Abstract
The incidence of hepatocellular carcinoma (HCC) is increasing with advancing age worldwide. However, the mean age of patients with HCC is highest in Japan. Various modalities for the diagnosis, surgical management and treatment of HCC have been developed and established worldwide. Recently, pathological concept of early HCC has been accepted as small nodular and well-differentiated HCC less than 2 cm in greatest dimension with an obscure tumour margin. The hepatobiliary-phase image of Gd-EOB-DTPA-enhanced MRI is reported to improve the detection of early HCC. Furthermore, this hepatobiliary-phase image of Gd-EOB-DTPA-enhanced MRI can be used for the prediction of microscopic portal vein invasion of HCC. Since the microscopic vascular invasion and intrahepatic metastases, surrounding tumour, are diagnosed in about 20% of cases, anatomical hepatectomy is the most effective treatment for HCC of 2–5 cm in greatest dimension. Furthermore, treatment for viral infections is required to prevent a second primary HCC and a progression to cirrhosis. This report summarizes the current knowledge of diagnosis, pathology, role of surgery and outcomes of hepatectomy.
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