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[Rational surgical approaches to the treatment of small primary liver cancer, and the prevention of postoperative recurrence].

From Sep. 1985 to Dec. 1990, surgical treatment was performed in 27 patients with small primary liver cancer (SPLC, < or = 5cm in diameter). Of them, segmentectomy was done in 23 cases and radical local resection in 4 cases with recurrence rate of 66.77% (18/27). Non recurrent lesions were located in the incisal margin. In this group re-resection rate was 55.6% (10/18). (1) Early detection and treatment of recurrent lesions remain a mainstay of prolonging survival. (2) Serum Alpha-fetoprotein (AFP), ultrasonography and X-ray chest film were basic follow-up methods for subclinical recurrence of SPLC. For re-operation cases, digital subtract angiography (DSA) are useful in identifying subclinical lesions. (3) For recurrent liver cancer local hepatectomy was a reasonable approach. (4) For SPLC, radical segmentectomy or radical local resection with a safe margin of 1 to 2cm was the authors' choice.