Objective：To investigate the treatment of recurrent small hepatocellular carcinoma (HCC).
Methods：The clinical data of 47 patients with recurrent small HCC after initial operation and treated in our haspital from January 2003 to December 2008 were retrospectively analyzed. The patients were divided into reoperation group and radiofrequency ablation group, and the 3-year survival and recurrences between the two groups were compared.
Results：Twenty-four patients in the reoperation group underwent local resection and chemoembolization with an implanted chemotherapy pump via hepatic artery. Twenty-three patients in the radiofrequency ablation group underwent local radiofrequency ablation and chemoembolization with a catheter introduced into the hepatic artery via femoral artery. The 3-year tumor-free survival rate of the reoperation group was higher than that of the radiofrequency ablation group ［66.7% (16/24) vs. 47.8% (11/23), P＜0.05］, and the local recurrence in reoperation group was lower than that of the radiofrequency ablation group ［25.0% (6/24) vs. 34.8% (8/23), P＜0.05］. However, the 3-year survival and recurrence rate showed no statistical difference between the treatment of reoperation and radiofrequency ablation among the patients with recurrent tumor size less than 3 cm (P＞0.05), but the treatment by reoperation had a high 3-year survival rate and a low recurrence rate compared with treatment of radiofrequency ablation among the patients with the recurrent tumor size between 3 to 5 cm (both P＜0.05).
Conclusions：For small (<3 cm) recurrent HCC, surgeons should give full consideration to the wishes of the patients as well as the specific condition of the patients in selection of reoperation or rediofrequency ablation. However, reoperation is the preferential treatment for patients whose recurrent tumor sizes are between 3 to 5 cm.