GROWTH AND EXTENSION OF SMALL HEPATOCELLULAR CARCINOMAS DURING NATURAL COURSE

Relation to Various Clinical Conditions

Abstract

In 23 patients with small hepatocellular carcinoma (HCC) less than 3cm in size at the time of detection, the growth and extension of tumors and clinical findings of patients were followed for a period of 20 months on average without anticancer therapy.
Speed of the tumor growth was measured in terms of doubling time (DT) from increase of tumor volume on the echogram.
DT of tumors smaller than 2cm was 11.3 months on average in 10 patients, while that of tumors of 2-5cm was 6.2 months in 19 patients.
The former was significantly longer than the latter.
Growth speeds of HCCs of a size of 2-5cm were divided into three groups, slow growth (DT_??_6.0 Mos), intermediate growth (3_??_DT<6.0Mos) and rapid growth(DT<3.0Mos).
During the natural course, the echographic pattern of the rapid and intermediate growth groups changed from the nodular type to the multinodular or massive type, and that of the slow growth group continued to be nodular in the majority.
Prognosis was poorer in the rapid and intermediate groups that the slow growth group.
Histologically, the tumors of the slow growth group showed Edmondsson-Steiner's grade I or II, and of a microtrabecular and monotonous pattern.
The tumors of the rapid growth group showed Edmondson-Steiner's grade II and III, and of a micromacrotrabecular and mosaic pattern.
One case of the rapid growth group showed Edmondson-Steiner's grade IV.
There were more habitual drinkers in the slow and intermediate groups than in the rapid growth group.
DT on the average in habitual alcohol drinkers was 12.8Mos and significantly longer than 6.0mos of DT in non-habitual alcohol drinkers.
A tumor of a size of 3cm showing AFP level of 400ng/ml was more frequently in the rapid growth group than the others.