Growth and Survival in Small Hepatocellular Carcinoma

(1989) A comparison between operative and non-operative management of blunt injuries to the liver and spleen in adult and pediatric patients. Management of blunt trauma to the liver and hepatic veins. Natural history of small untreated hepatocellular carcinoma in cirrhosis: A multi-variate analysis of prognostic factors of tumour growth rate and patient suroival. We analyzed the growth pattern of tumor masses and the survival of 39 asymptoma-tic Italian patients with a total of 59 small (-< 5 cm in diameter) hepatocellular carcinomas arising from cirrhosis. The total length of the observation period ranged from 90 to 962 days, with an average of 364 _+ 229 (mean __+ S.D.). Doubling time ranged from 27.2 to 605.6 days (mean _ S.D., 204.2 _ 135; median 171.6 days). Three different growth patterns were recognized: (a) tumors with no or very slow initial growth pattern (doubling time > 200 days), 10 cases (37%); (b) tumors with declining growth rate over time, 9 cases (33.4%); and (c) tumors with almost constant growth rate, 8 cases (29.6%). Using the stepwise discriminant analysis, we found a score based on albumin, alcohol intake, number of nodules, echo pattern and histological type that allowed a correct prediction of short doubling time (<-150 days) in 55.6%, medium doubling time (151 to 300 days) in 60% and long doubling time (> 300 days) in 100% of cases. The estimated survival rate of the 39 patients,