Endoscopic ultrasound and fine-needle aspiration for the diagnosis of hepatocellular carcinoma.

Hepatocellular cancer (HCC) is the sixth most common cancer in the world with an estimated incidence of more than 650,000 cases per year. The major risk factor associated with the development of HCC is cirrhosis caused by viral hepatitis B or C and chronic alcohol consumption. The overall prognosis of patients with HCC remains poor with 5-year survival estimates that range between 0% and 10%. This dismal prognosis is mainly the result of the advanced stage of HCC at presentation and the background cirrhosis. Systematic screening of high-risk patients is key to an early diagnosis of HCC allowing for the use of an appropriate treatment modality. This article briefly reviews the current guidelines for surveillance and diagnosis of HCC in high-risk patients and the potential role of endoscopic ultrasound and fine-needle aspiration for the diagnosis of small HCC. 2010 Elsevier Inc. All rights reserved.