OBJECTIVETo evaluate the suitable treatment methods of small hepatocellular carcinoma (SHCC).

METHODSFrom 2000 to 2004, 849 cases of SHCC (< or = c5 cm) were enrolled and divided into two groups: resection group (n = 406) and minimally invasive treatment (MIT) group (n = 443). The survival rates, recurrence rates, and post-treatment complications were compared retrospectively.

RESULTSThe 3-year survival rate in the resection group was 72.1%. The 3-year survival rates in tumor < or = 3 cm and tumor 3-5 cm of resection group were 73.3% and 70.5% (P = 0.46), respectively. The 1-year, 2-year, and 3-year recurrence rates in resection group were 13.5%, 29.9%, and 39.8%, respectively. The 3-year survival rates in MIT group was 73.8%. The 3-year survival rates in tumor < or = 3 cm and tumor 3-5 cm of MIT group were 74.7% and 72.2% (P = 0.45), respectively. The 1-year, 2-year, and 3-year recurrence rates in MIT group were 12.6%, 28.7%, and 40.4%, respectively. The 3-year survival rate was significantly different between these two group in tumor < or = 3 cm (P < 0.05). The post-treatment complication rates of these two group were 30.8% and 6.1% (P < 0.01), respectively.

CONCLUSIONSMIT is as effective as the traditional resection in SHCC. However, MIT is superior to the traditional resection in terms of minimal invasion and less post treatment complication rate. The recurrence rate of HCC was still high after treatment. Comprehensive therapies, including MIT, may increase the survival rate and life quality in SHCC patients.