| [ Summary ] |
A nodular hepatocellular carcinoma (HCC) less than 2cm is not always a form of early HCC with well differentiated features. Tumor characteristics including tumor diameter, vascurality, histology, and macroscopic morphology are important in determining the tumor's aggressiveness. Depending on the results of such tumor characteristics, we will make treatment decisions of single and nodular HCC less than 2cm with good liver functions. Aggressive HCC of the single nodular type with extra-nodular growth and the confluent multi-nodular type should be ablated by surgical resection if indicated, and other aggressive HCC should be treated with thermal ablation therapy, such as microwave coagulation therapy (MCT) or radio-frequency ablation (RFA). A HCC of the single nodular type and vaguely nodular type may be considered to be a localized tumor, and should be ablated with MCT or RFA to avoid over-treatment. Percutaneous ethanol injection therapy may be an alternative treatment for such small HCC, if surgical resection, MCT or RFA are not indicated. |