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We congratulate Silva et al (Gut 2008;57:1592–6) for addressing an important issue in the management of patients with suspected hepatocellular carcinoma (HCC). We agree with the authors that biopsy of liver lesions should not be performed indiscriminately and that they should be undertaken preferably within or at least only after consultation with a liver transplant centre.
Some HCCs can be managed successfully with resection. However, our own series of 85 patients showed that biopsy of such lesions, almost exclusively being carried out before referral almost halved the patients’ chance of disease free survival at 5 years post-resection (52% vs 24%).1 We agree that a …
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