The most common liver cancers are hepatocellular carcinoma (HCC), cholangiocellular carcinoma (CCC), and metastatic colorectal cancer. In HCC patients, the extent of the surgical resection is limited due to the functional status of the underlying cirrhotic liver. Limited resection, transarterial catheter embolization, ethanol injection, and microwave coagulation have been applied to treat the patients with lvier hypofunction ; however, the intrahepatic recurrence rate was relatively high in those patients. Therefore, liver transplantation is the only radical treatment to remove HCC and cirrhotic livers with viral infections. Recent advances in anti-viral agents promise to improve the outcome after liver transplantation in patients with HCC. On the other hand, CCC is outside the indications for liver transplantation because of the broad extension of lymph node and nerve plexus. In liver metastasis from colorectal cancer, overall survival is not greatly improved, although arterial chemotherapy reduces mortality related to liver metastasis. Surgical resection including repeated hepatectomy indicates better survival in patients with liver metastases. In the future, both CCC and metastatic liver cancer could be candidates for gene therapy. For the 21 century, a new therapeutic strategy incorporating clinical evidence, molecular biology, and organ replacement needs to be established for the treatment of liver cancer.

肝臓癌には，肝細胞癌や胆管細胞癌などの原発性肝癌と大腸を中心とする転移性肝癌がある．肝細胞癌，胆管細胞癌，転移性肝癌に分けて外科治療の現況と展望について述べた．今後は肉眼的な腫瘍の切除による減量，切除を目的とした外科治療から，臨床で得られたエビデンスをもとに発癌の原因や母地，遺伝子レベルなど多方面から腫瘍を解析し，その特徴に応じた臓器移植や遺伝子操作などを取り入れた集学的治療の確立が急務である．

Liver cancer, Liver resection, Liver transplantation, 肝臓 ; 肝細胞癌 ; 胆管細胞癌 ; 腫瘍転移 ; TAE療法 ; マイクロ波 ; 感受性試験 ; 薬剤感受性 ; 造影剤 ; 薬物療法 ; 併用療法 ; 抗腫瘍作用 ; ジクロロジアンミン白金 ; 抗腫瘍代謝きっ抗物 ; B質型肝炎ウィルス ; 免疫グロブリン ; 抗ウィルス薬 ; 遺伝子療法 ; 肝切除脂肪族カルボン酸 ; 脂肪族よう素化合物 ; ウレア化合物 ; ヒドロキシ化合物 ; 窒素複素環化合物 ; 有機ふっ素化合物
M.S.LIVER.MCT.HCC