Special Interview with Prof. Erica Villa, University of Modena and Reggio Emilia

On July 3, 2026, Hepatoma Research had the pleasure of interviewing Prof. Erica Villa from the University of Modena and Reggio Emilia, Italy, a distinguished hepatologist, internationally recognized expert in hepatocellular carcinoma (HCC), and senior editorial board member to the journal. Throughout the interview, Prof. Villa shared her perspectives on the evolution of hepatology, the growing influence of artificial intelligence (AI), individualized risk prediction for liver cancer, multidisciplinary clinical management, scientific publishing, and future directions for the global hepatology community.

Reflecting on more than four decades of academic research, Prof. Villa observed that the progress of hepatology has been driven not by a single revolutionary discovery but by the steady accumulation of scientific knowledge. Among the most transformative developments in recent years, she identified the rapid emergence of AI and advanced molecular technologies - including spatial transcriptomics, single-cell RNA sequencing, and bioinformatics-driven analyses - which are fundamentally reshaping liver research. While recognizing their enormous scientific value, she also highlighted an important challenge: unequal access to these sophisticated technologies is creating an increasing gap between large, well-funded research centers and smaller investigative groups, potentially affecting diversity and innovation within the field.

The conversation then turned to the expanding role of AI in biomedical research and academic publishing. Prof. Villa shared her own experience using AI to support literature searches, manuscript preparation, language editing, and other routine academic tasks. At the same time, she emphasized that AI should remain an assistant rather than a substitute for scientific reasoning. She noted that experienced investigators are generally able to recognize inaccurate or misleading AI-generated content, whereas early-career researchers may be more vulnerable to accepting incorrect information without sufficient critical evaluation. She further discussed the responsible use of AI in peer review, stressing that while AI can assist reviewers in checking completeness or identifying potential issues, editorial decisions and scientific assessments must always remain under human supervision.

Drawing on her pioneering research in hepatocellular carcinoma, Prof. Villa also discussed the future of precision hepatology and individualized risk prediction. She argued that many of the tools required to identify patients at high risk of developing HCC - or those likely to develop aggressive disease - already exist. However, translating these discoveries into routine clinical practice remains challenging because of the complexity of changing established clinical paradigms and achieving broad acceptance within the medical community. She emphasized that improving early risk stratification represents one of the most promising opportunities to optimize surveillance strategies and personalize patient management.

Prof. Villa also highlighted the indispensable role of multidisciplinary care in managing patients with liver cancer. Because hepatocellular carcinoma almost always develops in the setting of chronic liver disease or cirrhosis, treatment decisions must simultaneously consider tumor characteristics, liver function, and multiple systemic comorbidities. She emphasized that effective multidisciplinary management requires not only collaboration among specialists but also strong clinical leadership capable of integrating diverse expertise into individualized treatment decisions.

Beyond scientific research, Prof. Villa shared extensive insights gained from her decades of editorial experience with leading hepatology journals. She emphasized that efficient, transparent, and author-friendly peer review remains one of the most important factors influencing researchers' choice of journal. She also discussed strategies for strengthening a journal's scientific impact, including commissioning authoritative review articles, organizing focused Special Issues, promoting published research through international networks, and fostering vibrant academic communities that extend beyond traditional publishing.

Finally, Prof. Villa expressed strong support for initiatives dedicated to promoting women scientists and gender medicine in hepatoma research. Drawing on her experience founding the Women in liver cancer reserach initiative, she emphasized the importance of creating supportive environments for early-career female researchers and increasing the visibility of sex-specific research in liver diseases. She also proposed several emerging research topics - including gender-affirming hormone therapy and liver cancer - as promising directions for future Special Issues and interdisciplinary collaboration.

We sincerely thank Prof. Villa for sharing her valuable experience and thoughtful perspectives. Her insights into artificial intelligence, precision care in HCC, multidisciplinary liver cancer management, scientific publishing, and academic community building provide valuable guidance for researchers, clinicians, and journal editors alike. We look forward to continuing our collaboration with Prof. Villa to promote high-quality research and academic exchange in hepatology and liver cancer.

Interview Questions and Answers

Q1. You have witnessed the remarkable evolution of hepatology over the past few decades. Looking back on your academic career, what has been the most exciting or unexpected change in the field that has impressed you the most?

Prof. Erica Villa:

Hepatology has evolved through continuous scientific progress rather than a single transformative breakthrough. Looking back over the past several decades, one of the most significant developments has been the rapid emergence of artificial intelligence and advanced molecular technologies. Techniques such as spatial transcriptomics, single-cell RNA sequencing, and large-scale bioinformatics analyses are fundamentally changing how we investigate liver diseases and hepatocellular carcinoma.

These technologies provide unprecedented opportunities to better understand disease mechanisms and identify new therapeutic targets. At the same time, however, they are reshaping the research landscape in ways that deserve careful consideration. Access to these sophisticated platforms is largely concentrated in a relatively small number of major research institutions with substantial technological infrastructure and financial support. Consequently, many smaller research groups - which continue to produce high-quality scientific work - find it increasingly difficult to compete for publication in leading journals.

