Prognosis of hepatocellular carcinoma smaller than 5 cm in relation to treatment: study of 100 patients.

A total of 100 patients with small hepatocellular carcinoma, less than or equal to 5 cm in diameter, seen during the last 8 years were analyzed retrospectively for survival time in relation to treatment and Child's grading. When analyzed with respect to major treatment modalities without considering stage, the median survival was 35.0 months for 34 patients treated by surgery, 28.8 months for 20 patients treated by transcatheter arterial embolization, 10.6 months for 25 patients treated by intraarterial chemotherapy and 9.7 months for 17 patients who received no specific treatment. When patients were divided into three stages without considering treatment, the median survival was 37.1 months for 37 Child's A patients, 16.2 months for 36 Child's B patients and 1.6 months for 27 Child's C patients. These results suggest that the prognosis depended on treatment given and the Child's grade. The effects of major therapeutic modalities on survival were analyzed with regard to Child's grading. Among Child's A patients, the actuarial survival rate for surgery was better than that for transcatheter arterial embolization and for arterial chemotherapy. Among Child's B patients, the survival rate for transcatheter arterial embolization was better than for other treatments. Among Child's C patients, there was no significant difference in survival rate regardless of treatment and its modality. These results suggest that surgery may be indicated as a first choice in Child's A patients, transcatheter arterial embolization in Child's B patients, and there is no effective treatment in Child's C patients. The major cause of death was hepatic failure irrespective of treatment.