[Diagnosis, treatment and prognosis of single-nodular minute hepatocellular carcinoma]

This article presents 14 patients of single-nodular minute hepatocellular carcinoma (HCC less than or equal to 2 cm) with coexisting cirrhosis. Of these nine patients were discovered by alpha-fetoprotein (AFP) mass screening or health check-up; and five by follow-up observations of chronic liver disease. All the 14 patients received radical resection with no operative mortality. The 1-5 year survival rates after resection were 100% (14/14), 100% (12/12), 100% (11/11), 100% (9/9), and 100% (7/7), respectively. This study demonstrates that the key point of further improvement in the detection of minute HCC lies in the establishment of diagnosis at a relatively low AFP level (less than 200 ng/ml). Realtime ultrasonography is the diagnostic modality of first choice in screening and monitoring. Surgery is strongly indicated for minute HCC with compensated liver function; Limited resection is the main type of resection for minute HCC with liver cirrhosis. The present data also indicate that HCC is not always multicentric in origin, even in patients with liver cirrhosis Intrahepatic spreading rather than multicentric origin may play a more important role in the multinodular pattern of HCC.