This growing imbalance is becoming more evident across Europe and elsewhere. Large national research centers are now able to routinely incorporate these advanced technologies into their projects, whereas many excellent investigators simply do not have access to the necessary resources. As these technologies continue to evolve, maintaining diversity within the research community and ensuring broader access to advanced methodologies will become increasingly important challenges for hepatology.

Q2. AI is rapidly transforming biomedical research. How do you think it has changed the way young hepatologists should be trained, and how should researchers use AI responsibly?

Prof. Erica Villa:

Artificial intelligence is already becoming an indispensable tool for researchers, and I use it regularly in my own work. It can greatly improve efficiency by assisting with literature searches, manuscript organization, language editing, formatting references, and many other routine academic tasks. For experienced investigators, these applications can significantly increase productivity without compromising scientific quality.

However, AI should always remain a supporting tool rather than a replacement for scientific judgment. This distinction is particularly important for early-career researchers. Experienced scientists are generally able to evaluate AI-generated responses critically, recognize inaccuracies, and distinguish reliable information from misleading or fabricated content. Young investigators, however, may not yet possess the subject-specific expertise needed to identify these errors, making them more vulnerable to accepting incorrect conclusions.

The same principle applies to scientific writing. AI can improve readability and language quality, especially for researchers whose first language is not English. Nevertheless, it should never be relied upon to interpret scientific findings or generate original scientific conclusions without careful human verification. Even seemingly authoritative AI-generated summaries may contain subtle but significant inaccuracies.

Responsible use of AI therefore requires continuous human oversight. Rather than replacing scientific thinking, AI should enhance researchers' ability to work more efficiently while leaving critical analysis, experimental design, data interpretation, and scientific decision-making firmly in the hands of experienced investigators. Developing this balance between technological assistance and independent scientific reasoning will be one of the most important aspects of training the next generation of hepatologists.

Q3. Your pioneering research has greatly advanced our understanding of hepatocellular carcinoma, particularly in risk prediction and sex-related differences. What do you believe is the most important breakthrough needed to improve early detection and personalized surveillance for patients at risk of HCC?

Prof. Erica Villa:

I believe we already possess many of the scientific tools needed to substantially improve the early prediction of hepatocellular carcinoma. Beyond simply identifying which patients are likely to develop HCC, our current knowledge increasingly allows us to distinguish between patients who are likely to develop highly aggressive tumors and those whose disease may follow a more indolent course. The challenge today is therefore not only scientific discovery, but the successful translation of these discoveries into routine clinical practice.

Throughout my career, I have found that changing established clinical paradigms is often far more difficult than generating new scientific evidence. Many promising predictive approaches encounter resistance before they are accepted into clinical guidelines. For example, our recent research demonstrated that patients presenting with large esophageal varices have a markedly increased risk of developing HCC within only a few years. This finding has important implications for personalized surveillance strategies, yet it took considerable time before the work was eventually published.

Similarly, several years ago our group developed a transcriptomic signature capable of identifying aggressive HCC at the time of diagnosis with very high predictive accuracy. Although this approach proved successful in clinical practice within our institution, broader implementation remained limited. These experiences illustrate that translating innovative biomarkers into routine patient care often presents greater challenges than the scientific discovery itself.

Looking ahead, I believe one of the most important priorities for hepatology is to move beyond treating HCC only after it develops and instead focus on identifying those patients who are most likely to develop aggressive disease. Earlier and more accurate risk stratification would enable truly personalized surveillance, facilitate earlier intervention, and ultimately improve long-term patient outcomes.

Q4. Would you say the future of hepatology is becoming increasingly multidisciplinary?

Prof. Erica Villa:

Absolutely. Modern hepatology - and particularly the management of hepatocellular carcinoma - has become inherently multidisciplinary.

Unlike many other malignancies, HCC almost always develops in the setting of chronic liver disease or cirrhosis. Consequently, physicians are not simply treating a tumor; they are managing a patient with complex liver dysfunction together with multiple systemic complications that may involve the kidneys, cardiovascular system, and many other organs. Every therapeutic decision must therefore carefully balance oncological benefit against the patient's remaining liver function and overall clinical condition.

This complexity makes close collaboration among hepatologists, liver surgeons, transplant specialists, oncologists, radiologists, pathologists, and other healthcare professionals essential. Advances in systemic therapies, locoregional treatments, transplantation, and precision medicine have further strengthened the need for coordinated multidisciplinary decision-making.

At the same time, multidisciplinary care should not become fragmented. An effective multidisciplinary team requires clear clinical leadership from someone with extensive expertise in both liver disease and hepatocellular carcinoma. While every specialist contributes valuable perspectives, successful patient management ultimately depends on integrating these viewpoints into a coherent, individualized treatment strategy. Without strong leadership and coordinated decision-making, multidisciplinary discussions may become inefficient rather than beneficial.

Q5. Based on your extensive experience as an author, reviewer, and editorial board member, what suggestions would you offer for improving peer review and enhancing the author experience?

