In my last commentary, I highlighted the emerging discipline of hepatobiliary oncology and noted that Hepatology encouraged submission of excellent papers on hepatocellular cancer (HCC)(1). Our collective goal was to highlight Hepatology as a forum for communicating advances in HCC. In this commentary, I will explore this latter concept in greater detail. Have we achieved our goal? Has Hepatology become a home for outstanding clinical, translational and basic research on this enigmatic, devastating malignancy?
On February 9, 2009 I examined the number of manuscripts published in biomedical journals. I performed a pubmed search for hepatocellular carcinoma with various limits. The number of publications generated by pubmed was then taken as the total for the defined parameters. I made no attempt to verify the results by reading titles and/or abstracts. Also, all publications were considered to be equal numerically whether peer-reviewed original papers, reviews, letters to the editor, discussions in Hepatology elsewhere, etc. Thus, in this respect, the data are unexpurgated. Because the defined parameters are the same for each time period and journal, the data are unbiased and useful for tracking trends or qualitative comparisons. Others may want a more refined analysis, but this more superficial approach does permit an initial exploration of the above questions.
What did I learn from this exercise? First, my search suggested that approximately 2,934 publications on hepatocellular cancer were published in the last 12 months, a staggering number of publications, suggesting immense world-wide interest in hepatocellular carcinoma. Obviously, no single journal should or could publish all these manuscripts. For example, Hepatology published 349 papers in 2008, or approximately 30 per month. For Hepatology to publish all of these HCC publications there would need to be 100 issues published/year which would translate into 8-9 issues/month or two issues per week. This is neither practical nor would it be acceptable to the readership of Hepatology.
This number of papers was also too large for my simplified approach and therefore, to further limit my analysis, I employed the ISI web of knowledge by Thomson Reuters to categorize journals by subject and impact factor. I searched the top-tiered journals in oncology, gastroenterology and hepatology, surgery, radiology and pathology. Only journals with leading impact factors in their subject matter which published at least 5 HCC citations in the last 12 months were further analyzed (Table I). The number of HCC papers in these journals accounted for 438 of the 2934; thus, 14% of all papers on HCC were published in these 21 journals. Given the multidisciplinary nature of HCC, this spread of papers over multiple discipline-related journals is not surprising. Of the top 7 journals publishing more than 20 HCC papers per year, 3 are in the subject category of gastroenterology and hepatology, 2 in surgery and 2 in oncology (Figure 1). Two of these 7 top tier journals are sponsored by the American Association for the Study of Liver Diseases; Hepatology and Liver Transplantation. Hepatology was the clear winner in this analysis with more than double the number of publications of the 2nd journal. Thus, our multidisciplinary society and its Journals feature prominently publications regarding HCC.
Table I. Leading Sub-special Journals by Impact Factor Publishing >5 Papers on HCC in 2008.
| Oncology Journals | Impact Factor | HCC Papers |
|---|---|---|
| Journal of Clinical Oncology | 15.5 | 12 |
| Lancet Oncology | 12.2 | 5 |
| Cancer Research | 7.7 | 29 |
| Oncogene | 6.4 | 19 |
| Clinical Cancer Research | 6.3 | 21 |
| Carcinogenesis | 5.4 | 17 |
| GI and Liver Journal | ||
| Gastroenterology | 11.7 | 33 |
| Hepatology | 10.7 | 97 |
| Gut | 10.0 | 5 |
| Journal of Hepatology | 5.9 | 39 |
| American Journal of Gastroenterology | 6.1 | 14 |
| Clinical Gastroenterology and Hepatology | 5.5 | 6 |
| Surgical Journals | ||
| Annals of Surgery | 7.4 | 12 |
| American Journal of Transplantation | 6.4 | 9 |
| Annals of Surgical Oncology | 3.9 | 31 |
| Liver Transplantation | 3.7 | 26 |
| Transplantation | 3.5 | 13 |
| Radiology Journals | ||
| Radiology | 5.6 | 17 |
| International Journal of Radiation Oncology | 4.3 | 12 |
| Pathology Journals | ||
| Modern Pathology | 4.3 | 9 |
| Human Pathology | 3.0 | 12 |
Figure 1. The number of publications in 2008 on hepatocellular carcinoma by specialty Journal.

Pubmed was used to identify publications related to hepatocellular carcinoma in 2008 in the top tier journals in gastroenterology and hepatology, oncology, surgery, radiology and pathology. Journals were selected for being a top tier journals in their specialty based on impact factor (see Table 1). The number of publications included whatever was deemed a publication by pubmed and includes original papers, reviews, editorials, letters to the editors, etc. Those journals publishing at lease 20 paper on hepatocellular carcinoma in 2008 are depicted.
In my final cursory analysis, I asked if the number of HCC publications in Hepatology is static or increasing. The number of HCC publications in Hepatology increased significantly in 2008 (Figure 2). Perhaps my prior commentary and having HCC-oriented Associate Editors has promoted this trend. What is yet unclear is the potential impact factor of these publications. Such an analysis of the 2008 publications will need to wait until 2010 and thus, it is premature to address this question. However, I am optimistic that these papers will be cited as often as other topic-oriented papers in Hepatology given world-wide interest in this cancer.
Figure 2. The number of publications in Hepatology per year on hepatocellular carcinoma.

Pubmed was used to identify publications related to hepatocellular carcinoma per year dating back to 2004. The number of publications included whatever was deemed a publication by pubmed and includes original papers, reviews, editorials, letters to the editors, etc.
Have we achieved our goal of providing a premier forum for excellent papers on HCC? The answer is, yes in part, but we can do better. These data indicate that Hepatology has become a forum for papers on HCC. Indeed, Hepatology is perhaps an ideal forum for HCC publications given its focus on ‘all things liver’ and the scope of its multidisciplinary publications covering basic, translational and clinical research. Hepatology was also third in Table 1 in regards to impact factor (Journal of Clinical Oncology and Gastroenterology had higher impact factors). Thus, Hepatology is increasing its visibility as a ‘cancer journal’. As I searched pubmed, I was impressed by the number of outstanding papers for which I was unaware. Many investigators choose to publish papers in journals which are sponsored by societies in which they are members or in journals specific to the geographic regime in which they live. They likely select these journals for their publications so that their colleagues see and read their papers. Local recognition can be important for referrals, academic promotions and stature. However, we emphasize the universal attraction of Hepatology as a journal for all disciplines to read and publish, given its high impact factor and its focus. We are a home for disciplinary integration for ‘all things liver’ and continue to welcome excellent HCC papers from our colleagues in surgical oncology, pathology, radiology and basic science.
Acknowledgments
This work was supported by NIH Grants DK41876 to GJG and the Mayo Foundation.
REFERENCES
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