Management of small hepatocellular carcinoma: selection of surgical resection or local ablative therapies        YIN Xiao-yu, LV Ming-de.Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080 ,China
Corresponding  author：YIN Xiao-yu, E-mail: yinxy@medmail.com.cn
Abstract    Surgical resection has long been considered as treatment of choice for small hepatocellular carcinoma (HCC), with a 5-year overall survival rate of 60%~72%.  However, with rapid development of ultrasound-guided local ablative therapies, they have been extensively applied in management of small HCC due to advantages of minimally-invasiveness, efficacy and safety, and achieved a similar long-term outcome to surgical resection.  So far there have been some retrospective studies and randomized control trials (RCTs) comparing surgical resection and local ablative therapies for management of small HCC.  Taken together, there are no significant differences in overall survival rates between two modalities.  But, surgical resection is associated with lower local tumor recurrence as compared with local ablative therapies.  Whether local ablative therapies can replace surgical resection to become treatment of choice for small HCC is still highly controversial.  The currently available data are not adequate to draw a solid conclusion.  Our opinion is that selection of treatment modality for small HCC should depend on the patient’s conditions, including liver function status, tumor size and location, and adjacent structures.