Prof. Erica Villa:

From an author's perspective, one of the most important aspects of the publication process is timely editorial handling. Few experiences are more frustrating than repeatedly checking a manuscript submission system only to find that the status has remained unchanged for weeks. Long periods without communication often discourage authors from submitting to the same journal again, regardless of the scientific quality of the publication.

Efficient peer review therefore represents one of the strongest competitive advantages for any journal. Researchers highly value journals that provide rapid, transparent, and fair editorial decisions, whether the final outcome is acceptance or rejection. A predictable and efficient review process enables authors to move forward with their research and publication plans and helps establish long-term confidence in the journal.

Equally important is maintaining fairness throughout peer review. Reviews should provide constructive scientific feedback rather than unnecessary criticism or excessive attention to minor editorial details. A healthy peer-review culture encourages scientific dialogue and improves manuscript quality while avoiding unnecessary barriers to publication. Building such a culture requires experienced editors, carefully selected reviewers, and a shared commitment to supporting high-quality science.

Q6. Having served on the editorial boards of several leading hepatology journals, including Journal of Hepatology and Hepatology, what do you think distinguishes a journal that simply publishes good papers from one that truly shapes the scientific community?

Prof. Erica Villa:

Building an outstanding journal requires much more than publishing high-quality original research. Scientific excellence is, of course, the foundation, but journals that truly influence their field also establish trust within the research community through efficient editorial processes, strong scientific leadership, and clear editorial vision.

One of the most important factors is the speed and quality of peer review. Another essential element is the ability to identify emerging research directions and invite authoritative experts to contribute comprehensive review articles and position papers. Well-written reviews on rapidly developing topics often become highly influential references that benefit both researchers and clinicians while substantially increasing a journal's scientific visibility.

Finally, visibility itself has become increasingly important. Today's researchers are overwhelmed by the number of journals and published articles. Scientific publishing can no longer rely solely on readers discovering papers independently. Journals must actively promote important research through professional communication channels, digital platforms, and international academic networks to ensure that high-quality work reaches the widest possible audience.

Ultimately, a successful journal is one that not only publishes excellent science but also helps define future research directions and brings together an active international scientific community.

Q7. Hepatoma Research is continuing to strengthen its international profile. Based on your experience, what strategies would you recommend for supporting the journal's future development?

Prof. Erica Villa:

One of the greatest strengths of any journal is its editorial board. Experienced Editorial Board Members represent valuable scientific networks that can help attract outstanding authors, identify emerging research topics, and encourage collaborations within the international community.

Rather than relying solely on unsolicited submissions, journals should actively commission high-quality review articles, invite internationally recognized experts to contribute perspective papers, and organize focused Special Issues addressing timely scientific questions. Personal invitations from respected researchers are often far more effective than general calls for papers and help establish long-term relationships with leading investigators.

Special Issues can be particularly valuable when they bring together several complementary viewpoints on a rapidly evolving topic. They do not necessarily need to present complete consensus. In many cases, publishing different perspectives from leading experts stimulates productive scientific discussion and provides readers with a broader understanding of complex issues.

Equally important is maintaining regular communication with the research community. In addition to social media promotion, newsletters and mailing lists remain effective ways of informing researchers about newly published articles, special collections, and upcoming academic activities. Consistent communication helps strengthen the connection between a journal and its readership while gradually increasing its international visibility.

Building a successful journal is therefore a continuous process that combines scientific quality, editorial efficiency, community engagement, and long-term academic collaboration.

Q8. Hepatoma Research is exploring initiatives to support women scientists and promote gender medicine in hepatology. What are your thoughts on this initiative?

Prof. Erica Villa:

I strongly support initiatives that promote women scientists and increase the visibility of gender medicine in hepatology. More than a decade ago, I founded the Women in Hepatology initiative with the goal of creating a supportive academic environment where female researchers could present their work, exchange ideas, and develop professional confidence.

One of the most important objectives was to provide early-career women investigators with opportunities to build scientific networks and communicate their research in an environment that encouraged discussion and collaboration. Such initiatives complement traditional scientific meetings by creating space for mentorship, professional development, and long-term academic partnerships.

Gender medicine is also becoming an increasingly important area of hepatology research. Sex differences influence many aspects of liver disease, including hepatocellular carcinoma, metabolic liver disease, and treatment responses. Emerging topics such as gender-affirming hormone therapy and its potential impact on liver disease represent promising directions for future investigation and deserve greater attention within the scientific community.

I believe Hepatoma Research is well positioned to promote these discussions by organizing dedicated Special Issues or thematic collections focused on gender medicine and women scientists in liver cancer research. Such initiatives would not only highlight important scientific advances but also help build a stronger and more inclusive international research community.

I would be delighted to contribute to these efforts and support future initiatives that encourage collaboration among researchers working in this field.

About the Interviewee:

Editor: Vivienne Yan
Production Editor: Xingyue Luo
Respectfully Submitted by the Editorial Office of Hepatoma Research