Context and biological diversity
Hepatocellular carcinoma, bile duct tumors and liver metastases are not the same disease. In hepatocellular carcinoma, organ function and underlying liver disease contribute to prognosis and participant selection. Tumor extent and liver function should be described separately.
What research makes it possible to study
The integrated TCGA study characterized hepatocellular carcinoma across multiple platforms and identified distinct molecular groups. It allows exploration of cellular pathways and subtypes but does not demonstrate that a signature is useful for choosing interventions. Tissue origin and acquisition conditions delimit the scope of each analysis.
Application in a research project
A surveillance cohort can record liver disease etiology, functional severity, examination frequency and confirmation criteria. Mortality studies need to distinguish deaths related to the tumor and to liver disease. Changes in access to tests or treatments over time can also affect historical comparisons.
Research questions
Does a marker add information about hepatocellular carcinoma detection beyond variables already available during follow-up?
- Study design
- A prospective cohort in a defined liver disease population, with prediagnostic sampling and external validation.
- What to measure
- Detection by stage, false positives, time to confirmation and competing hepatic events.
- Interpretation limits
- Hepatocellular carcinoma findings do not apply directly to cholangiocarcinoma. Differences in etiology and hepatic reserve can limit transportability.
Interpretation limits
Hepatocellular carcinoma findings do not apply directly to cholangiocarcinoma. Differences in etiology and hepatic reserve can limit transportability.
Original references
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Research questions
Educational content for framing research. Consult the original document, study population and methodology before interpreting a conclusion. Methodology