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World J Gastroenterol. 2013 Feb 28;19(8):1193-9. doi: 10.3748/wjg.v19.i8.1193.

Management of small hepatocellular carcinoma in cirrhosis: focus on portal hypertension.

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  • 1Hepatocellular Carcinoma Translational Research Laboratory, Barcelona-Clinic Liver Cancer Group, Institut d'Investigacions Biomediques August Pi i Sunyer, Liver Unit, Hospital Clinic, 08036 Barcelona, Spain.


The incidence of hepatocellular carcinoma (HCC) is rising worldwide being currently the fifth most common cancer and third cause of cancer-related mortality. Early detection of HCC through surveillance programs have enabled the identification of small nodules with higher frequency, and nowadays account for 10%-15% of patients diagnosed in the West and almost 30% in Japan. Patients with small HCC can be candidates for potential curative treatments: liver transplantation, surgical resection and percutaneous ablation, depending on the presence of portal hypertension and co-morbidities. This review will analyze recent advancements in the clinical management of these individuals, focusing on issues related to the role of portal hypertension, the debate between resection and ablative therapies and the future impact of molecular technologies.


Clinically significant portal hypertension; Hepatic venous pressure gradient; Hepatocellular carcinoma; Liver cancer; Liver stiffness; Percutaneous ethanol injection; Portal hypertension; Radiofrequency ablation; Resection

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