Growth kinetics of small hepatocellular carcinoma

OBJECTIVETo further define the growth rate of small hepatocellular carcinoma before initiation of any specific treatment for cancer. PATIENTSThe study included 18 patients with an hepatocellular carcinoma nodule ≥30mm in diameter. RESULTSThe doubling time of the tumour volumes and serum alphafetoprotein levels was 28–230 days (83 ± 52 days, mean ± SD) and 10–77 days (36 ± 20 days), respectively. The time taken for the tumour to increase by 1 cm from a mass of 12–20 mm was calculated to be about 85–315 days (mean 151 days). The low density zone around the tumour nodule, representing its fibrous capsule, developed in conjunction with the tumour, after the largest tumour diameter had increased to more than 2.5cm. Necrotic formation in the tumour nodule was observed as the tumour expanded and was found in almost all patients after the tumour diameter exceeded 3 cm. CONCLUSIONSFrom these data, the suitable screening interval for small cancer detection in patients at high risk of hepatocellular carcinoma seems to be 3 months. Analysis of the tumour volume doubling times and serum alphafetoprotein levels suggested that the tumour growth rate is not constant, even in the same patient, and may change and accelerate or decrease at any time during the course of growth.