Evaluation of the prognosis for small hepatocellular carcinoma based on tumor volume doubling time. A preliminary report

Abstract

The relationship of tumor volume doubling time to length of patient survival was investigated for 15 patients with small hepatocellular carcinoma smaller than 4.5 cm in diameter. The mean tumor volume doubling time of these 15 nodules was 102 +/- 77 days (mean +/- SD; range 41 to 305 days) before the initiation of a specific treatment for cancer. These doubling times tended to correlate with mitotic indexes of the tumors and the patients could be divided into two groups according to the therapeutic modalities used. Patients in Group A received systemic chemotherapy without response or nonspecific treatments for cancer. In this group, there was a positive correlation between tumor volume doubling time and survival length (r = 0.8812; P less than 0.025). Patients in Group B either received hepatectomy after transarterial embolization or systemic chemotherapy or received hepatectomy alone. In this group, early death occurred in patients who had shorter tumor volume doubling times. Three surgically treated patients in Group B were evaluated as having survived for a significantly long period as assessed from their tumor volume doubling times. These results indicate that tumor volume doubling time is one of the determining factors of survival length in patients with hepatocellular carcinoma, and, therefore, can be used in the evaluation of therapeutic efficacy.

A follow-up analysis of the pattern and predictors of dropout from the waiting list for liver transplantation in patients with hepatocellular carcinoma: Implications for the current organ allocation policy

“…This potentially confers an unfair advantage for these patients over patients without HCC but with comparable MELD scores reflecting the severity of their liver disease. Based on natural history data for untreated, small HCC, [27][28][29][30] it seems unlikely that a single small lesion Ͻ3 cm will increase in size to more than 5 cm (dropout under UNOS guidelines) in less than 6 months. For example, in the study by Ebara et al, 27 only 1 of 22 patients with a single HCC Ͻ3 cm was found to have rapid tumor progression exceeding a diameter of 5 cm in less than 6 months.…”

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

“…However, the present study showed that the 4-month interval was not short enough, and it may not be practical to further shorten the surveillance interval in terms of cost-effectiveness. It should also be noted that the prognosis of patients with rapid growing tumor may be poor even after curative hepatectomy [25,26]. Sheu et al [23], by comparing tumor sizes on two ultrasound examinations at an interval of 36-860 days, reported a median tumor doubling time of HCC as 117 days (range = 29-398 days).…”

Effect of Alcohol on Tumor Growth of Hepatocellular Carcinoma with Type C Cirrhosis.

“…Their subjects were cases of recurrent HCC,and the difference in the TVDTmay be between primary, intrahepatic and multicentric nodules. Okazaki et al (8) and Barbara et al (9) reported that the TVDTwas not statistically significantly correlated with histopathological findings, as was found in our study. The difference in the TVDT of the reports maybe due to the differences in subjects because the patients in those reports had several factors that seemed difficult to compare.…”