughout the course of treatment. This article proposes some HCC CTC-based strategies for the treatment of HCC, including the monitoring of HCC CTCs before, during and after radical hepatectomy, therapeutic targeting of HCC CTCs, prevention of the generation and colonization of CTCs, as well as the use of CTC indexes for the selection of indications, prediction of prognoses, and planning of individualized therapeutic regimens. Innovation and technological development of therapies targeting CTCs, as well as their translation into clinical practice, will help to effectively reduce postoperative recurrence and metastasis, and significantly prolong the survival of HCC patients.

Keywords: Hepatocellular carcinoma; Circulating tumor cells; Recurrence and metastasis; Surgical treatment; Individualized treatment

Core tip: Circulating tumor cells (CTCs) can lead to recurrence and metastasis after surgical treatment for hepatocellular carcinoma (HCC). The development and utilization of new methods or techniques to target these cells will help reduce postoperative recurrence and metastasis and prolong the survival of HCC patients. This article proposes CTC-based strategies that provide a more comprehensive and personalized approach for the treatment of HCC. Treatment methods that incorporate multiple aspects of identification, targeting and monitoring of these tumor cells may provide more efficient and effective regimens for HCC patients undergoing radical hepatectomies.