What is the definition of small hepatocellular carcinoma

Small hepatocellular carcinoma generally refers to the early stage of hepatocellular carcinoma with a tumor diameter of less than 3 cm, but there is no unified diagnostic standard internationally. Okuda's standard in 1997 is that the maximum diameter of a single cancer nodule does not exceed 4.5 cm, and the number of multiple cancer nodules is less than 4 and the diameter does not exceed 3.5 cm.

In 1983, the Japanese Liver Cancer Research Group published the "Clinical and Pathological Research Standards for Primary Liver Cancer", which defined small liver cancer as a lesion smaller than 2 cm. The Chinese Liver Cancer Pathology Collaborative Group's standard in 1983 was: the maximum diameter of a single cancer nodule should not exceed 3 cm, the number of multiple cancer nodules should not exceed two, and the sum of their maximum diameters should be less than 3 cm.

Small liver cancer reflects the early stage of the tumor to a large extent, and the growth rate of liver cells is measured by ultrasound imaging. They proposed that if the growth curve of the tumor is moved to the zero point of the tumor size, it will take 9.8 months to 10.9 years for liver cancer to grow to 10 cm in size. It is inferred that a rapidly growing 1 cm liver cancer will take at least 44.6 months to grow to 3 cm, so liver cancers below 3 cm can be found by checking every 4 to 5 months. It can be seen that small liver cancer can be found early based on the biological characteristics of the tumor and regular imaging examinations. At the same time, when patients with cirrhosis have small liver cancer (<5 cm), according to Barbara's observation, the natural course of small liver cancer without treatment, the Kaplan-Meieri survival rate is 81% in one year, 55.7% in two years, and 21% in three years. Therefore, the natural survival time of small liver cancer is longer, providing doctors with a period for treatment.