[Concept and problems of the early stage of primary liver cancer]

Study of 25 patients with less hepatic tumor than 5 cm in diameter was made on pathohistology and prognosis. In relation of portal vein embolus to tumor size, portal vein embolus (vp1) developed histologically in four (30.8%) to thirteen patients with less than 3 cm tumor in diameter, but in eleven (91.7%) of twelve with more than 3 cm tumor diameter. The accumulative survival rate of patients with less than 3 cm tumor in diameter was 92.3% at one year, 78.0% at three and five years. It is more favorable than survival rate of patients with more than 3 cm tumor in diameter. Therefore, at present it seems to be adequate that tumor size is less than 3 cm, portal vein embolus (vp1) is negative and solitary as concept of early stage of primary liver cancer. Most patients with liver cirrhosis do not meet well functional reserve of the liver and minimized regional resection is often obliged. However we can have favorable results, if the portal vein embolus (vp) and intrahepatic metastasis (im) surrounding the tumor are identified by echogram during operation and resected with tumor. Its accumulative survival rate was 87.9% at one year, 72.5% at three and five years.