This paper summarizes the "study On small hepatocellular carcinoma and its extensionII in Liver CancerInstitute

Zhongshan Hospital Of Shanghai MedicaI University during the past 25 years. The results 1ndl-cated that it was an impOrtant approach to obtain long-term HCC survivOrs

of the 239 patients with 5-yearsurvival

small HCC resection accounted for 51. 4 %. It was an effective apprOach to lmprove the prognosisof HCC in the entire series

the 5-year survlval of lnpatients treated ln authorsI institution was 4. 8% in1958

1

970

l2. 2 % in 197l

1983

and 46. 7 % in l984

1995; which were correlated to the increaseProportion of small HCC resection in the series; it was more effective as compared to large HCC resection

the 5 year survival was 6l. 3 % （n= 645 ） versus 33. 6 % （n= 950）. ExtensiOns of small HCC study includ-ed early detection and treatment of small recurrent HCC

Of the l47 patients wlth re-resection

the 5-yearsurvival was 48. 9% caIculated frOm the time Of first resectiOn. Another extenslon was conversiOn Of largeHCC intO small HCC

using multimodality combination treatment

72 out of the 663 patients wlth surgical-ly verified unresectable HCCs have been converted to resectable

5-year survival being 62’ l %

wh1ch wascomparable tO that of small HCC resection. Studies on related basic aspect of small HCC such as cell originof recurrence

and mOlecular aspect of small HCC

indicated that biOlOgical characterlstics

particularly thetumor invasiveness

remalned the key link for further prolong survival after small HCC resection. Recent-ly

a’patient-like’ human HCC metastatic medel in nude mice has been established. Experimental inter-ventions have also been tried. Clinical trials fOr preventiOn of recurrence after small HCC resection haveshown preliminary encouraging results. However

the IIcOst-effectivenessn Of screening

the invasiveness ofHCC

the multicentric origin

the coexisted Child C cirrhosis

etc.

remained great chal1enge.