Early hepatocellular carcinoma (HCC) has been defined as a well-differentiated cancer containing Glisson's triad, but it remains unknown whether this lesion is curable. We prospectively studied 70 patients (enrolled from 1,172 referrals between 1982 and 1991) who had a diagnosis of a single HCC 2 cm or less in diameter (Stage T1) and who underwent curative hepatectomy and long-term follow-up (range, 0. 2 to 14. 3 years). Patients were eligible for surgery if they had a tumor that met the diagnostic criteria for HCC and were in Child-Pugh class A (n = 59) or B (n = 11) status. Among the 70 patients, there was 1 operative death. Based on our typing system, the tumors were assigned as early HCC (n = 15), overt HCC (n = 52), and non-HCC tumor (n = 3). The rate of microscopic regional spread was lower in early HCCs than in overt HCCs (7% vs. 42%; P = . 01). The early HCC group had a longer time to recurrence than did the overt HCC group (3 VSports手机版. 9 vs. 1. 7 years; P < . 001) and had no local recurrence. After a median follow-up of 6. 3 years, both overall survival and recurrence-free survival in the early HCC group were significantly better than those in the overt HCC group (P = . 01; P = . 001). In these two groups, the 5-year rates of overall survival were 93% and 54% (P = . 01), and those of recurrence-free survival were 47% and 16% (P = . 05), respectively; a significant survival benefit persisted over a decade (57% vs. 21%; P = . 05). The early HCC group was at a lower risk of recurrence (relative risk, 0. 31; 95% CI, 0. 15 to 0. 65; P = . 002) and death (relative risk, 0. 26; 95% CI, 0. 09 to 0. 73; P = . 01) than was the overt HCC group. Early HCC is a distinct clinical entity with a high rate of surgical cure, thereby justifying its definition. It can be a lesion that corresponds to "Stage 0" cancer in other organs. .