HCC

[Upbeat]

Hi all
         I got the dreaded call from the liver doc today telling me i have a 1 centimeter tumor. Not a clue as to where its located yet.  I have hep c and cirrhosis.  The doc started with i needed a liver transplant.  The doc said I should wait until in grew to a two then get an exception for the waiting list. I am lost on how to proceed.  It seems to me the first course of action would be to remove the tumor by either tace or burn it or freeze it or remove it with minimally evasive surgery. Any insight would be appreciated

[Thomas D Schiano, MD]

we typically repeat scans every 3 months when HCC is documented.  some can grow quite fast.

[Upbeat]

Thank You for your response.  I received a copy of the mri report today and  it is as clear as mud to me. They don't mention the size of the tumor they only reference washout in the 4 b segment. They want me to return in 2 or 3 months for another MRI with and without contrast.  I am somewhat confused, would they know more in 2 or 3 months and could the tumor really grow that much in 2 months?

[Thomas D Schiano, MD]

an individual gets priority on the liver transplant list if the tumor is 2 cms in size or greater.  the chance of locoregional therapy to cure HCC is small, but the cure rate is greater when the lesion is smaller.  if the liver function is compromised and you need a transplant from that perspective it is reasonable, but if the HCC would be the only inidcation for transplantation, early locoregional therapy can be considered to obviate the potential need for transplantation.  i presume that liver resection is precluded as a treatment.