[Diagnosis and course of small hepatocarcinoma in cirrhosis. 6 years' experience]

Diagnosis of hepatocellular carcinoma smaller than 3 cm in diameter was possible in 64 (27.7%) of 231 consecutive cases. Ultrasonography provided the highest diagnostic sensitivity which was further increased by combining this methodology with laparoscopy. Evolution of nodules was more often multicentric but sometimes unicentric with slow growth. Surgical treatment in selected patients (small resections) was associated with high operative mortality (37.5%). Survival of patients (Child C excluded) after percutaneous ethanol injection under ultrasound guidance was 100% at three years.