[Small hepatocellular carcinoma (HCC) and its remote outcome].

Comparative study of 92 cases of pathologically proven small HCC (less than or equal to 5 cm) and 787 clinical HCC treated and followed in Zhongshan Hospital from 1958 to 1984 demonstrated that: 1. Resection of small HCC is the best way for long survival, 26 of the 51 patients who survived for more than 5 years had had small HCC. 2. The increase of the 5 year survival rates from 1.7% (1958-1966) through 7.1% (1967-1975) to 22.6% (1976-1984) of the whole series is due to the increase of proportion of small HCC (0%, 7.2% and 15.1%) in the respective periods. 3. In comparison to clinical HCC, small HCC showed higher resection rate (28.7% vs 85.9%), lower operative mortality (9.7% vs 1.3%) and better 5 year survival (19.9% vs 70.3%). 4. Concepts of early detection, early diagnosis, surgical treatment, management of recurrence and metastasis, prognosis, natural history of HCC, early development of HCC, etc. may be changed basing on this study. Reoperation of subclinical recurrence after small HCC resection has improved the 5 year survival from 56.2% in 1981 to 70.3% in this study.