Natural history of hepatocellular carcinoma

The natural history of hepatocellular carcinoma is variable. In many patients the tumor has a long-lasting subclinical incubation period and often grows as a solitary mass to a size at which it can be detected by ultrasound. In other patients, however, the onset of the tumor is multinodal with great variations in the growth rates. Prognostication of patients with hepatocellular carcinoma takes into account the size and number of tumor nodes and their relation to the portal veins, and the degree of liver impairment.