Growth kinetics of hepatocellular carcinoma.

We measured the size of 17 semispherical hepatocellular carcinoma tumor nodules in 13 patients repeatedly by either computed tomography or ultrasonography for 10 to 291 days. At the initial examination the diameter of these tumors was 30 +/- 15 mm (mean +/- SD). When the doubling time of these tumor volumes was calculated by the formula proposed by Schwartz, it was 119 +/- 96 days (mean +/- SD). There was no correlation between the doubling time of the tumors and the degree of impairment of liver function in any case. There was also no correlation between the doubling time of the tumors and the alpha-fetoprotein level. However, in patients with hepatitis B surface antigen, the doubling time was short (48 +/- 8 days), when compared with the antigen-negative cases (140 +/- 98 days). Based on the shortest doubling time of the smaller tumors, it was revealed that the diameter was duplicated in four months. Since the minimum tumor diameter that was detected by ultrasonography and/or computed tomography was considered to be 1 cm, we recommend that ultrasonography and/or computed tomography should be performed at least every four months to detect so-called "small hepatocellular carcinoma," which has a diameter of less than 2 cm, in patients at high risk for hepatocellular carcinoma.