Abstract
Clinicopathological study was made of 15 nodules of small hepatocellular carcinoma (HCC) less than 2 cm in diameter in 12 resected cases. Liver cirrhosis was present in 10 cases. Excepting 3 hospital deaths because of liver failure, the cumulative 1-and 5-year survival rates were 100% and 86%, respectively. Histologically, 12 nodules showed well differentiated HCC and capsular formation was thin and incomplete. Capsular infiltration (fc-inf) was observed in 14 nodules, but vascular invasion (vp) was nil or mild in 13 nodules. Surgical margin less than 5 mm [tw (+)] was observed in 5 cases, but there was no evidence of recurrence in association with tw (+). On gross classification single nodular type with extranodular growth presented a number of fc-inf and vp. Therefore, considering the above type of gross appearance, partial hepatic resection with tw (+) can be justified as a radical operation. On the other hand, we noted multiple nodular type and/or intrahepatic metastases in 4 of 12 cases, one of which died of recurrent carcinoma. Our experience suggests that even for small HCC it is important to grasp the tumor extension and to take adequate adjuvant therapy.
