Diagnosis, treatment and prognosis of small hepatocellular carcinoma

Diagnosis, treatment and prognosis of hepatocellular carcinoma (HCC) of small size, not larger than 5 cm in diameter, were studied in forty-three patients with underlying cirrhosis, who were detected among one-hundred-and-sixty-five HCC cases over a period of 4.5 years from 1981 to 1985. The patients included fifteen cases with tumors smaller than 3 cm in diameter which were diagnosed HCC mostly during the follow-up period of liver cirrhosis. Among various imaging procedures, real-time linear scan ultrasonography (US) had a 91% positive HCC detection rate, hepatic angiography 93% and computed tomography (CT) 88%. Surgical treatment including partial resection, subsegmentectomy and segmentectomy, was carried out in fifteen HCC cases with well-compensated cirrhosis. Transcatheter arterial embolization (TAE) was performed in nineteen cases with severe liver dysfunction and multiple location of tumors. Three-year survival was 80% in twelve patients with hepatic resection (performed since 1981) and 19% in the TAE cases; none of the other cases survived.