[Surgical therapy of liver and bile duct tumors]

The most effective surgical therapy of primary liver cancer (HCC) or proximal bile duct cancer (BDC) is radical resection, but only 20% of the patients will undergo this procedure, because the remaining patients in the advanced tumour-stage or cirrhosis can be given palliative treatment only (chemo-embolisation for HCC, endoscopic or percutaneous draining with or without iridium-after-loading for BDC) or a liver transplantation (LTX), though under immunosuppression an early recurrence of the tumour is frequent. One-year survival after resection because of HCC without cirrhosis is represented by a figure of 80%, whereas with cirrhosis it is 18%; 3 years after LTX, 26% of patients are alive. Three-year survival in untreated BDC is 24%, after resection of the hilum 42%, after LTX 40%.