DETECTION OF PRECLINICAL HEPATOCELLULAR-CARCINOMA IN PATIENTS WITH CIRRHOSIS

The association between hepatocellular carcinoma (HCC) and cirrhosis p rovides a formidable means for prospectively studying patients who are at risk of HCC. Early diagnosis of HCC is possible not only due to kn owledge of the risk factors for this tumor, but also because HCC has a very long phase of intrahepatic growth and tends to grow as a solitar y mass. Early diagnosis is also possible because sensitive and relativ ely inexpensive diagnostic tools are available. Several prospective st udies of Oriental and Western patients with cirrhosis now in progress have led to the identification of many patients with small tumors. How ever, in the face of this evidence that screening high-risk patients m ay increase the yield of subclinical small tumors, no firm conclusion has yet been reached on whether early diagnosis of HCC may also increa se the number of operable patients and reduce the mortality rate for t his tumor.