Current status of surgical therapy for primary liver cancer in Japan

The current status of diagnosis and treatment of primary liver cancer in Japan and its problems are described. Most primary liver cancers in the Japanese prove to be hepatocellular carcinoma complicated with liver cirrhosis. Based on these characteristics, at least three factors are important for the diagnosis of early stage of liver cancer 1) follow-up of high risk individuals 2), alpha-fetoprotein screening, and 3), application of ultra sonography (US) or computerized tomography (CT) in suspected cases. With relation to surgery, the following two points should be considered; 1), complications of esophageal varices and 2), development of postoperative hepatic failure or multiple organ failure (MFO) after extensive resection.