CLINICOPATHOLOGICAL STUDY OF SMALL HEPATOCELLULAR CARCINOMA -DEVELOPMENT AND PROGNOSTIC HISTOLOGIC FEATURES-

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Clinicopathological study of 25 resected cases of small hepatocellular carcinoma (HCC) with a diameter equal or smaller than 3 cm was made. The 25 cases had 29 nodules of HCC. The 25 cases were divided into two groups by tumor diameters, classifying as less than 2 cm (group A) and 2-3cm (group B). There were 12 cases in group A and 13 in group B. The 5-year survival rates were 87% and 62% for groups A and B, respectively. With an increase in tumor diameter to 2 to 3cm, single nodular type with extranodular growth, capsular infiltration, vascular invasion (vp) and intrahepatic metastasis (im) increased. Therefore, from the viewpoint of radical resectability partial resection and subsegmentectomy were at least considered necessary for groups A and B, respectively. We noted multinodular type HCC in 4 of 25 cases. Most of this type HCC were considered to be a multicentric emergence. There were 4 patients with widespread multinodular recurrence in the liver remnant although they underwent more than subsegmentectomy. The 4 cases had single nodular type with extranodular growth or contiguous multinodular type, vigorous vp and im, and DNA aneuploid tumors. Our experience suggests that even for small HCC some adequate adjuvant therapies after resection would be mandatory.
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