Single HCC between 2 and 5 cm: the grey zone: surgeon's perspective

In the treatment of hepatocellular carcinoma (HCC), control of the tumor itself, vascular invasion, and minute intrahepatic metastases is the main important factor to be considered. Based on previously reported indirect evidence, liver resection would seem to have advantages over percutaneous ablation for single HCCs measuring between 2 and 5 cm in diameter. In conclusion, liver function permitting, resection would be the therapeutic option of first choice. In cases with poor liver functional reserve, liver transplantation would be a good therapeutic option, depending on the age of the patient.